Choosing a Sitter When your Child has Autism Spectrum DisorderHigher-stakes Sitters I used to say that only a Ph.D.-level child psychologist could babysit my son. It wasn’t really a joke, because that’s what I was at the time, and two close friends and colleagues were his earliest babysitters. They, and my mom. This was before James was diagnosed with Autism Spectrum Disorder, when he was an extremely fussy, unpredictable, hard-to-read infant. My main worry was that a babysitter wouldn’t be able to withstand James’ crying, which was long and loud. That he was vulnerable to abuse. Only someone who loved him or me could do the job. Thankfully, James became less fussy and much more fun to be around. But I remained wary of sitters. With James, the stakes were higher. What was I supposed to do? Hire a “special needs babysitter,” if such a person existed? And how much would that cost? I wasn’t going to call up the teenager down the street, but I thought I could make do with someone experienced, someone older. Also, was a diagnostic label—to which I was still adjusting—really necessary in order for the 75-year-old lady across the street to put James to bed while my husband and I went out to dinner? Autism Spectrum Disorder can be a hidden disability. It’s not always apparent at first meeting, so a parent has a choice about whether or not to identify their child. How would you like being introduced to new people with your worst qualities highlighted? ‘This is Lynn. She’s extremely nearsighted and more anxious than most people. She’s okay at throwing, but she can’t catch. Oh, and she gets really cranky when she’s tired or hungry.’ James had trouble reading people and being read. Because of his autism, he didn’t communicate typically about really important topics: sleepiness, hunger, thirst, discomfort, anxiety, illness—basic requests. So this became my tactic. Instead of using the A-word, I’d deliver a clear, focused message about what made James different. Like ad copy: “You know how most kids yawn when they’re tired? Well, this one runs up and down the house like a greyhound.” In this way, I graduated from Ph.D.-level babysitters to preschool assistant teachers, Teach for America people, and budding speech/language therapists. That’s where I remain today, when my mom’s unavailable. Most importantly, I troll for sitters at James’ school, looking for people with whom he already feels comfortable, and who know him without my having to explain much.Seek the familiar, avoid the know-it-alls Terry Johnson, Ph.D., a child psychologist specializing in Autism Spectrum Disorders, suggests looking for “someone who is already a little bit familiar with your child from school or therapy. Your child will be familiar with them, too.” Any sitter must be able to accept that some children are different, and that parents know their own children better than anyone else can. Dodie Powers, J.D., LCSW, care coordinator at Butterfly Effects, a network of applied behavior analysis (ABA) therapists, psychologists, and other related health services providers, cautions about a certain type of sitter that I’ll call the Know-It-All. The Know-It-All tries to reassure me that she doesn’t need my instructions, that she’s perfectly capable of handling James, and that he’s not really so different from other children, after all. All these statements are true, most of the time. But no matter how well James does with babysitters, and he does very well nowadays, the stakes are higher because of his autism. Even higher than they are for his younger sister. And that’s because, for children with autism and other special needs, major routines are all-important. I’m not talking about which book you read before bed, or how many times you say goodnight. I’m talking about how much and when they eat and drink, when they use the bathroom, when and if they take any medication, and when they fall asleep. A slight variation in any of these can result in such ills as: bedwetting, night waking, early morning waking, stomach upset, and fussiness for days afterward. None of which are a good follow-up to my wild night on the town. So that’s it. You don’t need an expert, but you do need someone who will keep major routines consistent. Someone who understands how important that is. And that person is most likely to be someone you already know, or someone who has experience with special needs kids. No Ph.D. required. Once you’ve met the potty/food/bedtime requirement, anything else is extra. At our house, the extras are the best part. There was Jessie, the Teach for America teacher who had a rollicking “tuck-in machine” shtick. Then Marcia, the preschool teacher who served dinner picnic-style on the playroom floor. And now we have Ben, camp counselor extraordinaire, who organizes tournaments that get the kids interested in board games that normally gather dust on the shelf. When we get home from our wild night out, the kids are in bed, bellies full and bladders empty. The next morning, they wake up happy, ready to share stories of the night’s adventures. Just like we are. Lynn Adams lives in New Orleans with her husband and two children. Find more of her work at lynnadamsphd.com. More tips for choosing the right sitterSchedule a play-date with the sitter as an introduction or try-out before you go out.If your child has a speech delay or an unusual way of communicating, provide translations in advance.Tell sitters in advance about unusual fears or worries.Always have a written emergency plan, including back-up caregivers.Emphasize that you’d rather have the sitter call you for advice than wing it, if something really unusual happens.-from Lynn Adams with input from Terry Johnson, Ph.D. and Dodie Powers, J.D., LCSW Click here to read "Challenges Facing Siblings of Special Needs Kids" by Pat Blackwell, Ph.D.