By Professor Tony Attwood and Dr. Michelle Garnett
Christmas Day is only one day of the year, but the anticipation and preparations may occur over several months. Shops, advertisements, and conversations will increasingly remind autistic individuals and their family members of past experiences of Christmas festivities and that Christmas, from the perspective of autism, can be overwhelming and exhausting.
As clinicians, we have often discussed Christmas preparations with families and are aware of the various dimensions of autism that need to be considered when organising and attending family celebrations. These include social expectations, sensory experiences, and coping with change, uncertainty and stress.
A family gathering at Christmas has a sequence of activities and social expectations that may need to be clearly explained to an autistic family member. This can include the presence of extended family members who may seem like strangers to an autistic person, the expectation to engage in greetings and expressions of affection and coping with so many people in a confined space.
There is also the family ‘ritual’ of giving and opening presents. This requires the ability to wait while someone opens a present and show gratitude when receiving and opening a present which may be a disappointment. Carol Gray has developed Social Stories (Gray 2015) to explain social conventions, and she has written Social Stories for young autistic children on themes relevant to Christmas, such as:
We’re going to a big family party.
Why are gifts important?
Why do people wrap gifts?
How to open a gift.
Some gifts are disappointing.
One of the characteristics of autism is not liking surprises, and parents of autistic children may adjust the present opening activity to avoid surprises, as described in the following quote from the National Autistic Society Christmas tips: “Last year my son chose his own main present and checked it was right when it arrived, then it was wrapped. He felt better knowing his present was right, and it wouldn’t be a surprise, so started the day calm”.
There can also be difficulties resonating with and responding to the emotional atmosphere of being merry when you don’t feel merry. There is the option of ‘masking’ autism and acting happy, but this will be exhausting, increase stress levels and decrease the ability to cope for the duration of the celebrations. There is also anxiety regarding the ability to successfully socially engage with extended family members and the vulnerability of being socially rejected and teased.
Strategies for coping with the social expectations of Christmas celebrations can include:
- Create and explain the schedule of activities and who will be there.
- Arrive early when few family members are present and the house is relatively calm and leave early.
- A parent to monitor the autistic person’s signs of stress and have regular opportunities throughout the celebrations for energy and emotional recovery in a quiet sanctuary in the house.
- Educate all family members on the perspective of the autistic person and how they can help in areas such as expressions of affection and needing personal space as well as sensory sensitivity and what would be an appreciated present.
Flashing and sparkling Christmas lights and decorations may be enchanting for non-autistic family members, but they can be perceived as aversive or distracting for an autistic person. There may need to be a compromise regarding the intensity of sensory experiences.
There can also be the issue of singing Christmas Carols with family members singing off-key, which can be especially aversive for some autistic individuals who have perfect pitch. There are concerns regarding general noise levels and sudden ‘sharp’ noises, such as someone with a raucous laugh.
The following quote describes the effects of auditory sensitivity at a Christmas gathering. I was frightened of balloons bursting, the suddenness of party poppers and the crack made by Christmas crackers. I was very cautious of anything that might make an unexpected loud noise.
It is also important to consider in advance what food will be served and whether the food is within the range of accepted sensory experiences and noting that social exhaustion and anxiety increase sensory sensitivity.
Coping with change and surprises
Sometime before Christmas, there will be changes to the home that include the arrival or construction and decoration of the Christmas tree, putting up Christmas decorations and moving furniture. These changes may be distressing for an autistic person who prefers continuity and consistency in their environment. They may need advanced notice and reassurance to cope with the changes.
A parent’s perspective
Family gatherings can be a source of stress for autistic people and also their parents, who have to be vigilant in monitoring the autistic person’s social and sensory experiences as well as maintaining their obligations as guests or hosts. Often, parents will prioritise the needs of their autistic child and compromise their enjoyment and commitments to their extended family. They will also be aware that family members may perceive them as personally responsible for their autistic child’s behaviour and their parenting strategies openly criticised. They may feel constantly ‘on duty’ and unable to relax and enjoy the family reunion as much as other family members (Moorthy, Carlstedt and Fischl, 2023). They would greatly benefit from family members sharing the monitoring and supervision.
Christmas for autistic adults
A Christmas party at work may have different social codes and expectations compared to a family Christmas celebration. An autistic adult will benefit from an explanation of the schedule of events at a Christmas work party and a work colleague who can provide guidance and support.
An advantage of being an adult is the potential to avoid a family reunion at Christmas, as illustrated by the following quotation: I’m looking forward to celebrating Christmas here in [place] this year. With the family I choose. Not the family I’m born into”.
Christmas can be a stressful time for autistic children and adults, but knowing the schedule of celebrations in advance, the social expectations and likely sensory experiences will reduce stress and encourage successful engagement and the creation of happy memories for all family members.
Gray C. (2015) The New Social Story Book: Revised and Expanded Arlington, Future Horizons
Moorthy, Carlstedt and Fischl (2023) Australian Occupational Therapy Journal, 70 500-513.