Transitioning Back Home from a Residential Treatment Facility

By William Killion, PhD, BCBA

Enlisting the help of a residential treatment facility can often be the most difficult decision parents of
children with autism face, particularly if that treatment center is far from home. Parents who have likely had little to
no separation from their child throughout the daily caregiving process feel innate anxiety leaving their children behind, and
there are obvious challenges and stressors for children with autism leaving the comforts of home and family for immersive
therapy at a residential treatment facility.

But what may be surprising is the anxiety that children with autism sometimes
face when returning home after adapting to life at a residential treatment facility. By understanding life at a residential treatment
facility and planning ahead to have similar structure in place at home, parents can help make that transition easier for their children.

Children with autism crave structure (Applied Behavior Analysis Education, 2019). They need to be occupied and busy
in order to avoid distressing behaviors that can cause stress for themselves and their caregivers. This is why, when children are
admitted into a residential treatment facility, they have a very clear schedule and routine that keeps them engaged with positive activities from morning until evening.
Days are filled with school work, therapy and plenty of physical exercise. Sports are a great way to keep students active and engaged. Therapists and other staff also
work with the children to help improve any physical symptoms and behavior issues, and to provide support for children to develop coping mechanisms (American
Psychological Association, 2019).

Children quickly adapt to this busy life at a residential treatment facility. Often
times they can become anxious about returning to a home life, particularly one that is unstructured or historically associated
with stressful family situations.

Upon completion of the residential treatment – which can be anywhere from about three months to a year – a discharge plan is
created for each child, with the goal of maintaining stability so they are able to leave without the need for future re-admittance.

In some cases, children may not need to be fully immersed in a residential program or they may need to transition from a residential program to a group home. While group
homes are also residential-based programs, they are less restrictive and give children with special needs the opportunity for more flexibility in the form of day programs and
activities outside of the residential home.

The goal upon discharge is to provide the least restrictive placement possible for the individual’s unique needs. Some
individuals in a group home may require permanent residence, while most leave after between three months and a year. Once residents are released and ready to head
back home, caregivers should follow the discharge plans in place to help the individuals maintain stability at home.

Specifically, to ease the transition, caregivers should:

1. Talk to the therapists about what works.
Therapists have been working with the child to develop evidence-based, proven strategies for success at home and
school, including coping skills to stay calm when agitated.

2. Maintain a routine and schedule. While your schedule does not need to mirror that of the residential treatment facility
exactly, maintaining a schedule helps children with autism reduce stress by being able to anticipate and prepare for
the day’s activities. Keeping them active in an engaging way also helps to reduce anxiety and opportunities for
bad behaviors to arise. The goal of residential treatment is to provide long-term well-being and success outside of the program. For families
struggling with behaviors associated with autism, residential treatment is often a necessary strategy for care. By understanding
the goals and methods of treatment, parents can increase their child’s success beyond a residential treatment facility.

Article featured in Autism Spectrum News – Fall 2019