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    Jay L. Hoecker, M.D.

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Question

Toddler behavior: Is sensitivity to change a concern?

Our 3-year-old hates change of any kind. If we move something or change something in the house, he has a meltdown. He threw a fit when I bought him a new toy box and when I painted his room. Should we be concerned about his behavior? Isn't resistance to change an early indication of autism?

Answer

from Jay L. Hoecker, M.D.

Most likely your son is displaying normal toddler behavior, and he will eventually outgrow this phase.

Typically, you can expect a toddler to show some resistance to change. Young children find comfort and safety in consistency. Also, most toddlers go through a "do-it-myself" phase. So your son may be reacting to changes that are being made without his involvement.

These facts may explain some of your child's behavior. However, it is true that extreme, persistent resistance to change can be an early indicator of autism spectrum disorder. Other signs and symptoms may include delayed speech, attachment to one particular toy or object, unresponsiveness to others and poor eye contact.

Keep in mind that some children are naturally more sensitive to change than are others. But you shouldn't shelter your toddler from change — it's unavoidable. Instead, help him learn to deal with change in age-appropriate ways:

  • Prepare your child for changes. Tell him in advance if you're planning to make a change that affects his routine or environment. For example, if you're planning to paint his room, tell him a few days in advance. Then remind him on the day you're going to paint. You may tell him before lunch that you're going to paint his room when he wakes up from his nap.
  • Let him participate when appropriate. Obviously, he can't paint his own room. But he could help you move some small things out of his room in preparation for painting. Also, you could let him help pick the color you paint his room by asking him, "Do you like blue or green?" You can pick the actual shade, but at least he had a role in the process.

If, despite your trying some of these methods, your son's behavior persists for longer than a month, consult your child's doctor.

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AN01821

April 3, 2008

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