Preparing well for changes and transitions

What the 2021 guideline named

• Structuring the environment and sequences of actions, for example through visual means, predictability and consistency of people. ^{[1, Rec. 3]}
• A daily structure and continuity of staff in supported housing as well as, where appropriate, visualised programmes with individual choices. ^{[1, Rec. 117]}
• At the workplace (in the guideline’s section for people without intellectual disability who do not obtain training on the open labour market): consistent routines and working hours. ^{[1, Rec. 114]}
• In school and nursery: teachers and early-years educators should know the importance of transitions, for example when changing school or changing caregivers. ^{[1, Rec. 109]}

The guideline also named changes in routine as possible triggers of crises that can be hard to recognise for untrained people. ^{[1, Ch. C.8]}

Big transitions

For starting school, studies in the guideline described that advance visits, conversations with the teacher and individual solutions can ease the transition. ^{[1, Ch. C.10.2.2]} More: Preparing for school entry, Transition from school to work and Autism in nursery.

Small changes in everyday life

Practical suggestions (a transfer by the editorial team from the principles named, not individually backed):

• Announce early what changes (appointment, place, people) and what stays the same.
• Make it visible: a plan, a calendar or pictures can show the sequence if the person finds this helpful.
• Keep anchor points: fixed rituals or objects can preserve part of the predictability.
• Allow time and make recovery possible afterwards.
• Review together: What helped, what did not?

What else you should know

• Not every change is a problem. Some people on the spectrum cope well with changes; the guideline does not state the extent. The person’s wishes should be asked about regularly. ^{[1, Rec. 4]}
• Not covered: studies on particular techniques (for example social stories). The editorial team has read no source on them.
• On the topic of daily structure: Routines, structure and predictability in everyday life.

Sources and literature

1. DGKJP, DGPPN et al. Autismus-Spektrum-Störungen im Kindes-, Jugend- und Erwachsenenalter. Teil 2: Therapie. S3-Leitlinie, AWMF-Reg.-Nr. 028-047, Stand Text 02.05.2021 (Empf. 3, 4, 109, 114, 117; Kap. C.8, C.10.2). – Guideline (in German); expired on 23 March 2026 (see no. 2)
2. DGKJP. Aktuelle Leitlinien (Eintrag 028-047: „Gültig bis 23.03.2026“). https://www.dgkjp.de/wissen/aktuelle-leitlinien/ – Professional society (website in German)