Anxiety Strategies & Techniques – (3-3-3)

I will be writing a series about some simple techniques which could help children and adults with triggered anxiety to help manage their symptoms. (Please note that severe anxiety which is impacting significantly on a person’s life may need the intervention of medical professionals and trained therapists).

The 3-3-3 technique is a wonderful tool to use with children as it is easy for them to remember. The objective is for them to feel more mindful, focused and grounded when their anxiety is starting to feel overwhelming.

3-3-3 involves the person identifying 3 objects around them they can see, 3 things that they can hear and moving 3 body parts (ie their fingers, wrists and toes). It works to reconnect the person with their physical surroundings and become aware of their body movements instead of their symptoms of anxiety like intrusive thoughts. Some steps from Choosing Therapy:

Step 1: Focus on 3 Objects You Can See

Focusing on things that you can see helps you become visually aware of your surroundings. You can notice big objects such as a tree or a chair, or you can look for smaller, more discreet objects such as a pencil or a coin. The idea isn’t necessarily to have objects in mind that you want to see, but rather to focus on the world around you. This helps you deal with your anxiety by removing you from the mental chatter causing you stress.

Step 2: Focus on 3 Things You Can Hear

Pinpointing sounds is another great way to help you deal with anxiety. Diverting your attention to your environment can help you transition from a state of inward thinking to one in which you’re connected to your surroundings instead. However, depending on your location, you may have a hard time isolating sounds. Some things to listen for include a clock ticking, clacking of keys on a keyboard, or someone sniffling. If you are somewhere outdoors, you may notice leaves rustling in the wind, cars passing by, or dogs barking.

Step 3: Focus on 3 Things You Can Touch/Move

Lastly, find three things that you can touch or move. These can be within your reach or even parts of your body. Identifying tangible items is one of the fastest ways to ground yourself when you’re feeling anxious. Teaching yourself to focus on the physical environment helps you feel anchored and reminds you to be present.

Beyond Nuggets – Food Aversion

Many children with ASD have very particular food palates and this can cause a lot of stress at home when this palate will not go beyond their restrictive favourites – often chicken nuggets which are dry, crunchy and very predictable in smell and texture.

I often get asked how to help children explore different foods and this is not a simple process. Often aversions can be related not only to texture, but the mixing of foods (ie spaghetti bolognaise), the temperature and how it is presented. For instance, eating a strawberry may not be palatable using fingers but may be accepted using a fork or given pureed in a fruit pouch. Experimenting with different cutlery, divided food dishes (so foods are not touching) and in different forms is a good first step.

The “SOS Approach To Feeding” could be tried to help expand a child’s view of food. This can be a very slow process and needs a lot of time and patience. Please do speak to a qualified speech pathologist or eating therapist who can help guide you through the steps if you need more assistance and support.

Getting Started

Step 1 Choose the right food to encourage: Consider some foods that are similar to the ones that your child already tolerates eg if they like chicken nuggets, try chicken schnitzel and also choose a food to try that is as consistent and familiar as possible.

Step 2 Start at a distance: Present the food away from your child, then move it closer once tolerated.

Step 3 Discover the food together: What are its colours, texture, temperature etc?

Step 4 Get closer: If your child feels confident, they may be able to move the food with a utensil, pick it up with their fingers or touch it to their body (on their arm or leg, for instance) or face. It’s important that all exploration is done in a fun and playful manner as we learn most, and will challenge ourselves most, when we are having fun.

Step 5 Once it feels ok to have a food around the mouth, you might be able to touch or hold it with the lips, then a lick or three seconds on the tongue.

Step 6 Rockets and Spit Cups: Once your child feels comfortable playing and exploring with food around their mouth, it’s time to include rocketing (spitting it out with some force while you yell rocket!) into the bin and using a spit cup. The spit cup is especially helpful as it will allow your child to taste, bite or crunch a food without pressure to swallow it. From there, multiple chews may be possible and eventually a swallow.