Hello again,

To be clear, I am not a doctor but I hope it’s ok if I give you some more tips. I don’t know how many doctors you have seen but if it’s only one, please see another. It’s really important that you become a pushy advocate for her. Autism Spectrum Disorder has many signs and symptoms. There are an endless amount of websites that can provide you with information and advice. One thing that is stressed to us as student support workers is that all behaviour is communication and we need to pay attention to what they are telling us. Behaviour is neither good or bad. Behaviour has a setting event (ie the train ride), an antecedent (trigger), the behaviour itself and the consequence. All behaviour is to avoid or gain something (for example it might be to get off the train or get attention either positive or negative). Try to see what the antecedent is and see if it’s something that you can help her manage or deal with before the behaviour starts. If it’s because the train is too busy, is there a slower time you can get on? Or a less busy car? Can she wear headphones to reduce the noise? Is there a way you can explain to her how to ride a train and keep her hands to herself? Look up social stories, video modelling, task analysis, chaining for tips. Also, is there a motivator for her such as a treat, a game or an activity that she really enjoys that could be used after if she behaves appropriately during a train ride? The younger she receives the support she needs, the easier it will be as she gets older.

I hope I didn’t overstep my bounds. I feel for your situation and hope you can get some help. Good luck.