The therapy is happening in your house. Here is what a grandparent can actually do.

Two questions come to us from grandparents more than any others. One is some version of how do I play with them in a way that is fun and still helps? The other is some version of what do I do when it goes wrong and I am the only adult in the room?

Both questions come from the same place, and it is not confusion about autism. It is a grandparent who is present — often for hours, several days a week — and who has been handed no role. This page is for that grandparent. If you are still at the beginning, our plain-language starting guide is the better first stop, and the page on how a grandparent can help covers the first conversations with your own adult child.

What you are there for

You are not a second therapist, and the team is not expecting one. They run the sessions. The parents make the decisions. What you have is the thing none of them can give your grandchild: you are the adult in the house who is not working on anything. That is not a consolation prize. A child who has appointments most afternoons needs one person who is simply glad to see them.

Hold on to that when you feel the pull to do more. The most useful thing you can do for the therapy is to make the house steady around it.

While the team is working

Ask the team once, at a calm moment, what they would like from you while they work. Some want a familiar adult nearby. Some want the room to themselves so your grandchild is not checking your face for the answer. Both are normal. Ask, then do the thing they said, and do not change it mid-session.

If your grandchild comes to you for rescue, be warm and brief and hand the moment back: "I'm right here. Go finish with Ms. Dana." Then stay where you are. Letting the therapist work through a hard minute is not coldness; it is the whole point of the hour.

Do not correct the team in front of the child, and do not add instructions of your own — two sets of directions is harder for the child than either set alone. If something worries you, write it down and take it to the parents afterwards. They decide what goes to the team.

The hours in between

Keep the routines the parents have set. If dinner is at six and screens go away at seven, hold that when you are the adult in the room. Predictability is something you can give without any training at all.

Play on their terms. Ask the parents what your grandchild is into this month. It may be the same three songs, the same trains, the same twenty minutes of the same film. Sit down inside the thing they love and let them lead it. Ten minutes of that most days does more for the relationship than an hour of something you chose.

Use the same words the others use. If the parents or the team have a phrase for a routine — "first shoes, then park" — use their phrase. One consistent set of words across the adults in a house is easier to follow than four well-meaning versions.

Safety, plainly

This is the part no one hands a grandparent, and it is the part worth reading twice. Ask the parents for the household's own plan first — everything below is general, and their plan wins.

Doors and wandering. Many autistic children leave the house or a room without warning, and a grandparent minding the afternoon is often the one who notices the door is open. Ask the parents how they secure doors and gates, whether there is a chime or alarm, and what you should do in the first two minutes if your grandchild is not where they were. Know which direction they head for — water, a road, a neighbor's dog — because that is the first place to look.

Water. Ask directly whether your grandchild can swim, and treat the answer as a safety fact, not a hobby question. Pools, ponds, bathtubs and neighbors' hot tubs are the ones to think about before they come up. If there is water on the property or next door, ask the parents what the rule is and repeat it out loud to yourself.

Seizures. Some autistic children have a seizure disorder and many do not. If your grandchild does, ask the parents for their written plan and where the medication is kept. The general first aid is: stay with them, note the time it started, move hard objects away, put nothing in their mouth, do not hold them down, and turn them gently onto their side as soon as you safely can. Call emergency services if it is their first seizure, if it lasts more than five minutes, if one runs into another, or if they do not come back to themselves.

Eating and choking. Ask whether there are foods to avoid, whether anything is cut a particular way, and whether they mouth objects that are not food. If they do, that is worth knowing before you are alone with them and a bowl of buttons on the side table.

In an emergency, act first. If you believe they are in danger right now, you call for help and sort out the protocol afterwards. Nobody will criticize a grandparent for that, and no house rule outranks it.

The hard moments

If they bite, pull hair, throw or break things, you do not have to fix it. You have three jobs: keep them safe, keep yourself safe, and be able to tell the parents what happened.

Stay nearby and calm. Lower your voice rather than raising it. Move what can break or cut. Give them room. Do not hold them down and do not try a physical hold you have seen somewhere — that is the team's territory and the wrong move can hurt you both. Wait it out. Afterwards, do not lecture them about it.

Then write down three things while they are fresh: what was happening just before, what they did, and what happened next. That is the single most useful thing you can hand the parents, and through them the team. A clear picture of the minute before a hard moment is what the professionals use to work out what it was about. "Bad day again" gives them nothing to work with; "the tablet went off at 5:10, they screamed and bit their sleeve, and it settled when the music came back on" gives them a great deal.

When you would do it differently

You will sometimes watch something and think you would have handled it another way. That is not disloyalty and it does not make you wrong. Raising a child has changed since you did it, some of what changed is real progress, and some of it is fashion — you are allowed to hold both thoughts.

What matters is where the thought lands. Take it to the parents, in private, as a question rather than a verdict: "Can you help me understand why the team does it that way?" A parent who feels backed up will tell you far more than a parent who feels judged, and you will get an answer instead of an argument.

The one exception is safety. If you think something is putting them at risk, say so plainly and say it that day. Being tactful is a courtesy; staying quiet about danger is not.

Looking after yourself

Grandparents in this position carry two loads: the practical hours, and the private worry about your own child's life as well as your grandchild's. If that weighs on you, our page on how a grandparent can help has a section on where to put the grief, and it is written for you rather than for the parents.

Where to start

If you have not read it, the free guide for grandparents is the place to begin — it is short, written for family, and assumes no background in autism at all. From there, how a grandparent can help covers the first conversations, and helping raise a grandchild with autism is for grandparents who have stepped into a bigger role.

When you want something more structured to work through, A Grandparent's Guide to Autism is our paid guide for exactly this situation.

You do not need a clinical background to be a steady, capable part of this child's life. You need to be there, be calm, follow the parents' lead, and know the safety basics. You are almost certainly doing the first one already.

Last updated 2026-09-18. This page is general information, not medical advice. Talk with your child's clinician about your specific situation.