Changes to Care for Children with Autism during COVID-19
Adjusting to quarantine looks different for everyone. For individuals on the autism spectrum, the substantial daily changes associated with the pandemic have proven especially challenging and confusing.
Many recently-published stories detail the challenges that individuals with autism or individuals caring for them currently face, including this one by STAT, this one by BBC and this one from AutismSpeaks. Each story highlights the disruptions to daily schedules and needed therapies, problems that are common for families at this time.
Infants and toddlers benefit from early intervention, which can improve cognition and communication, and can result in positive long term effects. Autistic children receive most of their intervention and supports in classrooms. These classroom programs address academic development as well as target social skills, a defining need of individuals on the spectrum. Diana Cooney, Director of Social Skills at Hall Mercer explains, “Often relationships are best fostered in their natural settings, for example in schools. It can also be beneficial to hold group sessions, where the kids are more comfortable and you can use didactic formats to teach and practice these skills and then incorporate them into their daily lives.” All of these services have been significantly disrupted because of the shelter-in-place orders.
Many organizations that offer these services for children with autism have had to abruptly transition to online learning and virtual group sessions. “There are some limitations on what we can deliver,” explains Cooney. “Some things we can do better in person than virtually, for example practicing something like personal space or in-person interactions. But, then there are other skills that seem to be amplified virtually compared to in person, for example reading non-verbal cues (which can be hard for children with autism) or gauging when others want to talk.”
Individuals with autism may actually feel more comfortable using technology for learning, showing the potential for promising developments in post-quarantine learning. But, it is difficult to implement this online learning with little notice and preparation. Dr. Heather Nuske, psychologist on faculty at the Penn Center for Mental Health, explains, “For some individuals with autism, digital platforms can offer an easier way to communicate and connect as they can help manage the processing load related to social interaction. Digital health platforms or use of videoconferencing are also quite promising for the delivery of psychosocial and behavioral interventions, which can be helpful for families living in remote locations, or as we are facing now, during a global pandemic.”
These opportunities work better for some than for others. Aggression and attention deficits, which are common problems for children with autism, increase the challenges of learning “person to person communication via video-stream.” In addition, Dr. Nuske points out that “using digital health platforms as the main or only format of delivery necessitates, in many circumstances, requires access to high-speed internet and a level of technical skill that families may or may not have.”
Dr. Brenna Maddox, a licensed clinical psychologist, explains that these added responsibilities contribute to the “enormous amount of new stress for these caregivers in the midst of this anxiety-provoking situation.” But, there are ways to reduce this new stress via at-home support. Dr. Maddox adds, “At-home support can include trying to stick to a schedule, perhaps one that the individual was used to before, using visual supports like daily schedules and calendars, and just listening to music and taking walks.”
A set of resources created by AutismSpeaks can help guide individuals with autism through this uncertain time. For example, for long-term at home stay, it can help to establish some sort of routine or set of expectations to manage stress and communication. Project ECHO from the University of Missouri Health System has collected a series of resources to help parents at home support their children with therapeutic activities, practicing good hygiene, and facilitating discussion about the ongoing epidemic. KidsHealth also provides a few more pointers about helping kids with autism and their parents cope during COVID-19.
To help researchers understand more about how families with children with special needs are coping during COVID-19, consider completing this survey: https://specialneedscovid.org/
Copyright © 2020, Penn Center for Mental Health.