Autism and COVID-19 Situation (First Things First)

Dear Parents,
Here is a special situation. I mean things have turned 180 degrees in matter of days. Until one week back we seem to knew what’s best or at least what’s beneficial for our children. We had a clear “Avoid list” and a clear “Pursue list” for our children. For instance, we have been told by experts not to give too much gadgets, mobiles, TV, and sweets to our children. That we need to engage them in a predictable routine consisting of play time, peer time, physical exercises and lots of time with the therapists. 
The situation is completely opposite now. Instead of going out and play, we are asked to be inside our homes. Instead of grabbing opportunities of socialization, we are asked to maintain social distancing.
Instead of using less and less of gadgets, we tend to continuously check our mobile phones for messages, and TV for news. 
We haven’t come across such a situation earlier in our lives. No matter what all the experts are telling us, we as parents parents of children with Autism (ASD) know that its a tough situation for us as families. What would compensate for a predictable routine that we had before this lock-down: a school or play school time, therapy sessions routine, outside play routine, home program routine.

Across all the noise of advice, I chose to think like an expert about the most important factors that could effect children with Autism in such a situation. Here, I am recommending the most important strategies(first things first):
1. We need an intervention plan in place
Remember that before this situation, children were enrolled in at least one therapy (Occupational Therapy, Special education, Speech Therapy, ABA therapy, Behavior therapy). In fact a majority of children with Autism must be engaged in more than one therapy at a time.
Children were already learning with their own pace with the help of these therapies. With sudden halt of such inputs, a variety of situation can emerge not favor in our children’ learning curve. So, we need to be aware of the general outline of the goals set by each therapist so that we are able to formulate a home plan. 
This intervention plan outline will help us prioritizing child’s daily activities.
2. Set a predictable routine for your child
With Autism, we know that they are quick to form rituals, that is engaging in repetitive tasks in a rigid manner. In absence of a routine based on their social, sensory, physical, cognitive, and emotional needs, these children can engage in activities which are part of core symptoms of Autism including behavior problems, being withdrawn, excessive sensory seeking, repetitive movements, etc.

The routine should consists of

  • a consistent waking time
  •  meal times
  •  activity time (inputs from therapy, try to engage in activities suggested by each therapist on the same days you used to take the child for therapies).
  •  free play
  •  floor time with parents
  •  TV time or mobile time (you anyway give them when they throw tantrums)
  •  sensory time (or a sensory diet in consultation with an occupational therapist)
  • daytime rest/nap  time (recommended only with children who don’t have problem falling asleep during nighttime)
  • consistent off to bed time

3. Set a consistent parenting approach

Children love exploring and they are curious in general. Children with Autism presents with additional tendency to engage in activities they find pleasurable to their senses. With a general intervention plan as our guide (point 1) and a routine (point 2) , all we need is a consistency in our approach towards implementing the same.

For instance , be sure about how much sweets you allow at a time, rather than depending on your child’s demands and the tantrums that follow. Similarly, be sure about which area of the house they are allowed to play, which cupboard they are allowed to open and explore, etc. Once you are sure, be consistent without giving in to your child’s tantrums.

4. Identify and correct any emerging undesirable behavior in time

We need to understand the ABC of behavior where A for antecedents, B for undesirable behaviors/problem behaviors and C for Consequences. if you notice any undesirable behavior emerging think of As (where, time, situation, whom), B( define the behavior in specific manner) and C ( is the child getting attention, object, eatable, escape from activity, sensory issues or medical issues).

If you pay attention early able to identify the function of a behavior, they can be remediated easily or at least early.

5. Watch your own mental health and behaviors

As we already dealing with the situation of lock down, caregiver burden (with increased family responsibilities, increased duration of care giving) will increase. It is utmost important that as parents we take care of our mental health. Now this can depend on individual to individual. The general principal is to have at least one relaxation activity and one pleasurable activity in your routine that you enjoy.

 Raqib Ali                                                                                              
 M.Phil. (Clinical Psychology)                                                       
Registered Child & Clinical Psychologist                                                 
RCI CRR NO. A55206
BL Kapoor Superspeciality Hospital, Delhi.
Founder and Director (CUBBE clinics)

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