Recovery, Renewal, Resilience

The COVID-19 pandemic has been a challenging time for everyone, especially in trying to adjust to new routines and living and working environments. This may be particularly true for children with autism and their parents, as children with autism have trouble adjusting to, coping with, and understanding change. To help with this, help parents to explain the current situation in clear and simple ways and can help children with autism to adjust to the 'new normal'. One way of doing this is to provide parents with access to materials that frame COVID-19 as a germ that can make people sick, so it is important to stay away from others and not touch things.

Advise parents to reiterate important rules to children with autism is also important to help them cope, such as:

• Washing hands well and often (for at least 20 seconds)
• Not touching their nose, mouth, and eyes
• Keeping at least 6 feet away from other people
• Wearing a cloth face covering or face mask in public places

Face coverings may be difficult for autistic children, some parents have had successes in attaching the ear loops on masks to their child's favourite hat with buttons to reduce sensitivity. Make authorities (such as transport providers, Police) aware of "Facemask Exemption Cards" that have been produced by organisations for parents to print out for those who cannot wear a mask. Local government can support parents of children with autism by working with respected specialist organisations to advise parents e.g. one encouraging mask wearing

• Demonstrate using the face mask on a preferred object or person, such as a stuffed animal, a doll, or a family member
• Allow the person to choose among different types of fabric face masks to find one that is most comfortable
• Start by practicing wearing the face mask for short durations of time, allowing for breaks when needed
• Plan initial outings in low-demand environments that are quiet and calm, so that the individual can experience success wearing the face mask
• Use a printed photo or digital photo of the individual wearing a face mask as a visual cue to wear the mask before outings

In addition to these changes, losing the daily routine that going school provides adds an additional layer of complexity for children with autism, and outs them at risk of not receiving the social care and support they require. While, some children may have found home schooling difficult, the time spent away from school may have resulted in the development of a new routine at home where they feel safe. As such, returning to school may cause anxiety and distress. Local government should inform teachers that some ways of reducing these anxieties include:

• Providing a visit to the school before it reopens if possible, to help children familiarise themselves with their environment and staff again
• Encouraging homes to introduce changes that are made in school at home e.g. explain social distancing measures, ask for photos of new classroom layouts to show children
• Asking parents for information about your child during COVID-19 so they have an understanding of their needs and how these may have changed due to COVID-19 restrictions

COVID-19 has also been a challenging time for parents of children with autism. One parent in the UK stated that support for them and their child had been reduced to occasional phone calls and they felt like they had been "left to struggle alone". They also stated that they were repeating the same or similar activities with their child from before lockdown and that it felt like their child's development had stalled. They stated that increased resources from their child's support worker such as a timetable of activities and development would have helped and made the experience of self-isolation and lockdown "less distressing".

Providing specialised phone lines and centralised hubs with resources for parents is vital, to ensure their well-being and that of their children, via reliable information and support. Local government can help employers to realise that parents also need to find ways to balance work and childcare responsibilities this can include:

• Arrange to work from home to ensure supervision, or childcare sharing arrangements with friends and family
• Prepare information about the child's support needs and successful learning and behaviour strategies for anyone caring for the child
• Develop an emergency contact list, and discuss it with friends and family. Include names and numbers of your personal autism support network, as well as medical providers
• Contact local organizations who may be able to offer support.
• Look through the child's medical records or evaluations related to autism as these may have recommendations on areas to focus on and can help you with making learning plans while schools are closed
• Reach out to others to maintain social support for the whole family e.g. social media, social media groups for autistic people and their families, and other virtual support groups that provide online resources for finding empathy and ideas while self-isolating or in lockdown

To read this case study in its original format (including references) follow the source link below to TMB Issue 16 (p.19-20).