The uncertainty we're experiencing during the spread of coronavirus disease 2019 (COVID-19) can be overwhelming for all children, but this time can be particularly challenging for children with an autism spectrum disorder (ASD).
"Many children are currently dealing with disruption to – or a lack of structure in – their daily lives," says Kimberly Dooley, Ph.D., a pediatric psychologist in the UT Southwestern and Children's Health℠ Center for Autism Care and Assistant Professor at UT Southwestern. "This is particularly challenging for children with ASD who usually thrive on structure and predictability."
Dr. Dooley explains some of the unique challenges children with ASD may face during COVID-19 and tips for navigating them.
Challenges for children with an autism spectrum disorder during COVID-19
It can be hard to know the best way to talk to your child about coronavirus. For parents of children with ASD, explaining the complex situation in which we now find ourselves may present additional challenges. Because children with ASD tend to think in concrete terms, managing the unknown can be difficult.
Additionally, children with ASD may experience a disruption to specialized services typically provided through schools or the community – such as speech or ABA therapy – that was once part of their daily routine. While school-age children still have some demands (like expectations of school work being completed), they do not have the same support services they had while physically in school.
Children with ASD may also face unique social challenges during COVID-19. "We do not have access to our social connections in the same way that we did before social distancing," explains Dr. Dooley. "This can lead children with ASD to feel socially isolated, since some may have difficulty initiating social connections in new ways, such as technology."
Because of these challenges, children with ASD may have difficulties expressing their feelings or have an increase in negative behaviors during this time.
6 tips for helping kids with an autism spectrum disorder navigate COVID-19
Dr. Dooley provides these six tips for parents to help kids with ASD best cope with the present situation.
1. Help children understand the situation
Describe COVID-19 and the current situation using clear, simple, concrete language and on a level that provides an understanding that doesn't increase your child's anxiety. Children may need to have this information presented to them multiple times; they learn by repetition. It may be helpful to use social stories (a story that clarifies the situation and possible responses using words or pictures) when speaking with your child.
Be honest with your child about not knowing all the answers right now, stay calm and convey what are you doing to keep your family safe. Focus on what your child and your family can control, such as washing your hands regularly and staying home as much as possible.
2. Encourage coping strategies to manage challenging behaviors
Fear, frustration and worry are common emotions for many people right now. It can be difficult for children with ASD to express these feelings – so the feelings may be expressed as negative behaviors. Here's how you can help:
- Be the calm in the storm! Remember that so much is unpredictable right now.
- Offer opportunities for your child to express what they are thinking and how they are feeling. Use artistic expression such as drawings, play and storytelling to help communicate feelings.
- Teach coping and calming strategies – such as listening to music, taking deep breaths, counting to 10, exercising, drawing or practicing yoga – and practice using the strategies daily.
- Provide regular movement or sensory breaks. Get outside, if possible!
- Try to determine what else may be contributing to challenging behaviors. Is your child tired or hungry when you see the challenging behaviors? It may help to track the behaviors to help understand patterns so you can make adjustments.
- Stay closely connected to teachers, therapists and other regular care providers. Make your home, routines and behavioral strategies as consistent as possible with the approaches that are used in school and therapies.
3. Emphasize the routines that are staying the same
Daily routines are important for everyone, and especially for children with ASD. Even though many daily routines have been upended, try to keep as many existing positive routines in place as possible. This may include keeping morning and bedtime routines consistent or family mealtimes.
4. Build new routines
Though regular routines are disrupted for now, building new routines amidst the uncertainty can help children with ASD better cope. Here are some ways for your family to create new routines:
- Make a written schedule using pictures or words, depending on your child's developmental level. It may help to use visual supports in other ways, too, such as breaking down the steps of new expectations (washing your hands every time you come in from outside) or for the passage of time (using calendars or timers), which can both be difficult to manage during this time.
- Provide choices and create goals and schedules together – if possible and developmentally appropriate. This helps increase your child's motivation and autonomy.
- Use "if-then" language to help clarify expectations, especially when completing a non-preferred activity: "If you do your school worksheet, then you can play outside."
- Be consistent.
- Provide lots of opportunities for success! Catch them "being good" and provide lots of praise for compliance.
- Tips for at-home learning: Set up a designated work area, minimize distractions, set concrete expectations (to-do lists) and build in reinforcements (such as a sticker chart) to help create structure and motivation.
- Be creative! Many places, such as zoos and museums, are offering free virtual learning experiences.
- With more time at home and competing demands, kids might have more access to screen time. This is understandable. Just be aware that it may become more difficult for your child to cut back when you want them to. Remember to set clear expectations for screen time each day. It may be helpful for your child to "see" the time remaining (e.g., using a visual timer).
5. Make time for social connections
It's completely normal to feel socially isolated during these challenging times. Many people have turned to video technologies to help maintain a sense of connection.
"Parents may need to be the ones to facilitate social connections using technology, especially for children with ASD," says Dr. Dooley. Using such an unfamiliar media to foster social connections can be challenging at first but speaking with and "seeing" loved ones can help maintain some sense of normalcy.
6. Parents, take care of yourselves!
With so many changes in place, many parents don't get the breaks they had built in before COVID-19. "It's normal for caregivers to experience fatigue," explains Dr. Dooley. "That's why parents need to take care of themselves, too." Here are some tips for parent self-care:
- Take it day by day. Focus on what is going right each day.
- Find an activity that you can do daily (even for 5 minutes) that is calming.
- Practice self-compassion. Parents have never had to deal with the challenges of this pandemic before. This is new for everyone. We are all dealing with this "new normal," which is anything but normal. Remember, you are doing the best you can.
For information about COVID-19 and more resources to support your family, visit the Children's Health COVID-19 hub.
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