Managing ASD (autism spectrum disorder) is often grounded on structure and routine, but the COVID-19 pandemic affected how families can structure their children’s days, explained Sarah Edenbaum of Hackensack Meridian Health, a network of healthcare providers in New Jersey. For parents, lifestyle changes such as social distancing, self-isolation, and online education can be challenging. Further, lifestyle disruptions can trigger fears of meltdowns and increased behavior problems among parents of children with ASD.
Survey On Young People With Disabilities and Their Families During the Pandemic
Children and Young People With Disability Australia (CYDA), a national peak body that represents children and the youth, found that children or young people engaged in early childhood education and care (9%), special primary school (16%), mainstream primary school (25%), special secondary school (14%), mainstream secondary school (18%), homeschool (3%), and day programs (9%). Other activities were open employment (4%), university (2%), and not in education or work (2%).
Regarding the living conditions of the child or the young person, 95% lived at home with family and 2% lived in private accommodation. 1% lived in a group home, in respite, or in another form of supported accommodation. On the other hand, 64% of respondents said they are unable to buy essentials and essential medications (18%) due to the pandemic.
Among other impacts mentioned by the participants were loss of income (20%), closure of school or education (19%), self-isolation because a child or young person has immune or other medical conditions (30%), and decline in their own or their child’s mental health and wellbeing. Because the responses were from family members, CYDA recommended obtaining data from children and young people with disability in future studies.
A Survey of Psychosocial and Behavioral Impact of COVID019 In Autism Spectrum Disorder
Marco Colizzi and colleagues of journal portal Research Gate involved a total of 529 participants in the survey, finding that 33.1% of children had a fluent language. 51.5% had behavior problems prior to the outbreak. Of those, 42.2% were receiving pharmacological treatment. 27.8% of ASD individuals had one comorbid medical condition, with neuromotor and gastrointestinal conditions and allergies and food sensitivity being the most reported conditions.
1.3% of nuclear family members reported COVID-19 positivity and the percentage was 4.4% for extended family members. Bereavement occurred in 2.3% of cases. 26.1% of mothers and 27.5% of fathers stopped working due to the pandemic. Most of them perceived the current period of change and restrictions as challenging (93.9%) and more challenging than before the pandemic (77%).
27.7% of parents received support from the Local Healthcare Services, with most of them receiving both direct (70.1%) support such as calls and videocalls and indirect (84%) support like text messages and assignments. 73.3% said they received both school support and support from the private therapist. Parents also reported the following difficulties; managing their child’s meals (23%), autonomies (31%), free time (78.1%), and structured activities (75.7%).
Prior to the pandemic, parents said behavior problems were more intense (35.5%) and more frequent (41.5%) in ASD individuals. Due to behavior problems, 19.1% of cases had an emergency contact with the child’s neuropsychiatrist and 1.5% of cases had access to Accident and Emergency (A&E) department. The authors concluded that the pandemic entailed a challenging period for the majority of ASD individuals and their families, including difficulties in managing daily activities and having more frequent or intense behavior problems.
Tips for Parenting A Child With ASD
1. Establish A Routine
Denise Aloisio, M.D., a developmental behavioral pediatrician specializing in childhood ASD, said creating a routine or a schedule can help both children and parents. Schedules can also be help children transition to the new norm, said Aloisio, who is also the medical director of The Child Evaluation Center at Hackensack Meridian K. Hovnanian Children’s Hospital.
Use the “pre-COVID-19” schedule to identify at least two or three habits each day that your family can continue. Don’t forget to dedicate time for bonding and breaks, with the latter helping you and your child’s mind to relax. It is recommended to create a child-friendly visual routine so kids with ASD know what to expect during the day. A visual schedule also helps ease their anxiety when moving on to the next activity.
2. Help Your Child Deal With Strong Emotions
Children with ASD who feel scared, worried, or frustrated may exhibit repetitive behaviors and tantrums, said Diane E. Treadwell-Deering, M.D. of KidsHealth, a physician-reviewed information and advice platform on children’s health and parenting issues. Help your child express their feelings by doing crafts, using augmented or alternative communication devices (for non-verbal children), and more.
You and your child can also try doing deep breathing exercises, listening to music, and watching a favorite video, or exercise to ease the latter’s anxious feelings. It is also suggested to limit the time your child spends on social media or watching distressing news.
3. Set Boundaries
A parent may be working and caring for their kids during the pandemic. Allocate separate areas or “activity zones” for play time and work time. Be visual and expect interruptions while working. You can also use a kitchen timer or cellphone countdown to indicate “uninterrupted work time.” Working parents can also work in shifts to take care of their kids.
4. Talk About COVID-19 In A Simple Manner
Children with ASD may not be aware of what is going on or unable to express their frustrations. When talking about the pandemic, be direct, succinct, and honest. You can say, "Coronavirus is a germ. It can make people very sick. We have to stay away from others to stay healthy."
Explain that your child will stay home from school and finish their academic requirements at home. Tell them that parents may work remotely and any family trips or activities will be postponed or on hold. Help your child practice frequent proper handwashing and not to touch their nose, eyes, and mouth.
Practice social distancing and require them to wear a face mask when going to public places. Let your child ask questions but try not to offer more detail than what they ask for. If they ask about those who are sick, be straightforward. However, don’t bring that up if your child did not ask about it.
Parenting a child with ASD can be more challenging as they are prone to exhibiting more intense and frequent behavior problems. Parents should create a schedule and allow their children to engage in soothing activities like crafts. They can also consult their child’s therapist via telehealth for consultations and other matters.