COVID-19 is keeping families at home and disrupting daily routines. The adjustment to a “new normal” is especially difficult for children with Autism Spectrum Disorder (ASD) who are increasingly isolated from social connections and external structure. Additionally, they may struggle to understand the pandemic and the concepts surrounding social distancing. Caregivers may also have difficulty discussing COVID-19 with their child, leaving children confused about the information. For example, a child with ASD recently asked me why Sesame Street or SpongeBob does not discuss COVID-19 and social distancing. In the absence of information from his caregiver he was looking to popular TV shows to normalize the pandemic and to help him understand how to “survive”. Furthermore, research has shown the importance of consistency in daily routines for children with ASD. Because routines provide feelings of well-being and stability, changes to routines frequently become cause for alarm. This can be especially difficult during the COVID-19 pandemic due to widespread cancellations of activities, and the constantly changing information. Children with ASD can struggle to understand why things are being canceled, and may struggle with the ambiguity of postponements.
What strategies can we use to help a child with ASD during COVID-19?
Story telling– Discussing the change before it happens helps the child to prepare to handle it. Story telling about Coronavirus and how it will affect our every day lives can cut down the surprise of the change. Social stories can help children with ASD to understand what is happening around them, how to behave in unexpected situations, and how to cope with the strong feelings following an unexpected change or cancellation. Social stories can also help children with ASD to normalize social distancing, and to better understand what it means when an event is postponed to an unknown future date.
Using visual aids– Pictures and written reminders can help children with verbal processing deficits understand what is happening. They can also serve as visual cues for how to handle strong emotions, and better understanding postponements. Caregivers can use charts, tables, pictures, schedules and clocks to introduce new changes into their routine.
Small changes and schedules– Start with small changes to the schedule so that children don’t feel overwhelmed. Do not feel pressured to play every minute of an eight hours school day. Frequently children with ASD or other executive functioning deficits were already feeling overwhelmed by the length of the school day. Limit the amount of time spent doing academic work to 1-2 hours per day. Leave a lot of space in the schedule for breaks and unstructured playtime. During unstructured playtime, is important to provide your child with a list of activities to do, as children with ASD frequently have difficulty structuring independent leisure. Make sure to leave space in the schedule for quiet time activities, and to enforce quiet time for both you and your children throughout the day. Assign your child chores around the house to help them gain a sense of responsibility.
Create a special space- Build a safe space or quiet space to process negative emotions. Encourage your child to go to the special space prior to having a meltdown. Do not use the special space as a punishment, but a coping strategy. Make sure to provide your child with a lot of reinforcement if they successfully use the special space.
Physical activity – Gross motor activities promote physical and mental well-being. Try to go outside every day for at least 30 minutes with your child (i.e., walk, bicycle ride or work in the yard). Ask your child to help you with chores around the house, give them some responsibility,
Reward their flexibility and positive behavior- By rewarding your child's positive behavior, you are essentially building skills and encouraging desired behaviors. Pair the reinforcement with a validation of the child’s feelings. For example, “I understand how frustrating it is to not go to the pool right now, I am so proud of you for being flexible and making a new plan. Tonight we can play a video game together.”
Fun Activities- Take advantage of some of the extra time to do fun and free activities with your child. Examples of this might be cooking together, playing video games together, playing board games together or creating a craft together.
Self-care- Make sure schedule something for 30 minutes to 1 hour that recharges you. During this time, have your kids do a quiet time activity or play on electronics, so that they give you space. Try to be realistic and understand that your new routine can’t be perfect, and that you don’t need to use this time to make dramatic self-improvements. For caregivers with children with special needs, the important thing is to be patient and understanding with yourself as you adjust to the new normal.
Pathways Behavioral Health Blog
Dr. Stillerova and Dr. Shriver
Dr. Lucia Stillerova joined Pathways Behavioral Health in 2018. She received her PhD in Applied Developmental Psychology from George Mason University and her Master of the Arts in Clinical Psychology from University of St. Cyril and Methodius. She has presented her research at national conferences, and published in international journals. She also serves as a part-time faulty member at George Mason University. Her research focuses on social–emotional teaching and learning in early childhood development.