All children and young people need support from adults during times of stress and uncertainty, including during the coronavirus pandemic. This is a challenging time for many people and this uncertainty is a significant source of anxiety, particularly for children with Autism.
What is Autism Spectrum Disorder (ASD)?
ASD is a lifelong developmental disorder that is wide-ranging. Individuals with ASD may:
- Find change and transition challenging
- Show rigid thinking
- Have repetitive movements or actions
- Display delays in communication
- Have sensory sensitivities
- Have learning disorders, or may have average or above average intelligence
- Have difficulties picking up social cues and may not interpret humour or sarcasm, often taking comments literally
- Some individuals may also have Attention Deficit Hyperactivity Disorder (ADHD) or physical impairments
It’s important to note that while many things are challenging for people on the spectrum and the people who love them, people with Autism also have many uniquely positive traits.
Many people with autism:
- Have terrific memories
- Rarely lie
- Have fewer hidden agendas
- Are passionate
- Rarely judge others
- Live in the moment
Tips for parents and carers
Talk to your child about COVID-19
Encourage (but don’t force) your child to talk about their thoughts and feelings about COVID-19 and other scary things. Describe the virus and the current situation, for example closures and social distancing. Make sure you use clear and concrete language and terms, and avoid flowery or abstract phrasing. Give them opportunities to ask questions, and inform yourself so you can give clear and factual answers that are appropriate to their age and developmental level. Correct any misinformation and put things into perspective.
Leave your child with a feeling of security and hope and avoid encouraging frightening thoughts. Help them to see that their world is basically a safe place, and that life is worth living. Try using visual supports to offer guidance on coronavirus specific actions and behaviours (such as washing hands and staying 1.5 metres apart) and to break down the steps of these new expectations.
Pay attention to your own reactions
Children may respond to the anxieties felt and expressed by the people around them. They often see and hear far more than adults are aware of, and they will take their cues for how to respond from you. If you are worried or panicked, then your child will sense this. Leave it until you are feeling more positive before you talk to your kids about what’s happening with COVID-19.
It’s crucial that parents maintain routines and rituals where possible. Knowing what’s going to take place in their day makes children feel safe and provides a sense of stability. Get up at the same time and have the same general schedule.
Children with Autism are more susceptible to social isolation and loneliness, and this may be heightened the current environment. By embracing technology your child can connect safely with loved ones. This can be done through phone calls, emails, face time, and social media. If those more immediate means are not available, writing letters is another great way to keep connected! You might need to check in to make sure social contact is continuing. Try scheduling time with friends, family, teachers and others to chat via safe online platforms.
To make managing life during COVID-19 a little bit easier for you and your family, we’ve compiled some Autism specific information, resources and tools below:
Autism Awareness Australia – Autism & COVID-19, the essentials
Autism Focused Intervention Resources & Modules – Supporting individuals with autism through uncertain times
Tips for medical professionals
No two individuals are the same, therefore the same strategies don’t always work. However, the tips below may help create a calmer and more pleasant experience when an individual with ASD visits your clinic.
- Offer appointments when the clinic is calmer to reduce sensory overload
- Early appointments when you are most likely running on time can reduce waiting room stress
- Booking longer appointments to help calm an individual before providing support where possible
- Having a clinic social story on visiting your clinic may be useful to create predictability. Some individuals and families already have these however others do not even know they exists.
- Consider the waiting room play space
- Are there loud toys that may cause frustration for auditory sensitivity individuals
- A small busy space may be avoided by an individual with ASD due to touch sensitivity and social challenges – offer an alternative play space
- If there is a TV consider a child may have a difficult time transitioning from this device – switch it off or change the channel where possible
- Have books in the waiting room such as ‘visiting the GP’ – these are often written with characters such as Elmo.
- Create clinic toolboxes containing calming items and small toys such as
- Colouring in tools
- Soft toy
- When it is their turn and their name is called consider it may be unpredictable for them and they may need time to process and transition. Remember they may need to think about where they are, where they need to be and how they need to get there, and this can take longer so be patient and help guide them by walking with them.
During the appointment
- Some individuals may have difficulty understanding you and/or communicating their issue. Using a ‘show me where’ visual can be useful
- Allow longer time for individuals to process questions and develop responses
- Use an ‘appointment toolbox’ with calming tools and games/toys to make your room more fun for young visitors
- Using a visual timetable or checklist helps individuals know what will come next in their appointment. Some children may need to be rewarded for participating in all of the steps – stickers, stamps or praise can work well for some children.
- Consider that some individuals with ASD have a high pain threshold and therefore may not be aware of pain and therefore not report it
- Talking with a parent or individuals on what helps make their appointment experience comfortable is important. Keeping a note on their file for their next appointment will ensure they get a consistent experience and you can build predictability for your client
- Having handouts and information on common issues, other professionals’ roles and developmental charts enable you to talk with a wide range of parents with differing learning types
Words of advice from Youthrive Occupational Therapist Portia Gunn
Not all individuals who visit you will have a diagnosis of ASD. However, it may be underlying or they may find medical spaces scary. These strategies can be used for any individual who has a difficult time attending appointments.
Remember, you may be the first medical professional this family has seen for support and they may not know what to do next. Listen to their concerns and enlist the support of an allied health team to further explore where relevant.