When schools closed their doors due to coronavirus, this created stress for parents everywhere. However, for parents who have a child with Autism Spectrum Disorder (ASD), the shelter-at-home quarantine can feel especially overwhelming. Children with ASD thrive on structure and routine and being told they can’t go to school is definitely a disruption to their routine.
One of the first orders of business for parents is to begin creating structure and routine.
It can be helpful to create a visual schedule of the activities your child will do each day. A visual schedule incorporates simple, clear words combined with visual images of the task and a check-box for when the activity is completed.
As much as possible, keep the schedule similar to what happened when school in session. Below is an example of how you might set up a visual schedule for your child.
Social stories are a good way to let children know what is happening using familiar language and pictures. It may be helpful to use a social story to explain what is happening due to coronavirus. You can create your own social stories using their favorite characters, or find social stories online.
You can re-read the story to help the child remember what is happening and what you are asking them to do as a result of coronavirus.
Time tables can be used as a part of scheduling or independent from schedules. Some children do well when they have specific times they are supposed to do certain things.
For example: I get up at 7:00 and eat breakfast and I brush my teach at 7:30. For other children, if there are specific times when things are to happen and the event doesn’t occur at exactly then, it becomes distressing.
For these children, use sequencing on the schedule to help them understand what order events will happen. For example, if they are to brush their teeth before they play, you would put tooth-brushing before play time on the schedule. It can also be helpful to divide the schedule into morning, afternoon, and evening to give them approximate times for when things will occur.
Many children—whether or not they have ASD—struggle to switch activities. Timers can be helpful in managing transitions. With your child, set a timer for when the activity needs to end and let them know that when the timer goes off, they switch activities.
For example: “We are setting the timer for three minutes and when it goes off, you will need to stop playing trains and get ready for bed.”
You can also set the timer twice to give a warning. You might say, “We are going to get ready for bed. When the timer goes off the first time, you will have one minute left to put your toys away, and when it goes off the second time we are getting ready for bed.”
Children with ASD have a very difficult time when their routine changes. This makes practicing navigating changes prior to having to do them unexpectedly extremely important. You can do this using their schedule.
1. Put something pleasurable on the schedule and do the activity at the scheduled time.
2. The next time, put a question mark or a gap on the schedule. Tell your child this gap is a mystery, and they will find out about it when it is time to do the activity. When the gap time arrives, do the pleasurable activity and reward your child for being flexible and adapting.
3. Next, do the pleasurable activity without it being on the schedule in any way. This will be difficult for your child so it is important to be patient and to praise and/or reward your child for adapting to the change in schedule.
You can also use social stories to help your child think about and learn skills to manage change. An example is this “Change is OK” social story.
Another way to help children adapt to change is rewarding them for being flexible. Do this whenever you see them adapt to things that don’t go exactly the way they want them to. If your child navigates having fish sticks for supper instead of the macaroni and cheese (navigating it might mean they don’t melt down but also don’t eat the macaroni and cheese), you should emphasize how flexible they were and reward this flexibility.
Meltdowns can be inevitable for children with ASD. Children with ASD are extremely sensitive to external stimuli and easily overwhelmed. When they become overwhelmed tears, screaming and sometimes even hitting can follow. When this happens, it is important to remember your child is overwhelmed—not being defiant or stubborn.
1. Make sure your child is in a space where they can’t harm themselves or others.
2. Lower the stimuli your child is experiencing. This might mean turning the lights down, turning off things making noise, or draping a weighted blanket over their shoulders. If you don’t have a weighted blanket, some children enjoy being “wrapped up like a burrito” which entails swaddling them just as you would an infant. Whenever wrapping a child in a blanket, it is always important to be sure they can free themselves if they want to and the blanket doesn’t cover their face.
3. In addition to reducing stimuli, it sometimes works to use either “first then” or “you choose” strategies.
Tell your child, “First we are going to do (desired behavior) and then we will do (something that is pleasurable and rewarding to the child). You can also reverse this if it is more effective for your child.
Give your child two choices—both of which result in your child doing what you want them to do. For example: You choose—you can brush your teeth and then play with your toy for three minutes or you can brush your teeth and play with your toy for five minutes. Again, you can put the pleasurable activity first if it works better for your child.
4. Sometimes, despite trying all of these activities, your child won’t respond and the meltdown will continue. When this happens, remind yourself they are overwhelmed and can’t do anything different right now. Sit quietly with them and/or take a few minutes to do something that normally soothes them and then try one of these strategies again
Caring for children with ASD is extremely demanding so it is essential that you take care of yourself. It is important to do things every day to replenish yourself physically, emotionally, and spiritually. This includes having places to blow off steam and recenter when childcare becomes overwhelming.
If at all possible, take breaks from childcare so you can replenish and be ready to take on the task again.
If you are housebound with your child right now, consider teletherapy as a way to get an outsider’s perspective and help in handling your child’s unique needs.
Jean Holthaus, LMSW, LISW has been providing outpatient therapy services since 1995 when she earned her Masters of Social Work degree from the University of Iowa. She has worked for Pine Rest since 1997. She currently serves as manager of the Telehealth Clinic and the Hastings Clinic and is also a Pine Rest Outpatient Regional Director.