Sudden change is never easy and often bewildering, but for young people on the autistic spectrum, it is especially difficult to navigate – and sometimes distressing.
The coronavirus spread has resulted in unavoidable change, leading to the closure of many schools and community settings, with the intention of slowing the pandemic. This has meant families around the world having to change their routines, if not their lives, and created unique issues for caregivers and people with autism.
Priory’s Dr Hayley van Zwanenberg says the important thing to remember is that people with autism, and those who look after them, need to be part of the conversation.
Situations could be particularly challenging for those with autism spectrum conditions who are often very sensitive to changes which could lead to sensory overload.
Dr van Zwanenberg, a child and adolescent psychiatrist at Priory’s Oxford Wellbeing Centre, who works with autistic children and their families, says: “Parents and carers will be extremely anxious to minimise any distress to an autistic child, so wherever possible, I would say it’s best to involve the young person in planning a new schedule and routine.
“If the child needs to be at home, leaving the day unstructured is likely to be far more stressful than creating a new timetable to follow.”
With many people now working remotely, she says that parents may well be at home more than usual so “it’s really helpful to discuss the consistent behavioural strategies you will use, as needed, with your child so everyone is singing from the same hymn sheet in terms of behavioural boundaries.
“You could consider making an inventory of food that is available to you with your child, and plan meals a few days or a week in advance if possible so if the food is slightly different from normal, the young person has been given some notice of this.
“It’s also important to consider noise levels in the house if more of you are at home than normal. Due to sensory sensitivities, the young person may become more aroused with more people in the house. Think about how you can minimise this. Does the young person need to use ear defenders at home or listen to their music through head phones?
“Do they have a quiet space they can go to if needed, with items in that space that will calm them.”
Dr van Zwanenberg says it is helpful to ensure that others in the house know that if the young person goes to that space, they should not be disturbed. “I would try talking to the child about the early warning signs that show they might be becoming over-stimulated. Have an agreement that if they feel these signs or you spot them, there is a code word or a sign they can use, and that is when they can always access their quiet space to calm.”
Dr van Zwanenberg said it was also helpful to try to maintain bedtime routines and good sleep hygiene techniques.
“Sleep is so important to mental state, and I would include:
– No caffeine after midday
– Engaging in some form of exercise if possible in the day
– Only using the bed for sleep at night time (not sitting on it on iPads during the day, for example)
– No screens an hour before bed
– Establishing and maintaining a bed time routine so the body learns the next thing in the routine is sleep
– Go to bed at the same time every day and get up at the same time every day, whether a week day or weekend
She added: “I would give children facts regarding the coronavirus, and say that we are all in this together, but try not to have the news on the television or radio too much and try to encourage a child not to search for further information on the internet, as misinformation is likely to raise anxiety.
“If they are disappointed about activities that were planned being cancelled, consider making a poster with them of the activities to be rebooked when possible so they know they will not be forgotten.”
She added: “I would also encourage some form of contact via the internet or phone with their friends so that social anxieties do not grow when they reintegrate with their friends and fellow pupils, and social distancing ceases. There is also useful information from charities including the National Autistic Society.”
Dr van Zwanenberg added that it was important for families to follow all official Public Health England advice around frequent hand-washing and social distancing.
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