During the coronavirus pandemic, we are all learning that we’re safest when we follow a set of rules that includes wearing a mask, washing our hands and maintaining safe physical distance from others. But how can parents help their children on the autism spectrum adjust to this new normal way of life?
“This is new for everyone and is something we are still figuring out, adults included,” says Danielle Lambert, a board-certified behavior analyst at Gateway Pediatric Therapy, which services seven locations in southeast Michigan.
Routines can really help, Lambert says. “Establishing some form of routine, whether your child has a diagnosis of ASD or not, helps them learn that although this is something new, we can work with it as long as we have a schedule,” she says.
Expectations that may seem unusual at first can become commonplace with time. For example, clients who attend Gateway Pediatric Therapy now have their temperature taken prior to their therapy session.
“This is something that wasn’t normal, but maybe after the first couple of times, clients notice the thermometer doesn’t hurt and they become familiar with the person taking their temperature. So as long as there is repetition and a schedule, my clients are not so bothered by it,” Lambert explains.
Techniques for practicing the new normal
For clients who read and understand verbal language, Lambert uses social stories to establish rules and routines. “It’s like a storybook that pertains to that child’s everyday life and explains what they can and can’t do using narratives and pictures. Through the social story, we describe how we are in danger when we get too close to someone.”
Lambert writes the rules out — in word or picture format — and then checks comprehension. “Even if a client can list the rules, it may be unclear whether this is an instance of true comprehension or simply rote memorization. You have to find out if he can actually put them into practice, for example, through hypothetical scenarios or role-playing,” she says.
Maintaining safe physical distance can be a challenge for children, but we can provide reminders through pop quizzes and reinforce correct answers. “We might ask what happens if he is at school and someone walks too close. Is it better to get closer or walk further away? He will answer, and we give feedback and talk about why he made his choice. If his response is incorrect, we review the rules,” Lambert says.
Through modeling safe physical distancing in grocery stores or other public situations, parents can describe how they are keeping six feet away from others and even ask what might be the correct thing to do if someone starts walking too close. “It’s good to throw those pop quizzes into real-life examples,” Lambert says.
Getting comfortable with wearing a mask means starting small
For children to feel comfortable wearing a mask, a gradual period of desensitization might be appropriate.
“Essentially we start with a goal that is easily attainable. It might be something as simple as having the face mask on the table next to the child for five minutes,” Lambert says. There may be 20 to 50 steps after this, including having the child hold it in their hand, holding it by the loops, looping it over the left ear and holding it there, looping it over both ears but under the chin and so on.
“This all depends on the client’s ability to understand what we are asking. We might use this desensitization with a social story about why they are wearing the mask and when they need to wear it,” Lambert says, adding that she might offer something fun after a child tries each step. Providing this immediate reward promotes learning and encourages the child to take additional steps.
Practice and visual aids are helpful with handwashing, too. “We practice modeling where an adult shows them first, starting with turning on the water and then washing their hands for 20 seconds,” Lambert says. “You can have a timer available or teach them to sing a song that is 20 seconds, like Happy Birthday or Twinkle, Twinkle Little Star.”
Lambert says she knows these efforts are having an impact. “I wasn’t sure if clients would understand the new normal, but I hear them say, ‘Because of the coronavirus … ‘ so I know parents are having success in sharing this important message with their children,” she says.