Dear Mr. Himelstein,
We are writing in response to your article, “Children with autism spectrum disorder need more support during the pandemic”. Thank you for highlighting the unique way in which the pandemic has impacted those with autism. Many face-to-face therapies for children with autism have been disrupted during the pandemic, which can be challenging for the child and family. Even when service providers are able to take all public health precautions, it has been difficult for most providers to ensure continuity of in-person treatment. Adding to this challenge are the many new expectations to which those with autism are expected to adapt. We appreciated how you explained the compounding factors that exist for individuals with autism during the COVID-19 pandemic. For example, rigidity and difficulty with change is part of the current DSM-V definition for autism. Thus, some individuals in the spectrum may have trouble coping effectively with the unpredictability of pandemic life.
Your article offered great suggestions to support parents and caregivers throughout the pandemic. As parents of our own young children, we welcomed the reminder for self-care. We wanted to offer some additional suggestions for parents and therapy teams to consider during this stressful time:
- Avoid non-evidenced based treatments. Especially now, time is a precious commodity. As you noted, it can be hard to maintain consistent face-to-face therapies during the pandemic. Allocating limited time and resources to focus on non-evidenced based treatments will likely lead to further setbacks. Our webpage offers more information on different treatments available, and their level of scientific support.
- If parents have the time and availability, they can and should be involved (particularly in virtual sessions) in their child’s therapy, and receive more parent training. Being taught to use different teaching and behavior support techniques in therapy sessions will allow parents to maintain continuity, even during disruptions.
- When under pressure, it can be a huge challenge to learn new skills. Instead, parents may wish to focus on helping their child maintain previously learned skills, particularly during times of increased unpredictability. Ensuring that previously learned skills don’t get lost minimizes regression during this time. This approach is also therapeutic when addressing challenging behavior, as practice of previously learned skills often feels familiar, comfortable and more routine.
- Parents can focus on functional at-home adapted living skills. In addition to the hygiene and self-care skills that are needed in a COVID-19 world, safety skills and independence are also critical skills to focus on at home. In our recent article, we discussed ways that families and providers can work on essential COVID-19 skills during this time.
Again, we commend you for raising awareness about this important topic. We encourage anyone who wants to learn more about autism to visit our website.
Sincerely,
Nicole Stewart, MSEd, BCBA, LBA-NY
Elizabeth Callahan, MA, BCBA
