Coping with autism in a world where everything has changed
One group of people who may find the current lockdown particularly challenging are those with autism. Here, Dr Vaughn Price, principal clinical psychologist with Ludlow Street Healthcare, offers five useful ways they can cope...
THE spread of coronavirus, and its subsequent lockdown, has been life changing for everyone. Since the quarantine was announced, life has ground to a halt and many people will be struggling to adapt to this unprecedented situation.
One group finding this time particularly challenging are people with autism, who value routine above everything.
Structuring their day enables a person with autism to have some element of control over the unpredictability of everyday life.
Everything from what they eat, to how they make a journey, is planned meticulously and is crucial to easing anxiety and supporting them in coping.
With this in mind, the impact of the coronavirus pandemic will have had an overwhelming effect on more than 700,000 people with autism across the UK.
Dr Vaughn Price, from Cardiffbased Ludlow Street Healthcare, a specialist healthcare provider which offers educational support to people with autism spectrum condition (ASC), said the lockdown will be “extremely challenging” for them.
Dr Price, the principal clinical psychologist at the provider’s dedicated educational facility, Beechwood College, said: “As someone who works extensively with people with ASC, I understand that adapting to this significant change will be extremely challenging.
“For myself, and I’m certain millions of people, this quarantine has been very difficult to get used to.
“But for someone with autism, who is absolutely reliant on routine and structure, it is incredibly difficult and will be a struggle to adapt to over the coming weeks.
“At Beechwood College we are supporting our day students who are social distancing at home with their families with educational continuity through online activities. We’ve set up Skype facilities for our residential students to help them stay connected with their families who cannot visit.
“We’ve also produced a range of easily-readable materials explaining the coronavirus, and why we have had to implement new routines to ensure the students understand.
“I’d like to extend my thoughts and support to all those with autism and their families during this time, and encourage them to seek assistance if they feel overwhelmed.”
To mark World Autism Awareness Week, from March 30 to April 5, Dr Price offered expert advice to support autistic people and their families through the lockdown:
■ 1. Creating a new routine
Normal routines may have evaporated due to coronavirus, however creating a new routine is essential.
Families can support a loved one with ASC to create a daily plan, which incorporates familiar elements of their old routine.
Dr Price said: “They can still wake and go to bed at the same time, and meals can remain the same. Clothing is also important for an autistic person, so offering favourite items can reduce anxiety.
“Timings throughout the day can also be kept consistent, bedtimes and lunch can remain the same to minimise disruption. If the lack of interaction with familiar people is proving problematic, schedule a WhatsApp or Skype call in keeping with their normal routine.
“Maintain prescribed sensory routines or activities, but meeting sensory needs indoors may require creativity.
“Special interests enable autistic people to find comfort when things get overwhelming. Encourage familiar and soothing activities, such as drawing or Lego, at specific but limited times, to help them manage anxieties, and engage with them during these.”
■ 2. Managing time
The loss of routine can make it feel like the days are blurring together.
This will be particularly confusing for people with autism who may struggle with altered times and breaks between activities, said Dr Price.
“Preparation and clear visual markers are essential for dealing with transition phases,” he added.
“Clearly signaling when a task will start and finish will help them understand what to expect in advance. For example, set out a timetable or planner for an activity, and breaks in between, using pictures, graphics, photographs, and other visual aids to support understanding.
“Creating a daily visual timetable will assist with establishing a new routine they can adopt.”
■ 3. Clear communication
Communication is always vital when adapting to change – and in the case of an autistic person, it’s even more crucial.
Dr Price said: “The coronavirus pandemic is constantly evolving, so clearly explaining what is happening and why will support them in accepting and adapting.
“Outline what change this has brought about using concise language so they fully understand. In the case of this pandemic, the situation is likely to be confusing, so keep the explanation simple, while reducing hand gestures (unless you are using signing) and facial expressions, to enable them to process the information.”
■ 4. Social stories
Visual aids are hugely beneficial in supporting people with autism, and with the coronavirus limiting interaction they have been particularly significant in recent weeks.
As such, social stories have emerged as a popular method for communicating to people with autism. A social story is a series of images with captions explaining what is happening, why, the eventual outcome, and just what they can do.
These can be used as guides during this turbulent time, to offer reassurance and help people with autism to understand how to react. Resources are available via the National Autistic Society’s website.
■ 5. Recognising the signs
During the lockdown, families may notice more signs that their loved one is struggling with change.
Symptoms of anxiety could include obsessiveness, loss of patience, difficulty concentrating, and sleep disruption.
Dr Price said: “It is essential that once you’ve identified a situation, person, or thing that is causing them anxiety, that you work quickly to address it.
“Speak to them and encourage them to express their concerns. If verbal communication is difficult, encourage them to draw what is bothering them, or create a social story.
“During this period, stress will inevitably be heightened, so it may be worth creating an anxiety action plan, setting out the issue, its symptoms, and how it can be solved.
“This will help the person with autism recognise when they are feeling distressed and reassure them there is a solution.
“There are many online resources that can help to guide the person’s thoughts away from their anxiety and back into the present.”
Those in need of further advice around coronavirus can visit www. gov.uk/coronavirus or access one of the many ASC charities and support groups.