The coronavirus (COVID-19) has had a huge impact on all our lives. It is keeping us at home and away from other people to help stop the spread of the virus. Sudden change like this is never easy for anyone, but it can be more difficult to navigate and may even cause distress to those on the autistic spectrum. Autistic people often find change very difficult to deal with and rely heavily on routines to get through the day. Take away these routines, even when it is for an unavoidable reason, and many will struggle. This resource is a guide to help your autistic child through this challenging time, how you can help them to get an understanding of what is going on, and how to prepare them for what they can expect on a day-to-day basis. It also covers coping strategies, what to do if your child shows symptoms of covid-19 and other sources of help. For more information about Covid-19 in the UK please visit www.gov.uk. You should always seek help and advice from a medical professional for any health-related issues. Download the PDF here How to talk to an autistic child about Coronavirus First, remember that this situation is extremely difficult for all of us to comprehend and take in! Nothing like this has ever happened to any of us before and hopefully never will again. None of us have experience of coping with this, and nobody has all the answers. We are all learning as we go, so be kind to yourself and do not expect to get everything right first time around. A lot of autistic children find it hard to express their feelings or frustrations, or even know exactly what is going on (but they will almost certainly sense that something very strange is happening and pick up on the worry and anxiety around them). This makes it really important for you to talk to your child about coronavirus in a way which is easy for them to understand. You know your child best, so think about speaking in a way that they will understand without frightening them. Start by sharing small amounts of simple information with them, perhaps using apps for nonverbal communication if it will help. You could say something along the lines of “Coronavirus is a germ that makes people sick, like a cold. So, we need to stay away from people to make sure we stay healthy.” You should repeat this simple information several times to help them to grasp it and give them time to take it in. Try and avoid using analogies or metaphors as these can be confusing to an autistic child. Framing it like this, in a clear, honest and direct way can help them to understand why they may have to stay home from school or nursery, why you are working from home as well, and why family trips out and other activities have been put on hold. You can also explain that this is difficult for everyone, and that we are all struggling with having to stay at home more and not seeing friends and family. Let them know that it is important they listen to the information as it will help to protect them and other members of the family. Visual stories and supports are two ways you can explain the situation and provide your child with a step by step guide they can use to understand the recent changes. You can use visual supports to explain to your child how to wash their hands, why their school is closed and the rules for social distancing. Try and get them to understand that the main rules are: Washing their hands well and often for at least twenty seconds – you could have a rhyme or song that you sing while washing Trying not to touch their eyes, nose or mouth Keeping at least one metre away from other people – you may need to show them how far a metre is, or tell them that it is the length of a broom or something else they are familiar with Wearing a cloth mask in public places – you could make it part of a big dressing up game we all have to play, or talk about being superheroes Give your child the space and time they need to come back to you with any questions, but don’t offer them any more detail than you need to. For example, don’t tell them about what happens to people who catch coronavirus, unless they specifically ask. It may also help to be careful about exposing them to sensationalist news reports which may provoke difficult questions. When you have finished talking about the guidelines, move onto something more enjoyable. How to manage changes to a routine Many autistic children find routine a real comfort, so you should try and keep as many of their routines as possible during the COVID-19 pandemic. Stick to their regular bedtimes and getting up times, snack and mealtimes, screen time, chores around the house and so on. However, you will need to introduce some new routines, according to your circumstances, for things like learning at home and taking exercise. You can help your child to adjust to these new routines by offering them some choices e.g. what lesson your child would like to do next or what they would like for lunch. This also encourages them to communicate as well. Using to do lists, visual schedules and talking about plans and what is going to happen may help the child to understand what to expect, while things like timers can help them transition from one task to the next. Having a set routine like this, and showing them that you have clear expectations for them, can help to lower their anxiety about things changing. When things have to change, give your child plenty of notice and talk to them about the change so that they have time to get used to idea. For example, if you are not able to get the food you want on the weekly shop, you can start to plan your meals in advance so that you can give the child notice that their meal is going to be different and give them time to get used to it. They may even enjoy being part of the planning process if you turn it into an adventure or a game! Managing challenging behaviour during lockdown Autistic children often have repetitive behaviours that they display when they are feeling scared, worried or frustrated – behaviours such as hand flapping or rocking. This is known as stimming. If the stim is not disruptive or harmful to others, the best strategy is likely to be to let the child continue – it will help them to calm themselves. However, some behaviours can be challenging for parents and caregivers to deal with. You are the best person to know how to best calm your child down, but some techniques that other parents have shared with include: Playing Acting out fears Talking together Doing crafts Writing Using augmented communication devices Other good calming activities include watching a favourite video, listening to some music or even deep breathing exercises. A key way to avoiding difficult responses to stress is to try to prevent the stress from occurring in the first place. It may help to not have the news on the television or radio too much, and encourage your child not to search for information on the internet or take too much notice of what is shared on social media. If they do see something upsetting, encourage them to share it with you so that you can talk it over between you. This can also be a good time to have a discussion about not believing everything that you read or hear, and the importance of evaluating information for yourself, if your child is able to manage these concepts. Coping strategies Make sure that everyone in the family and that comes into regular contact with your child, not just the autistic child, is aware of the new behavioural strategies you are going to put in place, so that everyone can use the same methods and give the same messages. It is also important to remember that with everyone being at home together more often, this will be a new environment for your child to navigate. Noise levels may be higher than they are used to, for example. If your child has sensory issues then this may cause them some distress and so you will need to think of a way to combat this – such as allowing them to listen to music through headphones or wearing ear defenders. Making sure that others in the home are also aware of these issues is also important – this is a difficult and frustrating time for everybody, and it is easy to forget things that are obvious in normal circumstances! Apps for non-verbal children are just one resource that can help during this stressful time, but make sure to stay in touch with your child’s health care provider or caregiver too, as they will be able to offer help and support. Be patient Think about how you reacted to the pandemic and the lockdown restrictions, and how long it took you to fully understand and be comfortable with them, and then realise that your autistic child will probably need even more time to come to terms with things. They may not immediately adjust to changes in routines so lower your expectations of this. Try and think of ways you can make their new routine more engaging for them and present it to them in a way which they will most easily understand. Turning things into games and adventures if you can is often a good technique. Understand that some things, such as wearing a mask, may never be a possibility for them due to their sensory issues – and that’s OK. Use free apps for nonverbal communication to help communicate with your child, and make sure they are ready for their activity to change – or other transitions. Provide them with structure Structure is key to helping autistic children (and adults!) to cope with anything, so provide them with structure in the way in which they prefer it – such as using visual clues and other schedules. Stick to the schedule – show them it is reliable and that their routine is predictable. Explain to them any changes that are going to happen, before they happen (if possible). If things do have to change at short notice, try to explain why this has happened in terms that they understand to prevent or reduce fear and stress arising as a result. Try and find and emphasise positives as a result of the change, such as more time together. Stay calm Being empathetic and staying as calm as possible during these difficult times is key, so that your child doesn’t react to your stress levels or amplify your feelings at a time when things are hard enough as they are. But also be aware that this is a very difficult time for us all, and staying calm can be very hard at times – don’t be too hard on yourself either! One possible solution may be to give each other more space than you would normally – and again, this is OK. Let your child self soothe (stim) Allowing your child to self soothe using a fidget toy, by rocking or hand-flapping is OK – as long as they not hurting themselves and can self-regulate. Look at it this way, many of us are soothing our worries by eating more or drinking more at the moment – so it is reasonable to assume your child will want to self soothe themselves in some way too. It is definitely more healthy to flap arms than to eat lots of chocolate! Be mindful of your child’s social preferences No two autistic children are the same. Some autistic children are extraverts who will miss the social aspects of their life massively, while others are more introverted and so don’t miss the social aspects of life and are more than happy with the fact that they now have to stay at home more. If your child is more extravert, explore ways to interact with other people while still observing the restrictions in place. For example, using technology to have video chats with friends and relatives, or sharing pictures of artwork with others online could be helpful. For introvert children, this could be a good opportunity to have more quiet time with them at home and explore some of their special interests in more depth. If they are interested in space, for example, you could draw pictures of the solar system together or build a model rocket. Turn being at home more than usual into a benefit not a drawback. Encourage them to get physical Exercise and movement is good for all of us, and especially if your child is energetic. Physical activity can help autistic children to better self-regulate, and endorphins, the chemicals our body releases when we exercise, make us all feel happier. With little or no private outdoor space available this can be more challenging, so consider what you can do with the resources you have and the restrictions you are under. If you can go outside, think about quieter times to go and less busy places you can visit. If you have to stay inside, see if you can clear some space and use age appropriate videos that get children moving, or play games like Simon Says with them yourself. Watch for any signs of illness You know your child better than anyone, so you will know if they are find it difficult to communicate how they are feeling, and so won’t behave like a ‘typical’ sick person. Some will carry on as though they are not sick, whereas some will absolutely implode. Sometimes, autistic children with temperatures, may even become more engaged than usual – so it may be best to establish your child’s baseline temperature, and check it daily to make sure. What to do if your child is presenting symptoms The most important thing to do is to follow the guidance issued by the authorities in your area and seek advice from medical professionals. In the UK, you can find the latest guidance at www.gov.uk. Understanding and experience of the symptoms of coronavirus, particularly as they may affect children, is developing all the time so it is important that you stay up to date with the latest guidance. The key thing to do if you think your child, yourself or anyone else in your household may have coronavirus is to isolate and stay at home immediately while you seek further help and advice. This minimises the chances of infecting others if the virus is present. Other helpful advice when someone is showing symptoms: Keep the sick person at home unless they have to get medical care and have been advised by a medical professional to attend a doctors’ surgery or hospital. In that case make sure that the destination knows that they have symptoms of COVID-19 and ensure the sick person is wearing a mask in order to protect others Keep the sick person separated from the rest of the family, in a specific room. You should also make sure they use a different bathroom from everyone else, if possible. Try and keep their eating and drinking utensils and clothing separate from the rest of the families as well. All items should be thoroughly washed after each use Everyone should wear masks when they are in the same room as the sick person, and all windows should be kept open (if the weather allows). Disposable gloves should also be worn in case you come into contact with any items that have been in contact with the sick persons bodily fluids, such as saliva or mucus. Throw away your gloves and mask after each use, and don’t touch your eyes, nose or mouth Make sure the sick person coughs or sneezes into a tissue – which should immediately be disposed of in a lined rubbish bin and then hands should be washed thoroughly with soap and hot water – or use hand sanitiser if no hot water is available Wash all of your clothes after each wear, at the highest possible temperature as dictated on the label. Clean your hands after loading the washing machine Access to help / resources Can I get mental health help for my child during the COVID-19 pandemic? Yes, you can. In the UK, GP’s and mental health services, including CAMHS (Child and Mental Health Services) are still operating – while observing the social distancing guidelines as set out by the UK Government. While this means that you may have to have a telephone or video consultation with them rather than in person, they are still able to support you as best they can – and it may take longer than usual to get an appointment. In the first instance, your first port of call should be the usual health professional you contact – as they know you and your family best. If you need more urgent help than they can offer, then you can try: Asking your normal GP for an emergency appointment Calling NHS 111 for advice Calling your local mental health advice line Calling 999 or going to your nearest open Accident & Emergency Department, if you have urgent medical needs What other resources are available? If you are already a member of any local support groups, they will likely be able to offer help and advice, and your child’s school or nursery will also have help available. For all physical health concerns, speak to your doctor in the first instance. There are also a wide range of other online resources available, but do take care to check that information you use comes from a reputable source that you trust – unfortunately there is also a good deal of misinformation around at this difficult time. You can download a PDF copy of this resource by clicking the button below. Download the PDF here Other Resources How Alternative and Augmentative Communication (AAC) can help your autistic child This resource gives an overview of alternative communication methods, including AAC devices and how they can be used to help non-verbal autistic children. How to communicate with a non-verbal autistic child This resource provides information around what non-verbal autism is, as well as actionable advice on how to communicate with a non-verbal autistic child. What is Non-Verbal Autism? This resource aims to provide a range of information, support and ideas about how to help a child with autism.