Although the provision of applied behaviour analytic services to persons with Autism Spectrum Disorder and other developmental disabiliities is an essential service in Ontario, we have not been immune to the impact of the COVID-19 pandemic. Because of the shutdown declared by the Province in early spring, we closed our congregate programs of Children’s College in Toronto and the two HUB programs (Oakville and Toronto). We put into place safety protocols for staff who continued to provide home-based IBI services and where possible, moved to more internet-based communication in place of direct meetings. Since then, we have reopened Children’s College and the HUB programs with physical distancing, PPE’s, sanitizing procedures while continuing with those protocols in our home-based IBI services. All of our programs are open to new referrals and the level of staffing and service provision is comparable to pre-pandemic levels.
Even with the promise of an effective vaccine, we are faced with many more month of coping with COVID-19. This impact is particularly difficult for persons with Autism Spectrum Disorder and other developmental disabilities who now are likely facing a reduced range of community activities including the closure of swimming pools, gymnasiums, bowling lanes and a long list of other activities. Now, more than even is the time to have a consistent routine and plan fun activities within the range of settings that are available. Here are our suggestions for the “do’s” of organizing your son or daughter’s day.
- Establish a clear daily routine of times to get up in the morning, things to do in the day, and a routine associated with going to bed.
- Provide visual schedules of the day, showing the breakdown of each activity in the order in which they will occur. Use the visual modality that would be appropriate for your child, including words if he or she can read, line drawings or photographs.
- Periodically remind your child what activity is coming up.
- As an activity is completed, have your child remove the visual cue of that activity in some way (e.g., remove a picture, place a check mark beside the activity, etc.).
- Try to plan more fun activities to follow less enjoyable activities.
- Use “When / Then” statements, such as, “When you finish making your bed, then you can have a bowl of Fruit Loops”
- Use a timer to show how much time is left in an activity. There are several visual timers available for free for I-pad and other electronic devices that depict a diminishing pie shape as time goes on.
- Use a calendar for the week to show when upcoming events are occurring
- Arrange Skype, Facetime, Zoom calls between your child and family members or friends.
- Place a limit on the amount of tv, games, and electronics that your child view or make contingent on the completion of a lower preferred activity.
- Set up a reward system for your child for the completion of low preferred tasks (e.g. chores). You may use access to electronics as a reward.
- Have your child complete expected chores such as cleaning up his or her room, setting the table, getting dressed independently.
It is also difficult for children and adolescents to follow the expectations for prevention of COVID-19 when they do go out into the community, such as wearing a mask, or physical distancing. Principles and procedures of applied behaviour analysis have been used to teach children with ASD to wear masks or to physical distance. In brief, this is how these interventions are designed:
- Set a measurable objective (e.g. Sean will wear his mask for 10 consecutive minutes when in the house with 0 attempts to remove the mask)
- Initially model how to wear a mask
- Start with your child wearing a mask for a very brief times and build up form there (e.g. Johnny wears the mask for 10 seconds without removing, then move to 20 seconds and so on)
- Give a simple instruction for wearing a mask
- Use visual reminders
- Reinforce mask wearing frequency with descriptive praise and preferred objects or activities
- Gradually increase duration of mask wearing and the locations.
Here are examples of the methods used by two organization to teach a child with ASD wear a mask. https://www.mayinstitute.org/news/acl/asd-and-dd-child-focused/teaching-a-child-with-autism-how-to-wear-a-mask-or-face-covering/