Tommy’s family is disrupted.
My husband and I are really missing Tommy's regular in-class sessions with his occupational therapist Tanya. Tommy misses her too. Tanya has been working with Tommy, who is ten, for the past two years and has helped him establish structure and routine that supports his particular needs related to autism spectrum disorder. We have been grateful that Tommy has been able to stay integrated into a classroom with his peers. With the ongoing closure and re-opening of schools during the pandemic, Tanya’s services have been cut off and he is acting out terribly at home, becoming frustrated with even simple tasks, anxious, unable to control his emotions. He can't respect barriers like the closed door that allows me to work from home. He disrupts everyone's schedule, including his younger brother and sister, leaving us all in a state of upset and sleeplessness.
Occupational therapists are essential to mental health. Tommy and his family need an OT.
DISRUPTION affects every member of a household and is exacerbated by close quarters, limited access to usual and desired activities and the extra energy needed to support a high-needs family member. The potential negative effects of the COVID-19 pandemic response is disproportionately affecting high-risk populations including children with behavioural problems or complex medical needs.¹
Changes to daily schedules can mean a loss of skills children may have gained during in-school programming or lead to increased anxiety and problem behaviors. In addition, parents who are also at home unexpectedly and juggling work with home life have fewer options to balance all these demands.
Fortunately, Tommy’s mom had benefit coverage to support the family in finding an OT. The occupational therapist helped Tommy and his family to:
Understand the new reality of COVID-19. Talk through and learn age- appropriate strategies. Use social stories and concept maps. Find new activities that are possible within the pandemic context like an online exercise or dance program, virtual visits to attractions or puzzles and games.
Use guided questions to help understand what Tommy’s behavior is communicating. Implement cognitive strategies for the whole family; match the size of reaction to the size of problem, and make a visual 'map' of the impact Tommy's actions have on others and how what he does makes others feel.
Learn about managing stress. Find new ways to deal with frustrations when habits and routines are disrupted, in a way that matches their physical space, culture and family dynamics. Get outside and connect with nature. Schedule together time and independent time, when each family is in a different room doing an independent activity.
·Establish a firm and predictable daily routine. Set up a visual schedule for Tommy to use throughout the day. Develop, draw and post family rules about respecting closed doors. Encourage a bedtime routine for Tommy that improves his sleep, including no screen time an hour before bed. Use comforting, calming strategies like a weighted blanket, soothing music, or a ‘white noise’; machine. Consider taking photos of Tommy doing what is expected and use those photos to make a book to help him better understand a positive routine.
Make a special school workspace for Tommy in his home. Include seating that helps him focus, like a wedged wiggle seat or a chair ball. Give him a break from sitting. For example, stand and do “wall work” at a wall-mounted chalk board, or make space for him to lie on his tummy and work with his arms propped.
Encourage connection with other parents of children with autism. Find virtual resources or groups that meet to share their coping strategies and other ideas for positive family activity.
Because of occupational therapy, our family is back on track.
The Canadian Association of Occupational Therapists (CAOT) provides a searchable national directory of occupational therapists for all Canadians to find the occupational therapy services they need.
Occupational therapy. Making the everyday possible.
1. Wong CA, Ming D, Maslow G, Gifford EJ. Mitigating the impacts of the COVID-19 pandemic response on at-risk children. Pediatrics. 2020 Apr 21 [Epub ahead of print].