A Model of Support for Families of Children With Autism Living in the COVID-19 Lockdown: Lessons From Italy

Abstract

Italy has been the European country most affected by the COVID-19 pandemic to date and has been in social lockdown for the longest period of time compared to other countries outside China. Almost overnight, Italian behavior analysts were faced with the challenge of setting up remotely whole-family systems aimed at maintaining adaptive skills and low levels of challenging behavior to be carried out solely by caregivers. Given these extraordinary circumstances, the protocols available from the applied behavioranalytic, parent training, and autism literature did not appear to fully meet the needs of parents having to be with their children under extreme levels of stress in a confined space with limited reinforcers for 24 hr a day, 7 days a week. To meet this unprecedented challenge, we developed a dynamic and holistic protocol that extended to the full day and that recognized the need for sustainable intervention delivered solely by parents, who were often looking after more than one child. These practices are presented in this article, together with a discussion of lessons we have learned thus far, which may be useful for behavior analysts working in other regions in which the effects of the pandemic are not yet fully realized. Although somewhat unorthodox, we include some parent comments at the end with the goal of sharing the parent perspective in real time as this pandemic unfolds across the world.

Behavioral Implications of the Covid-19 Process for Autism Spectrum Disorder, and Individuals' Comprehension of and Reactions to the Pandemic Conditions

“…One such program was described in Italy, where after parents of children with ASD reported their children no longer being satisfied with their usual reinforcers, becoming increasingly uncooperative, and displaying high stereotypy and problem behavior levels, researchers formulated a protocol through their observations and discussions with parents. Verbally interactive children received tutoring and the parents of preschool-aged and minimally verbal children received parent coaching ( 13 ). As they did not yet analyze their data, the effectiveness or mediators thereof are not known.…”

Psychosocial consequences of COVID‐19 in children, adolescents and young adults: A systematic review

“…Children with ASD, monitored by their parents, more frequently failed to follow through simple instructions, lost their independence and communication skills, engaged in problematic interactions with their parents, and performed pranks for attention. 9 A series of guidelines, techniques, and physical exercises have been promoted in order to help ASD children remain calm during the pandemic. 9 Children with ADHD, on the other hand, have been reported by their parents as uncontrollably angry, and unable to stay focused and perform everyday routines.…”

“…9 A series of guidelines, techniques, and physical exercises have been promoted in order to help ASD children remain calm during the pandemic. 9 Children with ADHD, on the other hand, have been reported by their parents as uncontrollably angry, and unable to stay focused and perform everyday routines. 10 New guidelines have been established to help address the mental health issues of children, proposing that monitoring medication and maintaining a strict sleep schedule could be beneficial.…”

“…5 Studying antenatal mental health is of particular importance because of the potential negative consequences on perinatal outcomes, 6 so we sought to assess anxiety and depressive symptoms in pregnant women living in the current quarantine conditions in Greece by applying the most commonly used instruments for antenatal anxiety and depression: the State-Trait Anxiety Inventory (STAI) and the Edinburg Postnatal Depression Scale (EPDS). [7][8][9] All pregnant women who received routine antenatal care in a university clinic during the 6-week period of total lockdown were asked to complete the STAI and the EPDS. State (S)-and Trait (T)-anxiety scores are categorized as <36 (no anxiety), 36-45 (mild anxiety), 46-55 (moderate anxiety), 56-65 (high anxiety), and >65 (very high anxiety).…”

Vídeos para instrução remota de cuidadores de crianças com desenvolvimento atípico durante a pandemia de COVID-19

“…Tendo em vista as orientações atuais das instituições de saúde, os analistas do comportamento têm apresentado guias e parâmetros a fim de auxiliar a tomada de decisão quanto aos moldes de atendimento a clientes com desenvolvimento atípico, juntamente com exemplos de implementação desses protocolos, visando manter a assistência mesmo nesse momento de instabilidade gerado pela pandemia (Canovas et al, 2019;Colombo et al, 2020;Cox, Plavnick, & Brodhead, 2020;Degli Espinosa, Metko, Raimondi, Impenna, & Scognamiglio, 2020).…”