While it is important to create time and space for all family members to process uncertainty, individuals with autism may cope best when daily routines are only minimally interrupted. Routines can provide increased comfort for individuals with autism (Faherty, 2008) and may allow them to better express their feelings related to the changes. For example, instead of skipping a Friday night movie tradition because of increased screen time at other times during the week, choose a movie that can facilitate a conversation about the changes, loss, and/or associated feelings (e.g. Inside Out, Finding Dory). Combining the stress of the COVID-19 related changes with the addition of changed routines--especially if the new activities are nebulous or unstructured--could potentially exasperate or extend the adjustment process (Lipsky, 2013). Important routines to maintain include:
- Sleep/wake routines: Maintaining physical health is key for all family members and ensuring proper sleep is an important contributor. Sleep disturbances are more common in individuals with autism, thus extra attention may be required to support good sleep hygiene and maintain bedtime and waking routines (see more https://www.autismspeaks.org/sleep).
- Household chores/daily living skills: Participating in structured household chores and routines is a recommended strategy to support children and young adults coping with stress related to COVID-19 (https://www.nctsn.org/sites/default/files/resources/fact-sheet/outbreak_factsheet_1.pdf). Individuals with autism may need additional supports, such as a task analysis, to be able to participate in and/or complete these activities. Several examples are provided for common chores along with a template that can be used for a variety of daily living activities.
- Expanding the use of a visual schedule, and using one more regularly throughout the day, may help facilitate participation in activities at home and reduce anxiety. Many caregivers use elements of a visual schedule already (e.g. a calendar on the refrigerator, a list of errand locations, a photo of which therapist is coming to visit) and these can be extended for use across the day. The format and length of the schedule may vary based on the individual’s needs, and several examples are included.