Effect of Covid on Autism
The COVID-19 (C-19) pandemic affected everyone. Especially, Persons with ASD (autism spectrum disorder) may be at increased risk of experiencing difficulties coping with the impact of C-19 (e.g. due to unexpected changes to usual activities and routines, and the general sense of uncertainty). The Effect of Covid on Autism in pandemic has a detrimental psychological and mental health impact, according to earlier studies.
Therefore, this preliminary study gathered the perspectives of health and social care professionals and researchers about:
Vulnerability factors for coping with the pandemic
Impact of the pandemic
Service Provision during the pandemic
Interventions to support re-integration during and post-pandemic
Read the original article
Why was this study on persons with ASD conducted?
The views of clinicians and researchers to address these aims is important as they have a working knowledge of service provision before C-19.
Importantly, they can offer insights into how services can be adapted currently and prospectively.
An online survey was conducted among professionals working with persons with ASD. The survey questionnaire comprised of questions with Likert-scale rating and free responses to the 4 factors mentioned above. Quantitative data were analyzed descriptively, and qualitative data thematically. It’s significant to note that, despite having an impact on society as a whole, the COVID-19 pandemic may not have an Effect of Covid on Autism on everyone’s mental health.
Firstly, who answered this online survey?
Secondly, what experience with ASD did these professionals have?
Lastly, what about the age group of persons with ASD the professionals were treating?
Let’s look at various opinions provided by the professionals for the four factors…..
1. Vulnerability factors for coping with C-19 and lockdown
The professionals were asked to list their views about what were the factors that were affecting persons with ASD due to the C-19 situation and the new normal. Here are some responses:
Social Communication Impairment
PwASD struggle to verbalize their thoughts
Also, communicating by telephone/online was difficult
Additionally, some ASD comfortable only with face-to-face interactions
Practitioners may find difficulty in communicating with PwASD
Difficulties tolerating uncertainty and coping with change
PwASD feel anxious due to uncertainity and changing routines
anxiety about being unable to plan treatment due to uncertainities
anger, upset and anxiety for not being able to do normal daily routine before C-19
Unable to use coping stragies in new-normal
Neuropsychological Traits
PwASD prefer knowing rigid set of rules
Some PwASD experinced difficulties when someone flouted C-19 rules
some found it difficult to cope with hanging rules
2. Positive and negative impacts of lockdown on persons with ASD
Let’s look at what different professionals working with ASD termed as Positive and Negative Impacts of C-19 on PwASD
Impact on PwASD
Positive Impacts:
Not going to less- less anxiety
managing homework was easier- Less anxiety
Much needed break from socializing
Negative Impacts:
Loss of specialized services at schools/rehabilitation centers
changed routine – unsettling
difficult to learn academic content at home- more distractions
Impact on Families of persons with ASD
Positive Impacts:
Families grew resilient during C-19
Families put greater effort to make PwASD accommodate to changes
Negative Impacts
Unable to provide a safe and predictable environment, families were stressed/anxious
Impact on Professionals working with ASD
Professionals were affected or recovering from C-19 while working simultaneously
the constant pressure to get upskilled to use online technology
uncertainty about jobs/layoffs
Juggling personal and professional lives while working from home was perceived to be difficult
3. Public Health Response to C-19
Information Dissemination
Lack of accessible information regarding C-19
Conflicting messages that come through media causing ambiguity
Frequent changes in legistations causing confusions to PwASD
Lack of clinical information for prfessionals to deal with PwASD during the pandemic
Social Distancing Measures
Some PwASD were happy with Social Distancing which reduced their social anxiety
Some of them did not like the new change
PPE
PwASD percieved a Lack of and Inconsistent use of PPE
Staff could not be trained to manage anxiety of PwASD towards PPEs
Staff thought that PwASD may not be able to understand and tolerate healthcare workers usage of PPEs
4. Service Provision for persons with ASD during the Pandemic
It was noted that professionals reported disruption of services to PwASD during the pandemic. A total of 27% of professionals reported mild disruptions, 65% reported major disruptions and 8% reported complete loss of services to PwASD.
Infrastructure and Staffing
Problems faced
Loss of direct appointments
Staff shortage
Redeployment of staff
Trouble adapting to telerehabilitation methods
Evidence-based vs Clinically Pragmatic approach
Professionals found it difficult to decide between informal methods of testing during a pandemic or to wait till restrictions were lifted.
Additionally, they feared the loss of quality of services
Also, they reported of lack of guidance
Finally, changes during the pandemic led to internal conflict between team members because of lack of guidance
Advantages and Constraints of telehealth
Advantages
Particularly, some PwASD felt tele-mode to be minimally anxiety-provoking
Preferred this mode if they had knowledge of operating devices like mobile or laptops
Constraints
Some PwASD found these methods confusing
A few of them refused to do online therapy
Other PwASD preferred audio-only mode
Professionals who participated in this survey listed certain considerations for telerehabilitation. General considerations relevant to autistic individuals, their families, and professionals
Firstly, Can prove efficient (e.g. saves on time and travel)
Reduces costs (e.g. for travel)
Requires IT equipment, software, skills and internet connection
Can be difficult to observe and interpret non-verbal cues
Can feel an intense method of communication
However, it requires focused and sustained attention
Patient-related factors
Can be a difficult method of input to understand (e.g. for young children)
Can be anxiety-provoking
Some Persons with ASD may prefer audio, rather than visual communication
It might result in avoidance (e.g. easy to leave the room)
May find it difficult to process information
Unable to use tactile forms of communication
Family-related factors
Requires time
Requires privacy
Professional-related factors
Can result in ‘Zoom fatigue’
May lead to a blurring of professional and personal boundaries (if working from home)
However, it requires a suitably confidential space to work
Treatment considerations
Minimal evidence base for telehealth in autism
Difficult to incorporate aspects of standard psychological interventions (e.g. exposure)
May not be able to practice strategies in real-world settings
Service-related factors
Easier to liaise with internal and external agencies (e.g. multi-agency meetings)
Allows for flexibility in appointment duration and frequency (e.g. shorter, more frequent)
Lack of clear policies and guidance
Lack of IT infrastructure (e.g. cannot receive/reply to emails from certain providers)
May not be possible to provide some aspects of standard assessment or treatment
5. Inequalities in Service Provision during Pandemic
Professionals reported that there were the following inequalities in service provision during the pandemic:
ASD diagnostic pathways were hampered during the pandemic
Adequate referrals could not be made due to closed educational institutes
Remote working resulted in delayed diagnostic processes
However, Not all PwASD had access to avail telerehabilitation
Lastly, Telerehabilitation was difficult for PwASD with other comorbidities
Looking into the future for persons with ASD
The participants felt “This may be a really good opportunity to make the world a more autism-friendly place”. As a result, it is important to examine people with ASD for vulnerabilities, psychological consequences, educational outcomes, leisure activities carried out at home, work status, and the pandemic’s Effect of Covid on Autism population.
Based on the themes discussed above the participants listed certain important factors to be considered to make things better for PwASD.
Change of Ethos
Evaluate needs on Individual Basis
Importantly, look for opportunities to make the world a better place for PwASD
Research Implications
Additionally, study what helps families cope under special circumstances
Emphatically, Reshape Service Provision
Making information accessible
providing more flexible clinical services
preparing professionals to cater to PwASD in special circumstances such as C-19
Living in the new normal
provide professional assistance to families to cope with new lifestyle post pandemic
Support for PwASD
Design and make available more support groups for PwASD
Lastly, Help them understand new regulations and new ways of living
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