Individuals and families continue to face disruptions in their daily routines as the COVID-19 pandemic continues. In this report by SADE OGUNTOLA, experts state why children with developmental problems such as autism are worst hit by the effects of the pandemic.
A DERONKE Ogunsanwo is a 21-year-old autistic lady who was brutally beaten up after people assumed that she wanted to steal a baby in Awe town. Although Aderonke, who behaves 15 years younger than her age hardly goes out from her parents’ home in Ibadan. But on that day, she had missed her way and found herself in Oyo town.
Ronke’s mother recounting the incidence said her daughter despite her difficulty with maintaining conversation had taken an Okada to Ojoo, but didn’t know how she eventually got to Owode in Oyo town.
Her love for babies had drawn her to some babies playing close to the motor park. It was the police that rescued her from being lynched.
Agnes is five years old but is yet to speak in a meaningful way. She tends to use a limited number of words and often use ‘you’ when she means to refer to herself; and then uses ‘I’ when referencing others.
Unlike the older two children of the family, Agnes is often pre-occupied with her own world, playing alone and does not seem to show any emotional attachment to her parents or siblings.
She is however, very rigid about the order of doing her things, or the use of a regular routine. She becomes very upset whenever her way of doing things is changed, even a little bit, and would start banging her head against the wall or biting her hand while screaming continuously.
Some of the family friends think she is just a spoilt child who likes to get her way but the parents are becoming more worried, especially due to her poor speech and emotional detachment. Otherwise, her physical growth and appearance have been normal.
Unfortunately, children with developmental problems like autism may not understand why their daily routine is changing as a result of the COVID-19 lockdown and this may lead to stress, frustration or anxiety. These emotional triggers can exacerbate the effects of autism and may lead to more severe behavioural and communication problems.
The American Autism Association says autism or autism spectrum disorder (ASD) causes a person to establish repetitive behavioural patterns and this often impairs their social interactions with other people.
It is typically diagnosed in childhood and usually its symptoms can occur before three years of age. Some autistic children only develop more obvious signs as they become older.
There are different types and severities of ASD. Some autistic people can live independently, while others require more sustained care and support.
Dr Jibril AbdulMalik, a consultant psychiatrist, University College Hospital described the lockdown period due to COVID-19 as a tough time for everyone, especially children with special needs such as cerebral palsy and autism.
According to him, “children with autism like to keep to routine or a fixed structure. For instance, a child that is used to going to school or to the cinema on a particular day who wouldn’t be able to do that because of the social distancing may become very upset and start to throw tantrum.”
The restriction of movement, arising from the lockdown could also affect how they have contact with. “A child that is already used to a caregiver before and now because of the restriction, the caregiver can no longer come to attend to him at home on a daily basis may have difficulty adjusting like their parents.”
Dr AbdulMalik added “Some of them also have special dietary needs and as such don’t take some particular food items. With the restriction in movement, there may be the scarcity of some food items or particular fruits that they particularly like.
“Frustration that they are not able to do the things they usually enjoy will be stressful for them. They bang their heads against the wall; hurt their arms and so on. So anything that will upset them and make them start throwing tantrums is a stressor that is better avoided.”
Autistic children may not understand why their daily routine is changing, which may lead to stress, frustration, or anxiety. These emotional triggers can exacerbate the effects of autism and may lead to more severe behavioural and communication problems.
He, however, said helping children with autism and other developmental conditions cope this season will entail the parents communicating well with them and rewarding them with pleasurable things that they enjoy.
In addition, he said helping them retain as much as possible, their old daily routine and staying in contact with their healthcare providers is important.
Although some autistic children may not fully understand the nature of the COVID-19 pandemic, parents and caregivers can focus on explaining their family’s current situation and how it affects the child’s regular activities.
The explanation may include how other activities, such as family vacations and weekend outings will be on hold for a little while they might continue doing their school work from home.
AVM Femi Gbadebo (rtd), founder, Benola Cerebral Palsy Initiative stated that the COVID -19 pandemic had brought increased hardship for vulnerable people, including individuals with developmental problems such as cerebral palsy and autism.
He declared; “sourcing for medications, hygiene products and therapy to maintain children with these conditions has become a problem. For instance a child with cerebral palsy is supposed to have physiotherapy if possible everyday but because of cost and the lockdown due to COVID-19, this had been very difficult.”
Femi and Alaba Gbadebo are proud parents of Olaoluwa, a male child born on 14 June 1996 and diagnosed at birth as having developmental delays, later confirmed to be Cerebral palsy.
Through Olaoluwa, they have come to see first-hand, the tremendous potentials in a child living with Cerebral Palsy, the complexities of managing an individual living with the condition, the difficulties in assessing proper care in a developing country and the stress which the condition places on family members and careers.
AVM Gbadebo declared that even with Olaoluwa, he had resorted to limiting the number of people visiting his home, including the number of times Olaoluwa gets physiotherapy at this period, because of his vulnerability to the coronavirus.
Moreover, AVM Gbadebo said persons with disability and physical challenges were greatly neglected in Nigeria, and the neglect was further worsened by the lockdown due to COVID-19.
“Emphasis has been on giving foods support to the poor this COVID-19 season. But when you look at the picture of how things are done, often the vulnerable groups, including people with conditions like autism are not recognised as a target group.
“In fact, their own needs are more and it is not the rice that is given to the mother whose child has cerebral palsy. Yes, the mother may eat the rice, but it will not meet the needs of that child with cerebral palsy. We keep following trends such as the COVID-19 pandemic but we forget that other things that should be kept in the public view.”
Several interventions such as exercises can reduce the severity of autism’s effects. In a 2019 review article, researchers found that those that exercised three times per week showed significant reductions in repetitive and aggressive behaviours. These behavioural improvements may last for at least 2 hours after doing exercise.
The following tips can also help parents reduce disruptive behaviours and deal with challenges related to autism.
*Giving praise when doing a complex task and avoid using negative language
* Practice good sleep hygiene and keep distractions to a minimum
* Break tasks down, think out loud and introduce wait time
*Explain rather than command
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