Back to school: Routine is key for children with autism 

Many children on the autism spectrum will find the return to school challenging due to the impact of repeated lockdowns - experts say they will need additional resources

OUT AND ABOUT: Before heading back to school, James Marshall and his sister Sarah enjoy a day out in Cobh.

Returning to school after an extended period due to a pandemic will be a challenge for many children. For those with autism, it could be especially difficult. 

At its peak, lockdown meant little or no social interaction or access to support services for children with special needs.

Sinead Marshall's nine-year-old son James, who has high-functioning autism and attention-deficit/hyperactivity disorder (ADHD), found life in lockdown difficult.

“It takes time for James to accept new people and situations, to make his mind up about them. He only reveals what he wants to reveal on his own terms,” she says.

From Kilmallock, Co Limerick, James missed out on occupational and speech and language therapy sessions that would usually be carried out in a school setting. The pandemic increased his social anxiety - he couldn't visit his favourite shops or accompany his mother to the supermarket - and important visits to the doctor were postponed.

“James missed out on 12 months’ worth of ENT (ears, nose and throat) care, we had to wait 18 months for him to have a simple ear procedure done. Since the procedure, he’s been in much better form so it must have been troubling him for a while,” she says.

With four older siblings, all girls, James enjoyed the time spent at home during the initial lockdown. But changes in his behaviour became apparent when he returned to the classroom last September, says his mum. “I’d get emails from the teacher about problems in school. We paid for a private psychologist to figure out why he was having problems with reading and writing. 

"By the second lockdown, he became very self-aware and almost obsessed by Covid. It caused him to regress and he couldn’t focus on his online school classes,” she says. 

Engaging with online lessons was difficult for James. Seeing multiple faces at once onscreen would cause stress and he eventually lost interest completely.

“It would overwhelm him, so we would go for nature walks together and talk about the plants and wildlife instead,” Marshall says.

Impact of school closures 

Recent research conducted by Dublin City University (DCU) highlights the challenges of school closures on children with autism, including refusal to leave the family home, a new fear of death and excessive hygiene routines.

Led by Dr Sinéad Smyth from DCU's School of Psychology,  the study is part of an ongoing investigation into the current and long-term impacts of Covid-19 related restrictions on children with autism and their families.

The most prevalent challenges for the children revolved around routine, sleep and emotional regulation. An overall decline in skills and abilities was reported for 63.3% of children.

“The impacts of the first and second school closures can be seen in the behaviours of children including more refusing to go to school once it reopened. We also know that this has impacted parents. Parenting stress can be higher in parents of autistic children relative to other parent groups,” says Smyth.

Stress on families 

According to Dr Michael Ryan, a Dublin-based psychotherapist who works through schools with children on the autism spectrum, families have a difficult time navigating the uncertainties and probabilities posed by the pandemic.

“Most people don’t deal with change very easily,” says Ryan. “The first lockdown came suddenly, and many found it pleasant to have extra family time. It was the second lockdown where we saw a lot of the problems emerge."

The pressure of establishing routine and discipline was compounded by navigating how to work from home, parenting, teaching, all while feeling anxious about finances, he says. 

Problems with sleep and an increase of anxiety and despair among both parents and children emerged.

“The parents of children on the autism spectrum I’ve spoken to said there were virtually no services or state interventions operating, so their children didn’t have access to occupational therapy equipment or assistive technology that help their development,” says Ryan.

To prepare children with autism who may be anxious about returning to school, he recommends establishing a routine and repeated mentioning of the school.

“This could equally apply to neurotypical children who feel anxious about returning to school,” he says.

Additionally, he advises showing children photographs of their new school and teachers in advance and introducing a reduced timetable for the first few weeks.

“Try to pre-empt and give them as much notice as possible as to what they can expect. Get them to try on the uniform to make sure the fabric is suitable, and don't make them wear a tie straight away. Meet their sensory needs. Assurances about homework will also put their minds at rest,” he says.

Additional support needed 

Elena Simón, an occupational therapist at the Shine Centre in Cork, says children with autism should have access to extra learning support to keep on track of their educational development.

“We must ensure these children make a smooth transition back to school. Personalised support is needed to assess and address the impact that two consecutive lockdowns have had on them,” she says.

When contacted for comment, a spokesperson for the Minister with responsibility for special education Josepha Madigan issued a statement in relation to additional support for students with special needs.

“This year we will have over €2bn allocated to special education this year, almost a quarter of the entire Department of Education budget. For the coming school year there will be over 13,600 special education teachers allocated to mainstream schools, who will support class teachers to address the special educational needs and learning needs of pupils who attend mainstream schools,” the statement reads.

Returning to school 

Sinead Marshall is preparing James for the return to school as best she can.

“We haven’t mentioned much to him about it yet since he finished July provision,” she says.

July provision, or the July Education Programme, is a funding initiative run by the Department of Education and Skills (DES) and usually offered to children on the autism spectrum who are enrolled in special or mainstream schools.

For James, it means he is socially connected with peers in a school setting. Some schoolwork is done but education is mainly done through playtime and day trips to places like Fota Wildlife Park.

“When the anxiety happens, we try to talk about it. This week, we are doing an activity each day together to keep the anxiety to a minimum– today it’s going on the train to Cobh and go to the playground, just for fun.”

Overall, there is no ‘one size fits all’ plan for supporting children with autism and the long-term impact of lockdown and COVID restrictions on children with autism will take time to evaluate, says Ryan. “The truth is, we don’t know how that’s going to pan out over the next few months or years. It’s difficult to know what long term effects this will have.”