Insight

In recent years mental health in

autism has been in the spotlight –
and never has this been more
important than now.
The Covid-19 outbreak has
impacted on every individual, every
generation and every society
across the world in ways not seen
in most of our lifetimes. The effects
on the mental health of the nation
have been speculated upon
greatly; realistically, we will not
know the full extent of this until
after the lockdown ends.
Already, we know that young
people with autism experience
anxiety and depression at much
higher rates than those without
autism. The question now is: in
what ways might the pandemic
have affected the mental health of
young people with the condition?
The closure of schools has
meant a disruption in routine for
many, which has been a challenge
to manage. Some may have been

One unexpected
positive for some
has been a reduction,

Manage the
rather than an
increase, in anxiety”
eligible to attend school; however,

negative, seize
for many the pandemic involved
an adjustment to a new routine,
and the loss of familiar activities
and people.

the positive
Particular challenge
Helping young people with autism
understand why they have to abide
by a new set of rules will have
been a particular challenge for
some, although many have
adjusted remarkably well. Even for
those attending school, it will have

How do you stay in control during

been a very different experience to
Not all bad: as usual. A loss of support services

these emotionally charged times well as many

difficulties,
may have had a negative impact
on the emotional well-being of
and prepare for life after lockdown? the pandemic
may usher in
many during this period.
On the other hand, one
Dr Ann Ozsivadjian, a clinical opportunities
for positive
unexpected positive for some has
been a reduction, rather than an
psychologist with expertise in mental change for
people with
increase, in anxiety. This has been
largely due to a removal of the
health issues in autism, offers advice autism and
their families
pressures of social, learning and
other demands related to attending
school. Mainstream education,

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 Can you contribute to research into the development
of babies with a family connection to autism?
At the Oxford University BabyLab we want to understand more about skill
development in babies with an autistic parent or sibling. This will help us to even with support, can be
develop ways of boosting development in the future. extremely difficult – even
traumatising – for many autistic
young people to navigate, while for
We’re interested in the development of Executive Functions; parents the SEN system can be
complicated and often adversarial.
those tricky skills that allow us to resist temptation, solve A return to life as it was before
problems, and plan and organise our lives. Our online Dr Ann Ozsivadjian is
an independent
the pandemic may be greatly
anxiety-provoking for many on the
study investigates how babies develop these important practitioner, an spectrum, posing an extra
skills. It includes a few fun games to try with your child. Honorary Principal
Clinical Psychologist
challenge to parents of those who
already had a strong preference
at the Evelina London for staying at home. Many parents
To be eligible for this online study your youngest child must: Children’s Hospital, will have made huge efforts to get
and an Honorary their children into school and they
• Be less than 2½ years old Researcher at King’s may feel they are starting all over
• Have an immediate family member with a diagnosis of autism (this College London. She again in helping their child
specialises in overcome anxiety.
could be their mum, dad, or sibling as long as they are a blood relative) neurodevelopmental Might this period lead to more
disorders and has a flexible delivery of education for
particular interest in some young people with autism,
Visit https://tinyurl.com/y5vwlvlo to find out more, and to register to take mental health with an ensuing positive impact on
part in the study, or email alexandra.hendry@psy.ox.ac.uk problems in autism, mental health?
and delivers training
Early Executive Functions in infants with a family connection to autism: Ethics reference number: R64473/RE001
and research in this Tolerating uncertainty
area. Some autistic children may have
worries about the virus that are
difficult to allay. Intolerance of
uncertainty has been recognised
as a central driver of anxiety in
autism, and this has certainly been
and continues to be a period of
great uncertainty.
Often, this is managed in one of
two ways: either by helping to
make the world a more predictable
place through routines, visual
timetables and other strategies; or
by gradually helping individuals to
tolerate uncertainty through
introducing elements of uncertainty
to a child, for example through
planned surprises.
As always, preparation will be
key in adjusting to life after
lockdown. This is somewhat
challenging when things keep
changing all the time, but one thing
we can do is to map visually what
we know, and what we don’t know.
For example, we can illustrate on
paper how life was before the
pandemic, what happened, and
what we know (schools will open);
we can also show what we don’t
know (exactly when and for whom).
Timeline or social story
This could be done in the form of a
timeline or a social story. Perhaps it
could even include a historical
perspective – for example,
highlighting that we have had
Many parents
will have made
huge efforts to get
their children into
school and they may
feel they are starting
all over again”
pandemics and other disasters
before and survived, with some
changes for the better afterwards.
When it comes to accessing
mental health support, there may
be extra difficulties in reaching the
already-scarce resources because
staff may have been redeployed or
buildings closed. Parents may be
left dealing with extremely
challenging problems in isolation.
However, the rapid switch to
online consultations has provided
another unexpected positive. While
LISTEN TO THE PODCASTS
Dr Ozsivadjian has recorded a number of autism-related podcasts in
collaboration with The Association for Child and Adolescent Mental Health,
which are freely available online. These can be found at:
https://www.acamh.org/?s=Ozsivadjian&current_tab=podcast
Insight
telemedicine certainly has its
challenges, it has worked
surprisingly well for many, and can
circumvent some difficulties such
as having to travel long distances
to access specialist care, or having
to adjust to meeting a new person
in an unfamiliar environment.
Meeting someone for the first
time within the comfort of one’s
home can actually facilitate the
engagement process, not hamper
it; therefore, parents should not be
put off seeking help if they need it.
Opportunities for change
A disadvantage is that online
consultations do not teach
community access skills. It means
that, as with education, optimal
delivery of mental health services
might involve flexibility and an
individual approach.
The impact of this pandemic has
been devastating for so many and
the effects are likely to be felt for a
long time. Some changes to society
may be permanent, some short-
lived. However, with every disaster
comes opportunities for positive
change. For people with autism, it
may provide an opportunity for
more flexible delivery of education
and mental health services, making
both easier to access, with a
positive impact on mental health.
Let us not squander this
opportunity by simply returning to
business as usual, and consider
more autism-friendly practices
using some of the new ways of
working that are available to us.

Create your own social stories

By Lorna Strong
A number of websites can help you to write effective social stories about life after lockdown. Among them are:
l PBIS World has a concise explanation of the different elements that should be used in social stories:
https://www.pbisworld.com/tier-3/social-stories/how-to-make-a-social-story-fact-sheet/
l Touch Autism offers an iPod app for creating and sharing social stories, which makes adding images easy:
http://touchautism.com/app/social-stories-creator-library/
l Your Autism Toolbox has links to a number of resources for creating social stories:
https://yourautismtoolbox.com/social-stories-for-kids-online/
l Your Therapy Resource explains how to create social stories with visual supports:
https://www.yourtherapysource.com/blog1/2017/11/18/write-social-story-visual-supports/

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