Autism therapies

Meeting needs despite quarantine barriers.
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Illustration by James Heimer

Children, especially those with an autism diagnosis, most often thrive on routine. Knowing that lunch comes after recess or bedtime comes after brushing teeth. Having a predictable daily routine.

But routines got tossed out the window thanks to a global pandemic and quarantine. No daily school routine, no seeing teachers and friends, and a move to virtual learning.

“Every student has been suffering and faced major barriers, but for those with autism certain structures weren’t there. The change was hard,” said Gary Walsh, supervisor of special education at Grand Rapids Public Schools.

For GRPS, which has 18 classrooms throughout the district for children diagnosed with autism and other needs, teaching during a pandemic meant breaking down the barriers to learning in a new environment.

“For some students, the change to the virtual environment was easier, and we could see signs of growth and strength,” he said. “But some had to build up the stamina to sit at a computer. We had to work with parents too because just turning on the computer so they could hear and see the teacher was harder for some children.”

Stephanie Sweebe, assistant clinical director at Gateway Pediatric Therapy, has seen the same issues with upset routines in the children serviced by the clinic. Gateway provides applied behavior analysis (ABA) for children diagnosed with autism up to age 21. ABA is an evidence-based treatment in which behavior analysis (the science) is applied to every aspect of life.

New challenges

Children diagnosed with autism have dealt with quarantine-specific issues such as not tolerating increased hand-washing, mask-wearing, sitting for longer times in front of a computer, and understanding how to use a laptop or virtual platform.

“New forms of communication mean new barriers to overcome,” said Stephanie Sweebe of Gateway Pediatric Therapy. “Children must learn how to respond to a teacher, how to raise a hand during virtual school, use the chat function. We can coach families by observing and identifying tools to work on so the child can be more independent.”

Grand Rapids Public Schools sent whiteboards, markers, books and other classroom materials to children with an autism diagnosis. “Our teachers went above and beyond, scheduling time with families outside of school hours. They went out of their way to keep that growth going,” said Gary Walsh of GRPS.

“There is always a relationship between skill deficit and challenging behaviors,” Sweebe said. “The treatment goal is to alleviate those deficits. Each child has an individualized plan in which we look at the behaviors, issues related to the behaviors and create a program to help them overcome those behaviors.”

Consistency is key, she said, and it’s been taken away during the pandemic. “Parents are trying to identify how a child can receive the level of support they got at school. They have to figure out how to get speech and occupational therapies, etc.”

This has prompted lots of inquiries from families about how to support their child’s online learning, about how they can help their child be successful with this new way of doing school.

Gateway, which opened its Grand Rapids office in March 2020 but began seeing clients in the fall of 2020 due to COVID-19, does not do diagnostic evaluations so families must come in with an autism diagnosis before an intake evaluation is completed. ABA best practices have specialists “looking at the underlying reason for the challenging behavior,” Sweebe said.

She says the field is ever-evolving with staff constantly looking at new research, new assessment tools and new teaching strategies. One of the newest advances is addressing problem behaviors in a trauma-informed way, understanding and alleviating problem behaviors in a way that keeps everyone safe and conflict low. Sweebe also mentioned therapies that involve mindfulness, acceptance and ABA, and combining ABA with other sciences to enhance treatments and outcomes.

Increased parent support is key to success both at Gateway and at school, especially amid the pandemic and the different learning circumstances it has prompted. Teachers are adapting, as are parents, to the new protocols.

“In the teaching courses, there is no pandemic shutdown section. We reinvented the wheel and made it happen,” Walsh said.

This story can be found in the April 2021 issue of Grand Rapids Magazine. To get more stories like this delivered to your mailbox each month, subscribe here

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