Covid-19 has caused heavy losses around the world according to the World Health Organisation, and we have witnessed the devastating effects of it in every sphere of our life i.e. education, job, employment, living and economic condition. The pandemic led to great changes in all aspects of life which affected most people especially vulnerable groups such as elderly patients with chronic diseases and persons with disabilities and their families.
A lot of studies have been conducted across the globe to understand and measure the impact of this pandemic, and the challenges it posed. Disability is a large and complex challenge as it greatly limits the performance of daily life activities and the ability to integrate with individuals. Children with disabilities (CWD) need health, education and rehabilitation services to improve the individual’s functional performance and some of them need this throughout their lives, depending on their physical, psychological or otherwise health status. These services are usually provided by rehabilitation teams, schools, special schools, daycare centres that work to improve functional performance and promote the child’s level of independence as far as possible.
Covid-19 brought countless challenges in different aspects of CWD and their caregivers’ lives. Most of the mothers found it exhausting to meet their children’s needs solely at home and keep them occupied. The challenges were multi-faceted; physical, social, psychological and financial burdens. Physically, caregivers experienced negative physical health due to increasing physical load that causes musculoskeletal disorders, exhaustion and fatigue. Socially they felt isolated and there was not much scope of social engagements that these children usually get in their school, therapy centre or daycare centre. Though the world has seen the booming tech communication and virtual meeting platforms, it was not that smooth and easy for many of the children with autism and communication challenges.
There were symptoms of increased anxiety, lack of sleep, behavioural outbursts and temper tantrums among the children which were majorly incurred due to lack of understanding of the outer world situation and disturbed daily routine. The engagement of these children with their school and daycare centres used to give some kind of respite for the mothers to breathe between their other home chores and responsibilities and at the same time keep the child occupied with therapeutic and meaningful engagements during the day. Many mothers went through psychological stress during the pandemic, feeling that they are not able to do enough or not able to give enough time to their children while managing office work and home responsibilities.
Other associated conditions that were observed among children, like meaningless munching at different times as there were no structured engagements at home, increased self-stimulatory plays and behaviours or spending long hours of screen time with phones and tabs. As the pandemic graph is on the lower side and gradually many schools and centres are opening up allowing children to come for sessions in small batches, caregivers are again witnessing some challenges as children seem to be struggling to get accustomed to getting back into the school setup.
How can their routine and structure be re-established? First and foremost, it is important for the centres to have a multi-sensory approach, organise play-based sessions with the children to allow them to explore the tools and environment, make them interested and look forward to their sessions. A visual timetable, a to-do list with a clear expectation of what to do, how to do and how much to do should be presented to the child at the beginning of the activity. The predictability of the session and the expected reinforcements at the end of successful completion always motivates the children, especially with communication challenges and autism.
Further, a social story of their daily routine with pictures and words based on the child’s comprehension level can be made, displayed and explained at home to familiarise the child with the new routine. Children with special needs need to be equipped with a better coping mechanism to face life.
(The author holds a Masters in Special Needs and Inclusion (University of Northampton, UK), is a Rehabilitation Council of India certified special educator (autism consultant) & an arts-based therapy practitioner.)