Consequences of COVID for children with ASD and their families

Has the virus affected psychosocial factors? What to do?

Subjectively, most humans can probably rattle off a few ways that the sicknesses caused by SARS-CoV-19 have affected our day-to-day lives. There are probably degrees of effects, with some being more horrible than others (loss of a loved one vs. fretting about whether to go to a park). However, as special educators and others interested in these effects on the children whom we serve, it would be nice to have more than isolated (i.e., "random?") anecdotes.

Aarabi et al. (2021) cast light on this issue by reviewing the literature in “Psycho-social consequences associated with COVID-19 in people with ASD and their families: A literature review” that is to be published in Medical Journal of the Islamic Republic of Iran in October 2021. They identified 17 articles (either in Persian or English) and found that “the change in routine and uncertainty caused by COVID-19 have caused distress for people with ASD and will worsen their symptoms and mental health. Excessive stress worsens the mental health of caregivers, and as this burden increases, they report higher rates of social harm, depression, and anxiety that affect their daily functioning” (from the abstract).

These findings may not seem surprising, predicated as they are on the idea of disrupted routines. Most people who've worked with individuals with autism recognize that interruptions in the regularities of daily living and activities can often be upsetting. And, to be sure, many of the studies included are based on sometimes unreliable self-reports. However, having some documentation of the idea, provides impetus for addressing the associated problems.

Importantly, the review is international in scope. Aarabi and colleagues included results from Canada, China, Cuba, Italy, the UK, and the USA (see Table 1). (I encourage readers to examine Table 1, as it provides a lot of data about the studies and findings.)

So, what do we, teachers and parents, do? How do we help? Szabo et al. (2020) provided what seems to me to be excellent guidance. They list best practice that “are composed of evidence-based kernels, or irreducible units of behavior-change technology that can be assembled into exercises that are easily adapted for children and adults with varying repertoires” (p. 569). They clustered these practices into four categories, including “exercises that (a) promote the use of schedules and routines, (b) promote family values and norms, (c) increase positive reinforcement, and (d) serve as antecedents for prosocial behavior” (p. 570). Here are the four kernal-informed practices from the first group:

  1. Help parents establish clear expectations:

  2. Use activity schedules;

  3. Teach parents to use timers; and

  4. Give “tootles.”

There are lots of good recommendations in the paper by Tzabo and colleagues, and those recommendations are clearly and substantitvely explained. If readers can snag a copy of the article and share the wealth, that'd be great!


Aarabi, M., Abdi, K., & Khanjani, M. S. (2021). Psycho-social consequences associated with COVID-19 in people with ASD and their families: A literature review. Medical Journal of the Islamic Republic of Iran, 35(131). [NOTE: As of my posting, the DOI fails, so use; the PDF indicates that it is available under a CC BY-NC-SA 1.0 license, so it's OK to snag and share a copy as long as one doesn't try to make $$ from it.]

Szabo, T. G., Richling, S., Embry, D. D., Biglan, A., & Wilson, K. G. (2020). From helpless to hero: Promoting values-based behavior and positive family interaction in the midst of COVID-19. Behavior Analysis in Practice, 13(3), 568-576. [NOTE: The preceding link may be inaccessible to some readers; the following link, which is clearly tracked, may take readers to a version of the article that can be downloaded without cost:]