The month of April is Autism Awareness Month. Within the United States, the prevalence of autism spectrum disorders (ASD) has increased from affecting 1 in 125 children in 2010 to affecting 1 in every 59 children in 2020 (Autism Society, 2020, para. 3). Markers of autism include verbal and non-verbal communication deficits, social skill deficits, and restricted and/or repetitive behaviors (The Autism Community in Action [TACA], 2019, para. 1). In this blog post, the third marker– repetitive behaviors–will be addressed in response to COVID-19.
Repetitive behaviors include an insistence on sameness and an inflexible adherence to routines (Applied Behavior Analysis Edu., n.d., para. 1). Changes in routines such as eating new foods, having visitors in the house, or cancelling activities can incite anxiety-induced or problem behaviors from individuals on the autism spectrum.. With the outbreak of COVID-19, day-to-day routines have been uprooted with school closures, shelter-in-place orders, and social distancing policies. The current situation can be difficult to navigate for families with special needs individuals. Listed below are a few different techniques and supports that are used within a music therapy session that can be used to help individuals with ASD and their caregivers and parents as well.
1. Visual Schedule: In music therapy sessions, visual schedules are used with many clients to provide structure on what the individual can expect and what will happen next. These are shown to reduce anxiety, reduce frustration, and decrease problem behaviors (Autism Speaks, 2018, para. 6). In a music therapy setting, visuals might include song choices or instruments. To build a visual schedule for learning purposes, Autism Speaks recommends starting with the first subject that an individual would normally begin with at school and then follow the same order of subjects and activities they would normally do (Autism Speaks, 2020, para. 4). For younger individuals, a visual schedule with just 2 items shown in a “first, then” manner may be more appropriate. A free visual schedule template and icons can be found HERE as well as an First/Then schedule template can be found HERE. A preview of the two can be seen below:
2. Positive Reinforcement: One of the guiding principles of Applied Behavior Analysis –ABA therapy– is positive reinforcement. When a desired action or behavior is completed by an individual, positive reinforcement or a reward is given (Autism Speaks, n.d., para. 5). This can be verbal praise, toy, food, a phone call to a relative, or anything meaningful to the individual. This increases the likelihood of the behavior in the future. In music therapy, a favorite song or instrument may be played or sung upon completion of another intervention. A popular non-musical reward is bubble blowing. Verbal praise is given frequently as well. Finding rewards for individuals with ASD can help them complete desired tasks when they understand that they will gain something upon completion.
3. Movement: Movement to music is an essential part of every music therapy session, regardless of diagnosis. For some individuals, movement acts as a reward for a completion of a task. For others, movement acts as a break between different interventions. GoNoodle provides movement-based videos for various ages. Video times range between short 3-minute videos and longer compilations up to 20 minutes. Non-screen options can include playing recorded music and having individuals mirror movements of another individual or using movement visuals to direct movements.
4. Breaks: While individuals with ASD may find comfort in routine, certain tasks may still pose a challenge. This is true within the music therapy setting as well. Taking breaks in between tasks or even during tasks can be beneficial to the individual. Setting a timer for a break can aid in providing structure as well, with the expectation that once the timer is done, work resumes (Raising Children Network, 2017, para. 7 ). For those individuals who are non-verbal, a free printable break visual can be found HERE.
5. (Indirect) Contact: Therapists and teachers alike are still eager to help in whatever capacity they can during these uncertain times. At this time, Therabeat music therapists are not only providing virtual music therapy but can provide home health videos and audio recordings as well. These videos/recordings can be movement–based or transition songs or songs based on academic concepts. Please do not hesitate to reach out if you are feeling overwhelmed by your child’s schoolwork or behaviors. Many of the techniques and supports listed above are very familiar to educators and therapists who can help guide implementation. Additional (non-affiliated) resources with more information about supporting your child with autism during this time have been included below:
Autism Speaks: How to cope with disrupted family routines during COVID-19
Autism Speaks: Visual Supports and Autism Spectrum Disorders
Raising Children Network: Changing Routines: Children and Teenagers with Autism Spectrum Disorders
The Autism Community in Action (TACA): Coronavirus and Students with Autism
-Sarah Deal, Music Therapy Intern
References:
Applied Behavior Analysis Edu. Why Is Routine So Important to People with ASD?. Retrieved April 4, 2020, from https://www.appliedbehavioranalysisedu.org/why-is-routine-so-important-to-people-with-asd/
Autism Society (2020). National Autism Awareness Month. Retrieved April 4, 2020, from https://www.autism-society.org/get-involved/national-autism-awareness-month/
Autism Speaks (n.d). Applied Behavior Analysis (ABA). Retrieved April 4, 2020, from https://www.autismspeaks.org/applied-behavior-analysis-aba-0
Autism Speaks (2020). How to cope with disrupted family routines during COVID-19. Retrieved April 4, 2020, from https://www.autismspeaks.org/news/how-cope-disrupted-family-routines-during-covid-19
Autism Speaks (2018). Visual Supports and Autism Spectrum Disorders. Retrieved April 4, 2020, from http://www.autismspeaks.org/sites/default/files/2018-08/Visual%20Supports%20Tool%20Kit.pdf
Raising Children Network (2017). Changing Routines: Children and Teenagers with Autism Spectrum Disorder. Retrieved April 4, 2020, from https://raisingchildren.net.au/autism/behaviour/understanding-behaviour/changing-routines-asd
The Autism Community in Action [TACA] (2019). What Is Autism?. Retrieved April 4, 2020, from https://tacanow.org/about-autism/