Our hearts and minds go out to those affected by Hurricanes Harvey and Irma and especially appreciate the challenges families with children with special needs are facing.
We would like to share some ideas that may be useful in supporting you and your children during this difficult period that impacts children and families in different ways. We hope the information and list of resources in this blog post will be helpful to you and other providers.
Serena Wieder, PhD
Helping Children with ASD, SPD and other Special Needs through Natural Disasters
Children on the autism spectrum and with other special needs present in many different ways and we do not always know what they are thinking or feeling. It is very difficult to understand when or why disaster strikes, but we know every child on the autism spectrum has feelings and may know more than we realize. Some may be able to verbally express feelings and fears and ask questions verbally or through devices, while others will communicate through facial expressions and gestures, go back to earlier behaviors, become more repetitive, suck their thumbs and try to self-sooth, or become loud, scream or just shut down. All children convey feelings in the ways they act and during stress may behave differently.
General Guidelines in Helping Children through Natural Disasters
Every child on the spectrum, just like every person, has feelings. Children sense and read the signals of their caregivers and others in their environments even when they do not understand all the words or what is causing all the upheaval. If evacuated or rescued, they will wonder why and be confused. Others watching these events on TV will also wonder if this might happen to them. It is important to monitor and limit the flow of information when possible and explain what is happening in simple ways they might understand. It is most important to help children feel protected and safe with you and your family. You can do this by holding them on your lap, having them hold a lovey or blankie, and rub their back or head. You may want to sing a familiar song or just move back and forth quietly. If your child is bigger, sit closely side by side, arms around him or her, and do the same.<p/P
Keep your child’s developmental level in mind to understand what things mean to them. We neither want to under- or over-estimate their ideas and feelings. When uncertain, ask them questions if possible, and keep observing changes in behavior or moods. Young children may not understand they will not be going back to the home they left. Even older children will not necessarily grasp the scope of what has occurred. It is important to focus on the security embedded in your attachment and staying together. You are now their primary anchor and they need your constant reassurance that you will take care of them.
Share information about next steps only when you are fairly confident about it. Children do not tolerate being suspended well. You can reassure them you will tell them and meanwhile you are safe together.
Do not be surprised If your child just wants to go on and play and not talk so much. That is fine and provides relief and some fun in their “children’s world”. They may come back to you later with questions or you may see changes in their behavior that will indicate they are responding to what you said but are still confused or scared.
Stress effects can take many forms, from disruptions of basic sleep and eating patterns to irritable, hyperactive or sedentary behaviors. In young children the stress may range from tantrums, defiance, impulsiveness, or aggression, to clinging, tearfulness, inability to make choices, and self-harm. Set limits when someone might get hurt, but generally be calm, soothing and reassuring. These behaviors are just some of the manifestations of anxiety and confusion re the disruption of their lives. Others may seem very adaptive and better than usual as they cope with the situation at hand and do not want to add stress, though delayed reactions may become apparent later.
While these are worrisome signs and times, research does show the greater majority of children do bounce back. Your child may even try to help, distract or entertain you. Appreciate these efforts and remember the good times together. Look at the photo album in your mind!
What to do?
There is no one solution to supporting children experiencing the repercussions of the hurricane. But some principles apply to all. Parents know their children well and need to know themselves as well.
Check in with your verbal child by asking how they feel or what they are worried about. Do this at a time you feel relatively calm and composed and are able to listen and ask “what else are you –were you worried about? You want your child to feel he can express his worst worries, e.g., what if I get lost, or we won’t find our house, or won’t see daddy again, or won’t find my teddy, or my iPad is broken…Expect to be surprised by your child’s response – the worry may seem trivial or may be terrifying if you hear your child ask if you will die. The more specific they are, the better your reassurance can be as you explain, e.g., we will stay together, we will find a home, you are safe now and we are young, healthy and strong. If your child asks how do you know, remind him or her of friends who will help, and acknowledge it was scary but now the hurricane is over and it is time to fix things.
Do not ask too many questions either and always monitor your child’s grasp or understanding. Respect his boundaries and comprehension. There will be other times to talk together. If your child was upset or avoidant, you might check in at bedtime and mention you were thinking of (what happened earlier – e.g., I was asking too many questions – Maybe we can talk now if you want to tell me how you are?
If you will need to make changes in where you live, allow your child to tell you what he will miss or what was lost. Share some of your feelings selectively and be empathic and reflective. Especially focus on what you will remember if changes are necessary and plan ahead when ready. It is ok to express “wishes” and dreams, but support reality if needed. Such conversations will go on for some time even after you have resettled.
If your child does not express his feelings through words and direct conversations, observe them carefully to find clues to their feelings and fears. Some children will use toys or re-enact some of their experiences through play, or cling to certain objects or rituals. Some might draw hurricanes or volcanoes. Others might crash blocks or cars. And some may have nightmares or get alarmed by their own fantasies. Still others may worry if they did something wrong as they cannot explain why else this happened. It is important to listen to these thoughts and then reassure them.
Listen empathically and reassure your child by holding them tightly if they like this and explain what can be done to alleviate some of their fears. Use familiar ideas such as community helpers, or rescue heroes they are familiar with, or religion they know. See if they remember other situations when they needed help and got it. Do not minimize or dismiss any feelings – it is ok to be angry, scared or wishful. These may be your feelings too and if it upsets you too much, pause until you can share and reflect on these feeling calmly. Do not be reluctant to get some help. Understanding your feelings and reactions are important so that you can listen to your child carefully. If they are overanxious, out of control, or seem depressed, seek help.
It will take time to return to a stable life and there are still unknowns and stress to anticipate. It will be important to revisit your child’s feelings and thoughts and keep observing their behaviors and ways they express themselves. But also remember that children will not want to stay with their worries for long and will seek the familiar activities they enjoy and want to spend time with you in familiar and positive ways.
Some Practical Tips
Re-establish routines as much as possible – Routines provide predictability and security so restore what you can, e.g. Meal and snack times, baths and bedtime rituals, school, daily Floortime (playtime), walks, timesto talk and other routine activities. Don’t forget favorite attachment figures or objects.
Have children help out in any way possible, such as setting the table, clean up, or small errands which allows them to be close and to be valued as they participate in the recovery of the family. You can make shopping lists, unpack groceries, pack your bags or help a neighbor.
Even establish new routines such as family game night, or cooking dinner or baking cookies together, or taking walks at a routine time. Play the games your children enjoyed before and add new ones, e.g. hide and seek, charades, Zingo, Candyland, Sorry, Chess and other games they understand. With older children you might make cards and write letters to family and friends.
Use visual schedules or lists to define the day and plan these the night before together as this will provide opportunities to talk and reflect on the day, as well as think ahead about tomorrow.
Mind and body go together! It is important to plan physical activities everyday, so get out to the park or some other safe area to play, ride bikes, play stop and go games, go running and climbing or get to a gym. It is useful to have movement breaks throughout the day – jumping jacks, running, Brain Gym, etc.
Sensory solutions – Consider your child’s sensory needs – keep the environment quiet or provide headphones, provide music that is soothing and calming, provide paper and markers for art, have various fidget toys or spinners to keep hands busy, or mouth toys and gum. Children also love squishy toys they can squeeze that light up and flashlights. Weighted blankets may be useful for restless sleepers – improvise as needed. Also check out your backpacks!
Floortime play every day! Try to set aside at least a half hour of uninterrupted time a day to be with your child or children. Connect and follow your child’s interests where he can initiate playful things you like to do together. For some children this may mean bubbles or pushing cars back and forth, rough and tumble play, chase and hide and seek. For children who are already symbolic or presymbolic, get out your toys and follow their ideas – have pretend food, doctor and tool kits, favorite figures, vehicles, and create stories. For children who bridge ideas create longer stories with their favorite characters and enter their fantasies and magical thinking, or re-enactments of the hurricane and other challenges which bring them to victory. Establish a time your child can count on you to play with him.
Be sure you always tell your child you are leaving when you need to separate, where you are going and when you will return. Do so even if you are not sure they will understand everything? Similarly, prepare for transitions and have your child pack their back pack or little suitcase with the items they love, or even favorite toy in their pocket, that help them feel secure even if just going to visit family. A transition object represents security. Have back ups!
As indicated earlier, most children bounce back and the above suggestions may be helpful in the interim, but do not hesitate to get help when you are not sure. Disasters can be overwhelming and getting help sooner rather than later is always a good choice. Speak to therapists you know or call into help lines. Many of us are standing by to help you.
Profectum is a non-profit organization dedicated to the advancement of individuals with ASD (autism spectrum disorders), mental health challenges and other special needs. We do this through a broad range of training programs for parents and professionals of all disciplines. Please check out our website, www.Profectum.org where we have a free Parent Toolbox to help you interact and play with your child.
Additional Resources for Helping Children with ASD, SPD and other Special Needs through Natural Disasters
Hurricanes and other natural disasters can be difficult for persons with autism. Sesame Street has put together this video and guide for families following a natural disaster:
The CARD center in Florida has put together a personalized social story about Hurricane Matthew to help our families explain what is happening. http://cfl.ucf-card.org/media/57f577ac17db4.pdf