COVID, Autism, and Stay Safe: Ask the Health Professionals

By Amy Carrison, PsyD, LADC and W. Brooks Donald, MD, MPH, Developmental and Behavioral Pediatrician, retired

As Minnesota slowly begins to reopen businesses across the state this week, new requirements are being announced to keep everyone safe. From social distancing to wearing masks, many of these new regulations can make the prospect of leaving the house a scary one.

AuSM Counseling and Consulting Services therapist, Amy Carrison, PsyD, LADC, has heard from many on the spectrum that Shelter in Place was comfortable as they did not have to try to navigate challenging social norms. While Shelter in Place had challenges, the time to rest and recuperate without masking has been a relief for some.

Dr. Carrison offers some tips on how to re-enter the community with the governor’s move from Shelter in Place to Say Safe Minnesota.

1. It is common to feel anxiety about the virus and worry about the uncertainty of this time period. You also may feel confused by new social norms and rules, frustrated with people who don’t follow those rules, and overwhelmed by having to mask in neurotypical society.
2. It is OK to return to the world gradually and in ways in which you feel most comfortable. You don’t have to begin socializing again until you are ready. Maybe you start with a few trusted friends and engage in activities that you prefer, such as taking a walk together, playing a game, or watching a movie.
3. You don’t have to jump back to your pre-COVID schedule all at once. Maybe you start by seeing other people once a week and increase over time. You also could start with a smaller number of people and gradually increase to places with more people.
4. Make sure to monitor the amount of energy you have each day, and practice daily self-care. If you go out and see friends and find you’re overwhelmed, give yourself time to recuperate. Plan to do something enjoyable and relaxing when you get back home after you go out. Where possible, start with activities outside of the house that you like.
5. Be gentle with yourself. If you find yourself more anxious or unhappy with being around other people, that’s ok. You may have to spend more time on self-care than usual while you build up your stamina and get used to socializing again.

To help keep the community informed, AuSM Board Member, W. Brooks Donald, MD, MPH, a retired Developmental and Behavioral Pediatrician, shared additional notes about autism and COVID.

Question: Are people with autism at a significant risk for COVID 19?

Answer: There are two risks involved here, one is the risk of serious complications or death from infection, the other being at risk for contracting and spreading the virus to the community.

Regarding the first risk, because the spectrum is so broad, the condition of autism by itself would not put an individual at serious risk. Serious risk only would include those individuals with autism having moderate to severe intellectual or physical disabilities, or co-morbidities that may compromise their ability to manage the illness such as seizures, neuromuscular disorders, and other conditions mentioned in the CDC guideline. Autistic individuals without these conditions would not be considered at higher risk than the general population. It’s important to remember that most of these infections are mild and self-limited. We just need to be as careful as we can, particularly regarding those in higher risk categories.

Regarding the second risk of contracting or spreading the infection, certain children and adults with autism participate in repetitive touching of objects or individuals, have difficulty with personal boundaries, and with other sensory issues related to their social environment may be at increased risk for COVID. All individuals with autism should follow the CDC recommendations, and parents and caregivers should have increased care and vigilance regarding these measures. Particular attention should be given to social distancing when in public; wearing masks when in public; covering coughing or sneezing; avoiding repetitive touching of objects, surfaces, or other individuals in public spaces; thorough hand washing; and cleansing of all surfaces frequently used. Also remember that 40 to 50 percent of the population, children and adults, will have the infection without symptoms, be either asymptomatic or pre-symptomatic 4-5 days before symptoms develop, and able to spread the virus to others. Wearing masks is important to protect ourselves and others.

If anyone in either group develops symptoms (fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea), they should be isolated at home and communicate with their health care provider by phone or remotely before visiting the clinic or hospital.

Question: How do we safely open up our public spaces?

Answer: There are ways to lower your risk for developing COVID 19 illness while still enjoying some common summer activities. Regardless of the activity, remember that the risk of air transmission of the coronavirus occurs through both large droplets that are inhaled or fall onto persons or surfaces within a few feet, as well as very small inhaled aerosolized droplets that can spread up to six feet or more depending on the environment, air flow, and location. This transmission increases with close exposure over longer periods of time with less airflow or ventilation. The virus can be spread through heavy breathing, speaking, singing, sneezing, and coughing. In all situations, continue to wear a mask indoors and outdoors in public settings; maintaining a six foot social distancing minimum; frequent hand washing or sanitizing before and after transitions or activities (remember those with tactile sensory needs may touch many surfaces); and avoid touching face or eyes (this is difficult for everyone).

National Public Radio developed a resource that helps classify the risk of certain popular public activities. “From Camping To Dining Out: Here’s How Experts Rate The Risks Of 14 Summer Activities.”

Additional Resources for the Autism Community

AuSM’s Counseling and Consulting Services team currently is accepting new clients for individual therapy via telehealth. Immediate openings are available for clients with the following insurances: Medical Assistance Plans including Hennepin Health, Ucare, Medica Choice Care, Blue Plus, and HealthPartners Care; also Blue Cross Blue Shield, Health Partners, Medicare, Ucare Individual and Family plans, and Preferred One. Please contact our office at 651.647.1083 ext. 13 or e-mail autismcounseling@ausm.org with questions about family therapy, case consultation, other services, and if you have insurance that is not listed.

AuSM is creating and collecting support resources to help guide you through the coronavirus pandemic. Access AuSM COVID resources.