The COVID-19 outbreak has triggered an entirely new set of parenting challenges. Everyone in Singapore has been making adjustments to the new way of living amid the pandemic. Coping with this new norm can be particularly difficult for children and adolescents with special needs, as well as their families. It is understandable that the strict safe distancing measures and uncertainty of the situation may cause confusion, disruptions to routines for the children and their families. Here are some tips for parents and caregivers looking after their loved ones with special needs.
1. Keep Communication simple and clear
The information you present to your child should be according to his developmental and cognitive abilities. Remember to give him time to process and understand the changes that are happening. You can keep your child engaged and enhance his understanding by using stories or pictures in your explanation. Very often during a crisis, we get inundated with the latest news (real and fake). You may want to limit your child’s exposure to news, both offline and online. Instead, you may guide him in the processing and understanding of what he watches on the news and social media to minimise misinterpretation of information, which may further fuel anxiety.
2. Take a visual approach to teaching self-care and hygiene practices
When teaching your child good hygiene practices such as masking up and covering his nose and mouth when sneezing, try using pictorial guides e.g. comic strips, and other visual sequences such as using a wave instead of high-fives for greetings.
For individuals with special needs who may have difficulties tolerating wearing a mask, a face shield could be worn (especially for children under 12). Written instructions completed with pictures on the sequence of steps to good hygiene practices can be provided to explain and teach these new routines. For example:
- Pack an extra mask, and check that you have a hand sanitiser in the bag.
- Drip a small amount (size of a 10-cent coin) of sanitiser on one of your palms. Rub to clean your hands.
- Put on your mask – hold it by the ear loops and put on both ears. Pull the top and open section of the mask gently to widen it completely. Ensure that the mask covers the nose and under the chin. Press gently on the nose strip to shape over the nose.
- Sanitise your hands again.
- Try not to touch your face when wearing your mask. Also try not to touch your mask until you need to remove it.
- If your mask is soiled (such as when you sneezed into it), change your mask.
- Remove your mask by holding on the ear loops. Do not touch the cloth material of the mask. Dispose of the mask in a covered bin immediately. If using a reusable mask, it may be helpful to have a sealable bag to hold the soiled mask before you can wash it. Remember to wash the inside of the bag too after the soiled mask has been removed before putting in a new mask.
3. Establish a routine in stressful times
In stressful periods, routines help us maintain our sense of control over our lives. This applies to your child with special needs too. If the old routines do not work, try establishing new ones. This can increase structure and a sense of predictability. Written or visual schedules displayed in a common space will be useful for everyone to refer to. At the same time, you can also highlight routine family activities, such as having breakfast as a family and watching an online movie/programme every Friday evening. This can provide some sense of normalcy for children with special needs.
4. Make time for fun activities
Fun activities help children to de-stress – these may be specific and unique to each individual with special needs. Those with sensory needs may need to engage in activities that provide sensory stimulation.
5. Exercise regularly / Outdoor activities
If your child has a habit of taking long walks in parks or public spaces, allow him to continue but limit the time spent on such activities in public spaces during this period. It may be useful to explain to the child that it will be a shorter-than-usual session and the reasons why. Keep each session safe by masking up and preparing your hand sanitisers.
Given that most ActiveSG facilities have reopened in the current Phase Two (safe transition) of post-Circuit Breaker, individuals with special needs can also resume outdoor and recreational activities such as swimming, racquet sports, beach and playground visiting. Safe distancing measures will still apply, hence it is important for caregivers to explain to the individual with special needs about what he can or cannot do prior to initiating the activity.
If your child has a habit of taking long walks in parks or public spaces, allow him to continue but limit the time spent on such activities in public spaces during this period.
6. Maintain personal well-being
Some individuals with special needs may have limited communication skills. It may be important for families and caregivers to recognise signs of distress in individuals who may not be able to articulate their emotions or experiences. Some common presentations could be sleep problems such as waking up at night, being clingy or having more frequent or longer tantrums.
For some individuals with special needs who are better able to express themselves with words, it does not necessarily mean that they may be able to understand or regulate their emotions well. They may find it hard to adjust to changes in routines or the restrictions to doing what they like. Families and caregivers should note changes in sleep or eating habits, or withdrawal from enjoyable activities as signs of possible distress.
Families and caregivers can try to support these individuals by checking in with them such as providing a listening ear or comfort (sometimes in their preferred way). Some individuals with special needs may engage in some restricted or repetitive behaviours. Some of these behaviours are meant to be self-soothing for them, and in the current situation, they may engage in these behaviours more as a coping mechanism. Allow time for such activities, as long as it does not impede daily functioning and is safe.
Despite your best efforts, you need to recognise that there is a chance that an individual with special needs may show regressive behaviour when experiencing stress. Should the individual with special needs experience overwhelming anxiety, he may present behaviours that seem like a loss in skills or ‘problem’ behaviours. Always remember to keep calm, reinforce basic rules and continue to praise positive behaviours no matter how trivial they may seem to you. Seek help from the doctor if the problem persists.
7. Support for families and caregivers
Given that some individuals with special needs may not be able to fully comprehend the pandemic situation, they can sense the anxiety from their caregivers and family. Your child can tell when you are happy, sad or anxious. When you are going through an unpleasant emotion, it is perfectly fine to let them know that adults can feel anxious too. You can try to be a role-model and demonstrate how both of you can stay calm and relax, together. Stay focused on the present – what you can do at this point in time, and not let the worries consume you.
If you need support, reach out for help by talking to someone or calling the helplines, specifically the National Care Hotline (6202-6868) that provides support for anyone during this COVID-19 situation. If you need advice on the management of your child, you can also contact your child’s school support personnel or attending therapists for further support.
Here are some useful resources for families caring for children with special needs during the COVID-19:
Additional resources and helplines:
- Institute of Mental Health’s Mental Health Helpline (6389-2222)
- Samaritans of Singapore (1800-221-4444)
- Silver Ribbon Singapore (6385-3714)
- Community Psychology Hub’s Online Counselling platform (CPHOnlineCounselling.sg)
- Big Love Child Protection Specialist Centre (6445-0400)
- HEART @ Fei Yue Child Protection Specialist Centre (6819-9170)
The contributor is the Principal Clinical Psychologist at the Department of Developmental Psychiatry, Institute of Mental Health.