In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families. Those challenges get far more intense during disasters. And coronavirus is proving to be the biggest disaster of all. Providing education and social services is proving to be very difficult.
The COVID-19 pandemic has led to an unprecedented global challenge in the care of individuals with ASD and IDD. [Intellectual Developmental Disorder] At a time when new waves of the pandemic are predicted, maintaining safety from increased transmission risk of COVID-19 in residential and specialized inpatient settings is of paramount importance. In lieu of dearth of international recommendations for protection of individuals with ASD and IDD requiring strong assistance in daily living, we draw attention to the following perspectives:
Infection Prevention and Control
- Care needs to be provided in the safest way possible without discrimination on the basis of disability;
- In view of asymptomatic COVID-19 forms, there is a need to strictly maintain social distancing measures, wear masks or cloth face coverings, and to compartmentalize COVID-19 free and COVID-19 safe areas, as well as to systematically plan to conduct RT-PCR testing before any admissions and transfers;
- Since ASD and IDD are complex neurodevelopmental conditions, there is a need for infection prevention and control approaches adapted to the cognitive, behavioral, and physical care needs of individuals and in implementing all barrier measures;
- The standard approaches to delivery of care need to be adjusted to incorporate telehealth and videoconferencing services in order to facilitate rapid access to primary care, and specialist providers, including those in mental and behavioral health, to access platforms with expertise in ASD and IDD, to address pressing COVID-19, as well as non-COVID-19 related conditions, and to make referrals as appropriate;
- For continuity and minimal disruption of care, direct service and ancillary personnel need to be monitored daily for any COVID-19 related symptoms and contact and advised to stay home according to occupational health policies;
- Since professional practice needs to be daily guided, it is important to continuously share the global experiences, and new evidence-based knowledge and scientific breakthroughs.
Screening
- It is essential to promote a well-coordinated and continuous screening strategy among residents and caregivers, with contact exposure risk assessment, as well shared decision-making involving families, guardians, and referral partners involved in care pathways;
- For rapid, highly responsive screening, the facilities need to be self-sufficient in performing nasopharyngeal COVID-19 testing with continuous availability of appropriately trained staff and provision of requisite transportable screening test kits;
- Since individuals with ASD and IDD have severe adaptive difficulties, screening needs to be offered on-site with benefit of personalized care and insight into their needs and any anticipated risks.
