We are so overwhelmed with going back to school. What can we do to prepare our family and our loved ones?

This “Got Questions” response is from Dr. Rena Sorensen, Ph.D., a clinical child psychologist at Cincinnati Children’s Hospital Medical Center.

Going back to school during a pandemic is no one’s idea of a great way to kick off a season of learning. There are many variables to consider, and there is no one right answer. Each family’s situation and choices will be different.

One unifying theme, though, is that your family and school-age children will be better prepared to succeed this school year by making a well-defined plan for school. You may find this planning tool useful as you think through your choices.

Your plan should cover:

Health and Safety

• What are the guidelines and options from your school/district?
  •  Write down your family’s choices within the school re-opening plan for your district.
• How will you prepare your child to follow the school health and safety plan?
  • Practice wearing masks and social distancing.
  • Review with your child how their routine will be different. Ask your child’s providers or teachers for a social story to walk through the new routine ahead of time.
• Will you need to request an exemption from these guidelines if your child is not able to wear a mask by the time school starts?
  • Some schools are permitting face shields for children who can’t tolerate masks, or allowing exemptions from face coverings.
• What will you do if your child is exposed to COVID?
  • Define areas to manage quarantine in your home.
  • Write down how your household will manage supervising your child’s health and learning at home while balancing work demands.
  • Designate a caregiver in the event you or your child has to quarantine.
  • Develop a plan for how to get groceries and other necessary supplies during quarantine.
• What will you do if your child has symptoms of COVID?
  • Talk with your primary care provider (PCP) about how you should handle this, including where to go for testing and when. Note that testing locations can change depending on many variables, including the number of cases in your area.
  • Consider whether COVID testing is something your child can handle and what resources are available to help. This social story may help.

Learning Needs

• How will your child’s IEP/504 or other learning supports be adapted this school year?
  • Consider both in-person learning and virtual learning environments, in the event of a school closure.
  • Organize your questions for the IEP team and/or specific administrators and teachers.
  • If your child is older, include their wants and needs in your discussions with the school team.
  • As a member of the IEP team, you can request a meeting specifically to address how the IEP will be adapted for online learning, in-person or a hybrid model for this year.
• What new routines will be in place for your child’s experience of the school day?
  • Write down your child’s schedule from a typical time they leave for school until arriving back home. Depending on your choice of in-person or virtual learning, this may include:
    • morning routine
    • bus pickup procedures or other transportation changes
    • classroom schedule and routines
    • new routines introduced by the school (such as “handwashing recess”)
    • lunch and cafeteria procedures
    • recess and gym class rules
    • the physical environment in the school and classroom
    • after school activities
    • returning home, including any new hygiene routines
  • Schedule time at home for teaching and practicing these new routines. These might include:
    • Adjusting to a new school bedtime, at least two weeks before school starts.
    • If you choose virtual learning, setting aside learning space in your home and establishing a schedule and routine for the remote school day.
    • Teaching handwashing using visual cues, social stories and a song or other auditory cues to help increase the washing time to 20 seconds. Write down when these are to be used, such as arriving home, before eating, after restroom or touching shared surfaces.
    • Teaching how to use hand sanitizer and when.
    • Teaching to cough/sneeze into elbow. Practice this skill and use social stories to explain the reasons.
    • Teaching social distancing with specific cues, such as stickers for where to sit or stand. Tell your child’s teachers about them so they can be used at home and at school. § Resources for many of these supports are available at Autism Speaks COVID-19 Information and Resources page.
  • Use a visual schedule at home to do a few structured activities each day to begin to prepare for the school routine. Start small and gradually increase the new routines you practice together.
  • Set up a way to communicate to your child’s teachers what is and is not working for your child. Write down how frequently you want to stay in contact with the school and how you’d like them to stay in touch with you.

Behavior Strategies

• Does your child have any behaviors or other challenges that would present a challenge for the health and safety guidelines at school?
  • Write down specific behaviors that involve hygiene or fluids, such as chewing, spitting, coughing, reflux, nose-picking, as well as other behaviors such as the child not tolerating adults wearing masks.
  • Work with your providers and teachers to develop strategies to handle these behaviors at home and in school, so that they are handled the same way in both settings.
  • Functional behavior assessments and specific behavior planning may be more necessary this year with the changes in routines and expectations around hygiene. Talk with your child’s IEP team about a consistent plan for home and school.
• How can your child’s communication needs be supported to avoid disrupted routines and maintain health and safety?
  • Write down strategies that can be the same for home and school, such as:
    • Speaking at a different volume and speed or using an alternative communication device to improve understanding.
    • Repeating instructions and asking questions to make sure your child understands.
    • When or if it is appropriate to remove masks or use mask alternatives around your child to improve communication. Special masks with a window may be needed for children who lip read or benefit from seeing more of the face to understand facial expressions.
    • Supporting with visuals and related tools, like choice boards and picture exchange communication systems.

Once you have outlined your preferences in your child’s back to school plan, remember to bring it to your child’s learning team in the spirit of collaboration. Everyone’s goal is to help your child have a successful year of learning. Working together can greatly improve your child’s back-to-school experience and provide some welcome structure in an otherwise chaotic time.

In a recent ECHO Autism webinar outlining these strategies, a panel of autism experts responded to some Frequently Asked Questions you might also find useful. The questions and responses are paraphrased below. You can also find a recording of the webinar, the slides presented and the list of resources shared by presenters at echoautism.org.

How do I navigate all this conflicting information?

Dr. Rachel Brown, MBBS, child and adolescent psychiatrist at University of Kansas School of Medicine: Use sources that rely on the advice of trained scientists and clinical experts. Internationally, that is the World Health Organization. In the U.S., the Centers for Disease Control and Prevention (CDC). Finally, your state and local health departments will further determine what will be effective in your local community.

How do we help our child who is afraid to go back to school and get sick?

Dr. Rena Sorensen: Fixation on infection or germs could become an issue for children with autism. We can help by making sure to manage our emotions and anxieties so they don’t feed off of that.

Give them a clear picture of what health and safety will look like at their school. Give them a consistent message that aligns with your school or school district policy.

Have direct conversations, and, when needed, use social stories to support their understanding. Focus on the positive and underscore what your family is doing to protect yourselves and others. Reassure them that medical teams are working on this and that everyone can do their part.

What can support coordinators and providers do to help families navigate this transition?

Melinda Odum MSW, LCSW, community resource specialist, University of Missouri: Providers should think about the families who don’t have any of this information about preparing for back to school – reach out to them so that they understand the choices in your district, the resources that are available to them and preparations they can make.

What about mandating masks? Can they legally require kids to wear masks at school?

Alicia Curran, director of operations for ECHO Autism and parent of an adolescent with autism: Rules can be broken with exceptions – for parents that can go to their physician to ask for an exception, sure, that might be an option. My son is very affected by autism and has lots of co-occurring conditions. He’s one of those tough kids to educate in ordinary times. We’ve worn masks from the beginning, and he wears a mask well now. Of course, there are questions about how it will be when he’s at school and everything is different. Our kids also need to adapt, so I encourage you – even if you do pursue an exception – to keep trying and keep practicing with masks. You should set the example. It helps keep them safe and others safe.

Dr. Kristin Sohl, M.D., pediatrician at University of Missouri Health Care: I’ve been asked by many patients for this exception. While I will do so if I think it is warranted, the legal question is not one your health provider can answer. Your individual school or district will be the ones you work with to find a solution for your child.

How do we go about navigating all this uncertainty?

Dr. Brown: I continue to see kids with lots of anxieties and exacerbations of anxiety. The things we do now are things we always need to do to stay less anxious. They include:

• Stick with routines. Work to keep things predictable to help everyone do their best.
• Make time for stress relief. Exercise, daylight, good diet, hobbies, and music are all supportive activities. It’s also critical to have someone to share your experiences with and reach out for support who can acknowledge that all this is really hard.
  • Ask for help. Do not be afraid to reach out for professional help. It is especially important when you are feeling overwhelmed to get the support you and your family need.