COVID-19 – Positive Behavior Support

Brave New Year

Kaarin Anderson Ryan, PhD, BCBA, LBA

It has felt like climbing up a mountain, hasn’t it? 2020 has been a year of unprecedented everything, and there will be lots of videos, blogs, and news to reflect upon this past year and look to the horizon for a better 2021. New Year’s Day has long been a symbol of fresh starts and resolutions, which is a great way to approach the new year.

But let’s face it. Nothing will be all that different on a worldwide level on January 1. We are still in the midst of a global pandemic, still looking for answers and witnessing or participating in all kinds of disagreement about the “best” way to handle the situation. This includes personal choices as well as government mandates. Nothing seems to be the perfect answer. So instead of re-hashing everything that has been tough about 2020, or making all kinds of glowing predictions about everything getting better when the calendar changes, I would like to reflect on the things that have been positive this year and how we can bravely move forward to bring all the best things that have come from the pandemic into the next year.

For many people, priorities have shifted. All around me I have seen such a re-focus on family and quality time with loved ones, because for much of the year we have been forced to isolate ourselves into smaller bubbles of contact. So in these bubbles many people have been able to really appreciate and enjoy that time and those people, reconnecting with an emphasis on quality of time spent together rather than trying to fit all kinds of activities into our time. For the new year, think about the times you have been able to find more enjoyment and relaxation with close loved ones, and when things start to feel more normal in the rest of the world remember the value of these times. Make it a priority to seek out those connections with family and close friends.

In our communities, we can all find countless examples of increased giving and support. In the spring, my local community had a surge of donations to food pantries, people volunteering to take food to others, and providing other types of support to families who had experienced job losses or health-related difficulties. Many towns and cities experienced a surge of support for local businesses, including people intentionally shopping at local stores and making efforts to support local restaurants by dining in or taking out food to help those businesses remain open. This spirit of giving back and providing support does not have to go away when the pandemic eases – our communities can always use support.

Large companies have also reached out to help people in need during the pandemic. Of special note is the focus on helping students to make the best of the situation. For school-age students with no internet in the home, companies across the country made internet available to families for free. In many areas, companies created free Wifi hotspots for students to use during school closures. In addition, there have been some nice efforts from everything from insurance companies reducing rates or waiving certain fees to all of these companies that have thoughtfully and often generously established ways to give back specifically to help in the wake of COVID-19. The surge of support from companies that can actually make a difference should help us see the positive side of humanity during difficult times.

In so many ways, we have seen a surge of creativity and industrious efforts to keep people connected. Between updates to Zoom, entertainment giants such as Netflix creating easy ways for people to have movie parties from different locations, and online games increasing access and ease for allowing people to spend virtual time together. We have all had to be more creative and flexible to stay connected to our loved ones, and the technology available to us has given us great opportunities to spend time together.

During this time, we have seen heroic efforts in medicine. Our health care workers across the board have been amazing, providing care under stressful conditions. Throughout this pandemic, there have been ever-changing guidelines on how to treat people who become very ill and have to stay in the hospital for lengthy periods of time. But our health care teams across the country and around the world have stepped up day after day to rise to the challenge of providing the best possible care. They are true heroes. In addition to the health care workers in the field, there have been incredible scientific efforts to learn more about this virus and to develop treatments and preventions, including the vaccines, to help bring an end to the pandemic. Scientific teams have worked around the clock to ensure medical progress that will help save lives.

In education, teachers and staff have gone to incredible lengths to provide the best possible education during this time. Parents have stepped up as partners, providing support while students are learning from home. As exhausting as this has been for both teachers and parents, the efforts have been tireless. Also, educators have tapped into creative and innovative ways to keep students engaged. Look at these North Carolina teachers who have come up with fun and engaging ways to teach online, or this one, who does different character videos for her interactive online class. Is it ideal? No, of course not. But it is also not stagnant – educators and parents are rising to the challenges and continuing to do what they can to give students the best educational experience possible under the circumstances.

I could go on and on with all the creativity and goodwill that has come out of our experience with COVID-19. But let’s take some time now to think about how we start off the new year with courage and strong hearts. One approach is to focus on our great need for things to get better, to get back to normal, to stop needing to think about masks and distancing and limiting interaction and activities. These things will be realized, probably within the next year but not within the next month. So to move forward with positivity, to be brave in the new year, take some inspiration from any of the categories listed above. In the new year, what will your resolutions be? It is always good to spend some time reflecting on personal habits and making changes for yourself, but look at all the positive changes so many people have made over the past year out of necessity. These positive changes have required courage, commitment and positivity. Let’s look back at 2020 with acknowledgement of how different and how difficult it has been, while we look to 2021 with optimism, and a renewed sense of positivity for what can be done by all of us, even under the most challenging of circumstances.

5 ways to help your child stay socially-distanced-and-social.

Kaarin Anderson Ryan, PhD, BCBA, LBA

After several months of lighter restrictions, along with outdoor activity options that gave all of us more opportunities for safe socializing, now we are seeing tighter restrictions in many states and communities as the pandemic hits a second wave. In much of the country, it is getting colder outside, making it more difficult to find safe places to socialize outside the family home.

This is really challenging for all of us. We miss the easy get-togethers, being able to see friends and family without a second thought. Many of us have made changes to holiday plans and traditions to protect ourselves and our loved ones. As much as we are struggling with the new social normal, it is especially challenging for kids and teens, and even more challenging for kids and teens with autism and other different needs.

One of my biggest interests is and always has been to help kids, teens and adults who have different needs to find friendship and social inclusion at school and in the community. We have come a long way in the past 20 years with schools, colleges and communities establishing many resources and opportunities for people with different needs to be involved, and to find friends. Now, with the pandemic, many of these opportunities are not available. This leaves us searching for options to help kids and teens find ways to stay connected and social in a healthy and fulfilling way. These ideas and resources will be helpful for anyone who is looking for ways to help their children with positive and fun social interaction, safely.

The following ideas are just a few suggestions for possibilities to help with socialization – please make sure as a parent that you screen and monitor anything you allow your child participate in virtually. These ideas could be beneficial for kids and teens with and without different needs.

Tik Tok. Just kidding! This will not help.

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Many of you already know about Kahoot, but if not, check it out. Not only does ot have educational activities, but it can also be used to set up interactive games online with friends or family.
Interactive game apps. One good one that is free to use is Psych, which users download then play together using a code. The app can be found on Apple or Google Play. There are some paid in-app options as well for extra game decks.
Watching movies together remotely. One way to do this is through Teleparty (previously called Netflix party). Users are able to watch a movie at the same time, with an option to chat while watching.
Try some online extra-curricular activities with Outschool. This website has thousands of classes for students that focus primarily on health and wellness. If you type in the search bar for you will find quite a few classes with a focus on socialization. You can also search by age, day, format, length of class, etc. These classes will have a fee, and the prices vary depending on the class.
Local resources. Our communities are scrambling to move things to virtual and online formats to accommodate a variety of needs. This ranges from curbside pickup for local boutiques who have updated websites to provide more shopping options, to expanded takeout food options, to virtual or parking lot church services, to a tremendous increase in the use of virtual meeting platforms for businesses. Within your own community, look to places like libraries, churches, parks and recreation departments, and community centers to see what social activities are available virtually.

Things are opening up. What is ok for you and your family?

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Kaarin Anderson Ryan, PhD, BCBA, LBA. 6.2.20

The information keeps flooding us, day after day more news and conflicting information about coronavirus. In my last post I talked about doing what you can each day. This time I will be turning the focus a bit back to children, and coping with the next phase of the pandemic when you have kids at home.

It seems to me that the new challenge for many of us will be deciding what to do. As restrictions start to loosen up in many states, the decisions about how to proceed with venturing back into the social world will be up to each of us, individually. Some may look to their family for guidance, or follow the lead of trusted friends. Others will do what they want or what they think is best based on what os happening in their area, or within their own family.

For people who have been home with their children for over two months, it will be tempting to jump back into life as usual as much and as soon as possible. There may also be some pressure for allowing playdates and other friend interactions, This pressure may come from your own children or it may come from their friends, or both. How will you navigate this next phase of the global pandemic?

As with many difficult decisions and tasks, it might be helpful to break these questions down a bit before you decide anything. Each thing you and your family do going forward will be based on your own personal calculation of the risks involved. What are some things to consider?

Most importantly, consider your family health risk. Are you or anyone in your family at greater risk for complications based on current health conditions? Do you care for someone who is at greater risk? If the answer to any of these is yes, it might be in your best interest to continue to stay home as much as possible and limit contact with others who are re-integrating into the world.

If you are at low or average risk for complications due to COVID, think about some basic common-sense measures you can take to protect yourself, your family, and others.

Social Bubbles. This is a concept based on the idea that it is safe to spend time with other people who have been practicing the same level of safe behavior as yourself. Do you have friends and family who have been working from home, rigorously distancing themselves from others, wearing masks out in public, and avoiding gatherings? If you have set a certain standard for yourself these past few months, and you know others with the same standards, they are likely safe to be with now. Here are a couple of recent articles on forming your own Social Bubble:
- PBS News Hour
- MIT Technology Review
Maintaining your own social distancing rules. Do you have friends or family who have been less careful than you? Do you know others who have had to go into a public work environment? As states ease restrictions and you want to see these friends, consider social-distancing gatherings. Sit on a deck or a patio, stay 6 feet away, bring your own food and drink.
Be careful in public. Yes, I know we still have mixed information on masks and how long the virus lives in the air and on surfaces. We – the public – do not know a lot more now than we did when this all started. But some studies are definitely showing a benefit to universal masks to reduce transmission if worn correctly. This means you •put it on • stop touching it • don’t touch your face • still maintain a safe distance from others • continue to wash or sanitize your hands after touching things in public • leave the mask on to talk, sneeze, cough (I actually heard about a woman in New York who was seen pulling her own mask down to cough into the air then putting it back on. True story.). The masks do not universally protect you. But used correctly, along with maintaining all the other recommended safety measures will certainly not hurt and will likely help.
Now for the tricky part. Think about your own kids. How will they do with maintaining boundaries? Are they able to keep a safe distance? Will they be able to keep their hands clean? Some older kids can actually do well with this. Other kids who are younger or who have behavioral or social difficulties may be more challenged with these safety measures. If you have one or more children who will struggle with maintaining safe standards, it will be up to you to decide what other people they can spend time with now. Will you let them play with other kids who have maintained the same level of caution as you have? The Social Bubble idea might be particularly relevant to families with young kids or kids with special needs.
For children, teens, and even young adults on the autism spectrum, this might be especially challenging. For one thing, if you have a child with autism and you have been at home with limited support, you may be tempted to take support and opportunities for your child to have time with others as quickly as possible, with less concern about the possible risks involved because basically, you have had enough. For another thing, people with autism may be less aware of how to maintain boundaries, and in some cases may have less social awareness and control to help them navigate interactions using distancing and other healthy precautions such as not touching their faces. The thing to remember is that you have choices. Using the Social Bubbles may help you with this, and it also applies to caregivers and support personnel, such as ABA providers or other therapists. If you allow your child to spend time with peers, do the best you can to make sure the peers and their families are following the same guidelines that you are. It may also help you to find caregiver support through ABA and other therapists, as well as local babysitters or respite providers who you trust to use precautions around you and your family.
Keep an eye on trends in your own area. As things open back up, how do the numbers look near you? Are things continuing to look better, or are the numbers going back up? You can decide how to handle your own safety measures based on what is happening where you live. Stay informed by the data to help guide your decisions, one day at a time.
If you really aren’t sure what is ok and what isn’t for you and your family, reach out to health experts in your area for guidance. This may include family doctors or local health officials who have been carefully following the trends with this outbreak. While it is good to be cautious, it is also important to balance caution with common sense measures you can take to help move back to some normal daily experiences.

Coping with the information, one day at a time.

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Kaarin Anderson Ryan, PhD, BCBA, LBA. 5.15.20

We’ve been isolating ourselves as much as possible for a bit over 2 full months now. At the beginning, there was so much information coming in from sources around the world that it was hard to keep up with everything. Now, it may be a little less of on onslaught, but there is still a lot to process. One of the big questions now is re-entry. How do we gradually move back to life as we knew at? Can we do this in the near future?

For many people, there is an overarching sense of anxiety now. What is going to happen in the world? What is going to happen with the economy? What about the food chain? What if we go back out and people start getting the virus in large numbers? What if my parents or kids get sick? What if I get sick? The questions still overwhelm the answers in many respects. And if you are a parent with kids at home, it can be challenging to answer questions about what’s next. If you have kids at home on the autism spectrum, your challenge is further increased because there is little sense of long-term predictability, which can be a problem.

Reflecting back on these past few weeks and the ever-changing information along with fears and worries that come with the unknown, something that has been helpful is to focus on what I do know, and what I can control. What is that right now?

My daily routine.
My weekly list of tasks.
My level of (remote) social engagement.
My sanity activities (getting outside, doing yoga or meditation, reading, watching a good movie).
Who I spend time with in-person and how to do that safely.
How much I go out and how I prepare for that.
How much I look at the media.

What can I not control?

Medical progress with the virus.
Changing information about the virus.
The behavior of other people when it comes to safety and distancing.
The decisions of leaders in government at every level.
The decisions of businesses starting to re-open with different rules everywhere.
The media (but remember, you can control what you read).

It takes some thought to put together your list of what you can and can’t control right now. If you have kids at home (with or without special needs) who are feeling tired of being home or showing signs of anxiety about the situation, this is a good time to teach them about what we have the power to control. This is much easier if you start with the smallest picture, which is today. What can we do today to make it the best day possible? How much structure do we want today? For some kids, it will be helpful to have a good plan every day, while others will manage well with looser structures and routines. One of the most important things will be to focus on what can and should be done today and this week, instead of spending too much time thinking about what may or may not happen in 2 weeks, 2 months, or even a year. This is especially true right now, because we just don’t know how things will look in our town, our state, our country or even our world. Is it possible that schools in your area won’t start again in September? Yes, it is possible. But mostly we don’t know. Letting yourself or your kids spend a lot of time and energy worrying about this will only prevent happiness and productivity right now.

Take another look at the list I made of what I can control right now. Do any of those concepts apply to you? Do any of those translate to action for your kids at home? How can you wrap your arms around the things that are in your control to help yourself and your family move forward in the midst of endless information but not a lot of concrete answers? Focus on here. Focus on now. Don’t worry to much about re-inventing yourself or your family, just do the best you can with what you know and what you have in front of you, today.

So ask yourself, and ask your kids, what can we control right now? What can we do with the things that are in our control to make the absolute best of each day? What can we do to try not to put a lot of our energy into predicting or worrying about the future? Make lists, make visuals, and celebrate the things that go well every day.

Information overload

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Kaarin Anderson Ryan, PhD, BCBA, LBA. 3.19.20

How quickly things can change. Within the past week we have gone from being on alert for potential changes in our country while watching other countries struggle with this pandemic, to being in full-scale crisis mode. This is especially true in certain areas of our country that are particularly hard-hit by COVID-19 and are scrambling to contain the situation. The amount of information out there is completely overwhelming and ever-changing.

Resources are popping up everywhere to give people help and support during this challenging time. I have seen great ideas being shared about how to help parents suddenly needing to have their kids at home and do their schooling from home, and in some cases including online schooling. There are resources for how to work remotely, how to social distance, how to stay healthy, how to prepare your home for a period of isolation, how much you need to isolate to protect others and yourself. Some are posting ideas on self care and finding peace in the midst of turmoil. It is wonderful to see so many minds sharing ideas on how to cope with this surreal situation.

But it is also just overwhelming.

So, this post is not going to link you to a thousand great resources. It is not going to tell you what to watch and what to read and what to ignore. Instead, this post will give you my own take on what to do now. For yourself, for your family, and for your community.

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For Yourself.

Breathe. Every day you will wake up with some sense of unrest. What will be in the news today? What is the status in my own community? Am I healthy? Are my loved ones healthy? The potential for overarching fear and anxiety is through the roof. So, remember to breathe. I am not talking about just a deep breath here and there, I am talking about intentionally taking moments throughout your day to stop and take at least 5 focused, quiet deep breaths. Stop thinking for a few minutes and focus on the air you are breathing in and the air you are breathing out. Breathe in slowly through your nose and out slowly through your mouth. Let some of the anxiety go out with your breath each time.

Make a list. What are all the things you wanted to have time to do, but never made the time? Being stuck at home, this is a good time to look at some of those projects, and spend some time with those. How you do this is up to you. Maybe you say, I am going to spend one hour per day working on project x, or catching up on miscellaneous tasks. Or maybe you jump in wholeheartedly to one big project that you have been putting off for a long time. Whatever you do is up to you and will depend on your own schedule and circumstances. But many people in the United States and around the world are finding themselves with a bit more downtime right now.

Share enjoyment. Can’t get out to socialize as much as you want? Set something up online. Of course it is not the same as person-to-person contact, but it is better than not seeing people you like. You can use any number of technologies, from FaceTime to Facebook video to Google Hangouts or Zoom. I have seen posts for musicians doing virtual living room concerts you can livestream and hear good music. You can also use Netflix, who has set up a way to watch movies with friends.

Get some fresh air. If you live somewhere where you can get outside without being near a lot of people, a daily walk is refreshing and good for your health. If you can’t leave your building without rubbing elbows with people on the elevator, open your window and let in some fresh air.

Workout from home. You do not need a home gym to work out from home. Not only are there loads of resources for using bodyweight exercises to get full body workouts, some gyms are now posting exercise classes online for you to livestream or view. They are doing this with the understanding that people do not have equipment at home, so you can do the classes from your own place.

Stay the course. If everyone does their part to flatten the curve and keep this pandemic in check, we will be back to normal sooner. Remember that this feels awful right now, but we will get through it and we will be back to normal.

For your family

Implement structure now. If you have kids or teenagers at home, start out by setting up a structure for the days. Most kids still have school work, and college students are finishing up their courses online. Have your family set up times for work and leisure every day. Implementing and maintaining structure can reduce stress.

Schedule family time. More time with family always sounds great, it feels like the right thing to wish for, but in reality being cooped up with your family for weeks can be a bit difficult. So make sure individual family members are getting their own space as much as possible, but also set aside time regularly, even daily, to do something fun as a family. Movies, games, puzzles, making video journals of your time in isolation, cooking and baking are all good ideas. All you need to do to get ideas is search online for things to do in quarantine and you will find a lot of recent posts and articles.

Stay positive. By taking good care of your own needs, as noted above, you will be able to stay more positive for your family members. And remember, this will pass. We can do this.

For your community.

Stop the spread! This is my most important advice right now. Not to get too much on a soap box about this, but we all have to do our part to stop this now. The horses are already out of the barn, so to speak, but it is up to us now to slow them down. Because our testing is way behind in this country, the advice from experts is to assume that everyone has it. That’s right. Assume that everyone has it. Including yourself. So this means you are isolating yourself as much as possible. Staying in your home, working from home, socializing only remotely, OR only with people you know are also being very strict about their interactions. When you do go out you are distancing from everyone. You are washing your hands much more than usual. If you think you may have been exposed, even if you don’t have symptoms, stay home. **If you are a young adult or you know a young adult, tell them to stop attending social events and gatherings!** Because they often don’t show symptoms but are contagious anyway, they are super-vectors for this disease. And even if they are lucky enough to not get really ill, they could easily give it to someone who isn’t so lucky. All you have to do is read about Europe right now to see that if we don’t slow down now it will soon be mandated, but not before lots of vulnerable people get really, really sick. Stop doing things. Just stop.

Help local service organizations. There are a lot of people who shouldn’t be going out at all. Community organizations everywhere are setting up delivery services for vulnerable people take them food, groceries, medications, and household needs. If you are healthy – and if you can follow all the precautions to protect others – contact local groups to see how you can help.

Donate to food pantries. Food pantries are going to see a growing need for supplies as people lose hours at work and need more help. If you are able, drop off food and necessities (toilet paper for example!) at a local food pantry. Every bit helps and they will need it.

Donate to charities. If you are financially secure through this crisis, consider directing some of your charitable contributions to organizations who are going to struggle. This would include shelters, soup kitchens, churches, and volunteer agencies who help those in need. Also consider helping community businesses who may struggle during this time.

This is a time when we need to reflect as individuals and as a society who we really are. Let’s take care of ourselves and each other, and let’s try to breathe through this and remember that only with each others’ support will we come out on the other side of this as whole and as together as possible.