Roles of HCPs for children with intellectual disabilities during COVID-19

    02-May-2020
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Thulasikanthan Mugesh & Sucharita Dutt
Contd from prev issue
Social distancing
In this period of strict social distancing norms being implemented, these restrictions have to be applied very stringently to children with intellectual disabilities as they may be at high risk because of their pre-dispositions. The parents and caregivers can be trained to use the usual methods of communication that are effective with the individual to help them understand the restrictions.
Identification of health concerns with the help of caregiver and parents
It is important to monitor people with children with intellectual disabilities for any signs of coronavirus – a new cough, sweating/ temperature, facial expression, and signs of pain or discomfort. It is likely that care giver or family members will be the first to pick up these and they have to be guided to initiate appropriate measures.  It is also important to educate family members or other caregivers about the necessity of monitoring these children with intellectual disabilities regularly for general health and underlying conditions as they have other health risks.
Shielding
There are some clinical conditions which put people at even higher risk of severe illness from COVID-19. It is important to educate the caregivers to be aware of such listed conditions, identify if their children or family members fall under such extremely vulnerable categories and follow the shielding guidance to protect these individuals.
II. Training measures:
 Parent and caregiver training on updated information –
We as health care professionals should facilitate knowledge updation of parents/caregivers on the latest information on COVID 19, prevention , infection control measures, social distancing , PPE, etc and upscaling their preparedness.
Caregiver training on ways and means of supporting the child
We can encourage parents to regularly stay in touch with the child’s health-care disability care professionals by calling or using available telehealth services and promptly seek help when needed
We can educate parents and caregivers on organizing calming activities and creating new routines at homes for fostering calmness among children with intellectual disabilities.
Parents can be educated on home based therapeutic, behavioural, educational and vocational activities
Training of children with intellectual disabilities with the support of caregivers/parents                          Orientation on COVID 19: -Children with intellectual disabilities can be explained on what is happening around and what are the preventive measures being adopted and the rationale
Assurance: They can be explained that this is  a temporary situation and by following  guidelines, life can come back to normalcy very soon.
Easy to train: The child training can be taken up using training aids which are very simple and in understandable format and language –Posters, charts , etc
Social story: We can create a small social story related to COVID-19 that includes concepts such as hand washing, social distancing and shelter in place, which makes it easier for the child.
Emotional Security: We can focus on promoting emotional security of children with intellectual disabilities by being predictable, patient, clear and calm.
Daily Schedule: We can encourage the Children with intellectual disabilities to establish a daily schedule, have a consistent wake time, meal time, work time and bedtime.
Positive caregiver-child interaction: We can promote positive caregiver-child interaction through child-directed play by encouraging quality family time.
Reinforcement System: We keep praising the children for their achievements and also can create a reinforcement plan or token system, focusing on two to three positive behaviors that the child can receive stickers/points which inturn may lead to a small prize or privilege.
Telecommunication : We can encourage the child to connect with their relatives’ friends, teachers, health care professionals and other social support systems through available online and telecommunication media.
Multi Sensory play: We can provide the child with sensory opportunities through multi sensory play  – tactile, auditory, olfactory and visual within home environment
Focus on the positive: We can focus on the positive – identify one positive aspect of your day, correct your child’s misconceptions and discuss something to look forward to.
The role of health care and disability professionals can be crucial in the training of children with intellectual disabilities. Let us all understand our responsibilities well and let’s try our level best to support these children with intellectual disabilities and their parents/caregivers at this crucial pandemic period by making best use of the available ways and means.
Stay Safe , Stay healthy and Stay Happy
About the authors:
1.Thulasikanthan Mugesh
Lecturer in Occupational Therapy
National Institute for Empowerment of Persons with Intellectual Disabilities
M: 9441675885/8074594163
[email protected]    
2. Sucharita Dutt
Lecturer in Rehabilitation Psychology
National Institute for Empowerment of Persons with Intellectual Disabilities