Autism and isolation

In April, people or organizations interested in the matter are particularly active in their effort to draw attention of wide society to issues related to autistic spectrum disorders. As decided by UN General Assembly, April 2 is World Autism Awareness Day recognized by many countries of the world since 2008.

As reported by US Center of Disease Control and Prevention, as of March of the current year, frequency of Autistic Spectrum Disorders (ASD) prevalence in babies and young children increased by 10% compared to the last year. If frequency of ASD prevalence was 1 out of 59 children in April of 2019, for April of 2020, this frequency is already 1 out of 54 children. Frequency of ASD prevalence has increased by 40 and more times over the past several decades which is partially explained by improved diagnostics and awareness.

Source: www.autismspeaks.org

There is no precise statistics of children with ASD in Georgia. Based on various data, there might be approximately 7 000 children with ASD. The first Autism Center in the country was formed with cooperation of Autism Association of Georgia and Ilia State University in 2010 where initially only 10 beneficiaries received therapy. Now up to hundred beneficiaries are recipients of the therapy.

First autism Habilitation State Program came into force on 1^st July of 2015. Within the framework of the said program, Mayor’s Office of Tbilisi Municipality provides funding for services relevant for 2-15 year-old children. In 2020, upper threshold for beneficiaries of the program has increased and became 18 years instead of 15. Habilitation State Program is available for children with ASD not only in Tbilisi, but in several municipalities of Georgia.

In April of 2019, a decision was made to build National Center of Autism in Georgia which will serve 16+ individuals with ASD and assist them in developing skills necessary for independent life. The center is being constructed by “Autism Research and Support Foundation”. To this day, only one out of six cottages envisaged in the project is constructed. As construction of the center is mostly funded by private individuals and companies, it is unclear when necessary financial resources will be available, respectively, there is no set date for completion of construction.

For development of various skills and integration in society, it is critically important for children with ASD to attend various therapy courses, which together with language and speech therapy may involve occupational therapy, sensor integration or development of academic skills. Success of the therapy significantly depends on its regular and systematic character. Due restrictions introduced because of pandemic situation related to Coronavirus all over the world including Georgia, children cannot attend therapy courses in centers. If we also take into account that one of the main challenges for people with ASD is adaptation with social environment, it is crucially important to have a routine of interacting with this environment. Due to spread of Coronavirus and related restrictions, people who suffer from ASD are under disproportionally high risk as even temporary cancellation of therapy courses makes negative impact on their development and may significantly worsen achieved progress.

Leaving house is critically important for people with ASD so that the environment they feel doubtful about not to become a scary place. In response to existing challenges, in Italy where citizens are under lockdown for weeks and can leave house only under special circumstances, a new regulation was activated in the city of Rimini – namely, children and adults with autistic spectrum disorder are allowed to walk around one of the parks of the city for several hours per week. As decided by the government of UK, citizens with ASD are allowed to leave the house several times a day and walk nearby their houses even under lockdown. According to specialists, such practices are important as it helps preserving the routine of leaving house. However, therapy is still believed to be particularly important.

As demonstrated by international practice, one of the most efficient mechanisms during self-isolation is therapy intermediated by parents. Organizations working on ASD issues use so called tele-intervention and by engaging parents, they offer distance therapy courses to people with the respective needs. If we take into account that one of the main challenges people with ASD face is adaptation with social environment, working on development of the said skills remotely is even more difficult objective. However, it is also worth mentioning that not attending the therapy is far serious challenge than attending the therapy course remotely.

As it turns out, practice of distance therapy is used in Georgia too. Based on international experience, “Mental Health Center” offers two services to people with special needs. Namely, the center will be offering tele-consultations and tele-interventions from April 1. Doctors, psychologies, therapists with various specialization will be providing tele-consultations while tele-intervention enables behavioral and other types of therapies intermediated by parents. For those families who, due to several problems, are unable to attend online consultations or intervention, the Center posts relevant recommendations on its Facebook page. Currently 95 beneficiaries utilize remote therapy.

Attending therapy course in physical environment is much more effective than remote therapy, but specialists believe that attending some of therapy courses even in online regime is critically important. This way, it is possible to preserve achieved progress and keep different kind, but still routine, which is crucial for individuals with ASD. Apart from the fact that availability of online services engages children in activities, it also helps them to keep in touch with therapists, which is also crucially important. Furthermore, availability of online consultations enables parents to receive advices on managing various situations or behaviors.

It is less likely remote therapy to replace physical therapy or even be as effective, but specialists may utilize remote therapy as additional, auxiliary mechanism of therapy. Furthermore, remote therapy may appear ultimate therapy for those who do not have access to respective centers because of various reasons (e.g. lack of financial resources, remote location and absence of centers near home). It is quite possible this practice to spike in realization of various interesting ideas and therapy to be used by far more children or adults, than it is available nowadays.