A Model of Support for Families of Children With Autism Living in the COVID-19 Lockdown: Lessons From Italy
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DISCUSSION AND REVIEW PAPER
A Model of Support for Families of Children With Autism Living in the COVID-19 Lockdown: Lessons From Italy Francesca degli Espinosa 1,2
&
Alma Metko 3 & Marta Raimondi 3 & Michele Impenna 4 & Elena Scognamiglio 5
# Association for Behavior Analysis International 2020
Abstract Italy has been the European country most affected by the COVID-19 pandemic to date and has been in social lockdown for the longest period of time compared to other countries outside China. Almost overnight, Italian behavior analysts were faced with the challenge of setting up remotely whole-family systems aimed at maintaining adaptive skills and low levels of challenging behavior to be carried out solely by caregivers. Given these extraordinary circumstances, the protocols available from the applied behavioranalytic, parent training, and autism literature did not appear to fully meet the needs of parents having to be with their children under extreme levels of stress in a confined space with limited reinforcers for 24 hr a day, 7 days a week. To meet this unprecedented challenge, we developed a dynamic and holistic protocol that extended to the full day and that recognized the need for sustainable intervention delivered solely by parents, who were often looking after more than one child. These practices are presented in this article, together with a discussion of lessons we have learned thus far, which may be useful for behavior analysts working in other regions in which the effects of the pandemic are not yet fully realized. Although somewhat unorthodox, we include some parent comments at the end with the goal of sharing the parent perspective in real time as this pandemic unfolds across the world. Keywords Autism . Parent training . Telehealth . Token economy Editor’s Note This manuscript is being published on a highly expedited basis, as part of a series of emergency publications designed to help practitioners of applied behavior analysis take immediate action to adjust to and mitigate the COVID-19 crisis. This article was submitted on April 5, 2020, and received final acceptance on April 10, 2020. The journal would like to especially thank Julie Kornack and Courtney Tarbox for their expeditious reviews of the manuscript. It is important to note that this article reports the approach taken by a particular group of clinicians operating under completely unprecedented circumstances in one of the hardest hit regions of the world. There are many ways to use the science of applied behavior analysis to support families, and neither the authors nor the journal suggests this is the only approach or the best approach. However, this approach produced positive results for this group of families, and the editorial staff at the journal believes that the rest of the world of applied behavior analysis may benefit from learning from their experience. The views and strategies suggested by the articles in this series do not represent the positions of the Association for Behavior Analysis International or Springer Nature. * Fr
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