While the infection rate of coronavirus disease 2019 (COVID-19) rises exponentially around the globe, individuals with autism spectrum disorder are being identified as part of a group at higher risk for complications from COVID-19.1 Furthermore, autism spectrum disorder is often accompanied by anxiety, dyspraxia, learning disabilities, epilepsy, fragile X syndrome, Down syndrome, and immune system alterations. Individuals with autism can also have different types of behavioral challenges including deficits in social communication, attention-deficit hyperactivity disorder, irritability, and aggression. Such common comorbidities can present additional challenges for individuals to cope with during the COVID-19 pandemic, making it more difficult to receive needed therapies, practice physical distancing, and adjust to disrupted daily routines. We assert that individuals with autism are an important group who might require additional support during the COVID-19 outbreak and future public health emergencies.

A common feature of children on the autism spectrum is obsession with routine, and disruptions in routine linked to COVID-19 might elicit major emotional and behavioural upheaval. Depending on the severity of the developmental disability that is associated with an autism diagnosis, children on the spectrum might have difficulty comprehending what is going on. Core features of successful educational programmes for children with autism include several hours per day of engaged instruction.2 Because of the COVID-19 pandemic, many businesses providing care or specialised educational programmes have closed across the world, either voluntarily or because of mandates. These closures mean that individuals with autism spectrum disorder are receiving fewer, if any, crucial therapy hours (eg, speech therapy, behavioural therapy, and occupational therapy) and classroom time than they normally would. The effects of this pandemic present a profound change of routine for these individuals, which is a considerable challenge, both for them and for their caregivers.

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Adrien A Eshraghi, Crystal Li, Michael Alessandri, Daniel S. Messinger, Rebecca S. Eshraghi, Rahul Mittal, F. Daniel Armstrong. COVID-19: overcoming the challenges faced by individuals with autism and their families, The Lancet Psychiatry, Volume 7, Issue 6 pp.481-483, June 1, 2020. DOI:https://doi.org/10.1016/S2215-0366(20)30197-8