In March 2020, Qatar plunged into a series of Covid-19 restrictions and lockdowns. Authorities began closing schools, public spaces, hotels, and malls. Social distancing, isolation, and face masks were mandated as everyone stayed at home and tried their hardest to come to terms with and make sense of the world. In June 2020, as Covid-19 cases decreased, restrictions gradually lifted, only to be reintroduced months later.
Who would have thought that since the first lockdown 18 months ago, the world would still be gripped by Covid-19? For many people across the globe, the pandemic continues to take a physical, emotional, and financial toll. Children and adolescents—who have faced some of the tightest restrictions here in Qatar—have also been greatly affected. According to a report by the Royal College of Psychiatrists in the September 2021 issue of the BJPsych Open journal, there is emerging evidence from the United Kingdom that depression and anxiety levels have increased in children and adolescents due to lockdowns. And for those who are neurodivergent, these mental health effects might be even stronger, according to a systemic review published in the September issue of the journal Child and Adolescent Mental Health.
WHAT IS NEURODIVERSITY?
Neurodiversity is an increasingly popular term used to describe the concept that some brains think and process differently to “typical” standards. Those brains are often described as “neurodivergent”. On the other hand, “neurotypical” describes brains that function within those standards. Sociologist Judy Singer invented the term to encourage equality and respect for adults and children with neurological differences such as:
- Asperger’s Syndrome
- Tourette’s Syndrome
Doha Family spoke to three families and Layal Aziz, a clinical psychologist, to gain insight into the mental health effects of the Covid-19 pandemic on neurodivergent children and their families.
Mother to Eesa, age six
“The covid situation has deeply affected my family, especially during the lockdown period of 2020. The change in routine and homeschooling has been exceptionally hard on my son and myself. In the beginning, we had no idea of what to do or where to begin,” says Nausheen.
Eesa, Nausheen’s son, found some aspects of virtual learning difficult, like staying seated in front of a laptop and completing certain tasks. Nausheen also struggled with teaching him things she felt were unfamiliar to her and keeping him focused. “As much as I tried to sustain a certain routine in the house, I initially failed to do so.” With all these hurdles, Nausheen’s biggest fear was that Eesa would fall behind on the progress his family helped him make so far. “Losing any of those hard-won skills was just unacceptable to me.”
Nausheen describes Eesa as “very outdoorsy and physically active”, and this, she says, made keeping him entertained while indoors a challenge. Water play, which is Eesa’s favourite activity, was one of his reinforcement tools, and access to that became limited. Eesa’s weekly swimming lessons were now cancelled, and the swimming pool in his compound also became off-limits. So, Nausheen and her family needed to get creative.
“We have focused a lot on keeping Eesa busy with an outdoor swimming pool in our front yard, cycling around the house, and different sensory activities that has involved lots of messy play. We have also allowed more screen time than usual,” she says. Yet, despite the family’s best efforts, Nausheen shares that Eesa was still negatively impacted by the lockdowns. “The lack of social interaction affected Eesa the most and the ability to regulate his emotions and behaviour within a crowd.”
But it wasn’t all doom and gloom, as Eesa also made some impressive progress during those times.
“Whilst being at home 24/7 during the pandemic, I’ve been able to successfully potty train Eesa, which has been a major achievement for me! Eesa has started using more words, speaking full sentences and singing nursery rhymes. I am still trying to figure out how that happened!” She says.
All in all, giving up was never an option for Nausheen, who ended up learning that she was tougher than she ever thought. “I’ve been surprised by my determination to keep going, even on the most difficult of days. When faced with such difficult and uncertain times, I did not have any other optionbut to be strong and to keep moving ahead, whic luckily worked out well for me and the family.” Plus, Eesa’s ability to pick up on her emotions made her even more determined to stay positive despite feeling more worried than ever before about his future.
So what’s Nausheen’s message to parents in her shoes? “It’s okay to feel overwhelmed, scared, or worried and experience more emotions when it comes to caring and providing for your neurodivergent child. It’s okay to feel low thinking about all of this but always remember to pick yourself up and get going!”
Nausheen also credits Zoom conversations with friends and family with getting her through the hard times. And above all, she realised this: “One of the most important points was, and still is, to keep my own mental health intact.”
Mother to six-year-old Omar*, three-year-old Ahmed*, and eight-month-old Adil*
“Our son Ahmed has issues interacting with his peers, so he keeps to himself. He was making slow progress at school, and suddenly, his nursery closed due to the pandemic,” says Sara.
According to her, keeping Ahmed stimulated has been necessary for his development, but this became difficult to maintain during the lockdowns. Despite that, Sara notes that Ahmed seemed to be relatively unaffected by this change. “Luckily, there has not been any mental health impact on Ahmed, or so it seems. He is still very young and easily entertained. Although he has lacked stimulation, he has been quite happy, even at home.”
But Sara’s concerns about her children’s well-being haven’t entirely cooled as she continues to worry about the pandemic’s effects on them. “I fear that I could/should do more and that I’m not doing enough to make this period as easy as possible for them.”
Additionally, Sara struggled to prioritise self-care when the whole family stayed at home and says this worsened her mental health. Yet, she and her husband still made a tremendous effort to keep themselves and their children grounded. This included hiring a nursery teacher to help Ahmed stick to a daily routine, which lifted his spirits. “It was one of our coping strategies. We have also tried to keep Ahmed stimulated and take him out as much as possible, even for just a short trip to my husband’s office. Keeping malls closed for children was a massive issue for us!”
Sara and her husband also tried to get Ahmed therapeutic support. However, the obstacles they faced meant that they had to put those plans on hold. At first, they tried the Hamad route before discovering that the waiting lists were very long. “Parents told us that we would have to wait for around six months for our first appointment,” she says. Then, they booked a private assessment where it was recommended for Ahmed to start speech and occupational therapy. Unfortunately, Sara and her husband found that private sessions would be too expensive and ultimately force them to pull Ahmed out of his nursery. For them, that wasn’t an option.
After facing these hurdles, Sara believes that neurodiverse families are often left in the dark with few resources. She also wishes that Hamad services were more widely available. “I would love to see a proper unit of medical and non-medical specialists dedicated to helping neurodiverse children under the Hamad umbrella. I know there is one already, but I mean a facility big enough to meet society’s neurodiverse needs.”
She also thinks that if neurodivergent children are routinely offered support as soon as they are diagnosed, it will lighten the load parents carry. From her experience, parents often end up “running from one doctor to another” with little help or guidance during the process.
Overall, how does Sara feel about pandemic family life? “I look at the pandemic as an opportunity to spend more time with the children and interact with them. The only positive impact of the pandemic is my husband and I have spent more time at home and with our kids.” Sara adds that time at home also allowed her and her husband to work on Ahmed’s speech delay. Yet, parenting guilt continues to loom. “My husband and I often feel guilty that we don’t give enough attention to our two ‘neurotypical’ kids because Ahmed requires a lot of attention.”
With everything said, Sara and her husband love being Ahmed’s parents. “I must highlight that interacting with Ahmed is a pleasure for us, not a chore,” she says. “He is a very happy and cute child, although he is often detached and in his own bubble.”
*Names have been changed to protect confidentiality.
Mother to eight-year-old Aljori, seven-year-old Aljazi, four-year-old Mohamed, and three-year-old Aljohara
“Our daughter Aljazi has high functioning autism and struggles academically for her age, especially in reading and writing. However, Aljazi has [an] amazing vocabulary and attends a school specifically for children with ASD,” says Aisha.
The start of the Covid-19 pandemic had plunged Aisha into a new, more isolated parenting experience. When school closures were announced, she had to explain to Aljazi that she could no longer go to school nor really leave the house. “She started closing the house doors. I put her school uniform, backpack, and shoes away. It took me quite a long time to create coping strategies.” By the time it was well into the pandemic, Aisha still found Aljazi pulling out her school uniform and getting sad when she explained that school was closed. “I would try to empathise with her, and I would say that I was sad too.”
Like many other parents, Aisha tried to turn her home into a fun learning environment. “We have a reading station, PlayStation, and Play-Doh. We made slime and stuck house rules onto the walls”. But even with those perks, things still aren’t “back to normal” in Aisha’s household and keeping her kids at home has brought some challenges. “My kids share rooms, and sometimes there’s too much fighting. My kids were seeing too much of each other, so my husband and I decided to give each child time,” says Aisha.
These new private child-parent sessions resulted in Aisha sometimes keeping Aljazi away from her siblings when it was their turn. She did this so they knew they could also get one-to-one “mummy time”. And it wasn’t only her relationships with her children that changed. The pandemic pushed Aisha to prioritise her physical and mental health, and it has paid off. “I began to feel much better and more able to emotionally handle situations,” she says.
So, what does Aisha advise other parents of neurodivergent kids? “You need to listen to your heart. There’s so much noise up there.” She also recommends taking up writing as a therapeutic tool. But if that doesn’t appeal to you, find something that does: “See what works for you—there’s no right and wrong.”
Layal Azizi, a clinical psychologist and school counsellor, says that one of the most significant ways Covid affected neurodivergent children’s mental health was that it made them feel isolated. Although this has been a common pandemic experience, Azizi says neurodivergent children are often worse off because of their needs. “The amount of academic and emotional support needed is bigger than most neurotypical children. Despite all the work done to provide support through telehealth, it is not enough,” she says. These shortcomings, she says, could increase neurodivergent children’s risk of having emotional difficulties.
Azizi states that neurodivergent children tend to need “multidisciplinary” academic and emotional support. But what can that look like? “On an academic level, most [neurodivergent] children need extra accommodations and in-person follow-up to attain their goal”, she says.
Azizi adds that virtual learning lacks this necessary in-person element that helps neurodivergent children stay focused and finish their tasks. On an emotional level, she says that neurodivergent children may need help learning social and emotional cues and self-management techniques—all areas where in-person support is vital.
Another consequence of virtual learning has been that parents have been trying to fulfil those support roles, which, according to Azizi, is harmful. “Parents are not qualified specialists. Asking them to act as one has resulted in putting parents into a failure position and becoming more frustrated,” she warns.
Nevertheless, Azizi understands that everyone—from parents to institutions—is trying their best in very unusual circumstances. “Surviving means doing your best to keep yourself sane through this global crisis. ”
Azizi advises parents and primary caregivers of neurodivergent children to navigate these tough times by doing “whatever it takes” to support themselves and their kids. “Keep in touch with their specialists, notice their primary needs such as reassurance, emotional support, learning through play, and act upon it.”
She also reminds parents to not pressurise themselves. “School standards have changed. What used to be the ‘norm’ pre-pandemic is no longer valid. Shift your expectations to what might be helpful to your child’s state.” And for families that still aren’t getting the help they need: “Reach out to specialists. Please remember, you are not alone. Help is near even if it is online.”
Child and Adolescent Mental Health Services (CAMHS)
- Outpatient Building
- Floor 1B and 2M
- Contact: 4003-3333
The Child Development Center
- Hamad Medical Corporation (HMC)
- Contact: 4025-3456/4025-3457
Childhood development and learning products
- Royal Plaza
- Al Sadd
- Contact: 5512-3374
American Academy of Child & Adolescent Psychiatry
MindEd for Families
DISCLAIMER: The information provided in this article should not be used to diagnose or assess neurodivergence. Please see a medical professional for advice, diagnosis, or treatment.