Effects of COVID-19 on children with autism

Table 1 Recommendations to minimize the effects of pandemics on people with autism

Intensive education:	Mandatory education of people with autism, their families, and caregivers about the symptoms and signs of COVID-19 and similar infections and the behavioral procedures to decrease the infection spread[28].
	Emphasize the importance of good sleep hygiene and nutrition during the pandemic[63].
	Educating, supporting, and strengthening the parents' ability to adjust could be particularly valuable in times of extreme life difficulties and during ordinary times that may not be expected[93].
	Training children with autism about how to use personal protective equipment (PPE) by their caregivers will prepare them for the social adaptations during pandemics[94].
	Launching regular mandatory education and updating all the healthcare providers about the management guidelines created for people with autism, supported by specialist providers such as psychiatrists, psychologists, occupational therapists, speech therapists, behavioral therapists, and other specialties as indicated[95].
Prioritization:	For testing and vaccination for people with autism, their families, and caregivers[86].
	For hospitalization and ICU admission in triage protocols[41,42].
	Regular or on-demand access to psychological services regardless of the enrolment[96].
During quarantine:	Allow for one-on-one home visits[97].
	Allow meeting the healthcare provider (e.g., physiotherapist, behavioral therapist) in a previously disinfected open area[97].
	Allow for small classes, and preadmission testing, allowing people with COVID-19 negative testing results to enter the class[98].
	Give permitted exceptions for people with autism, granting them to leave their homes more than once daily[98].
	Providing a sensory-friendly sanitized space for children with autism to release their extra energy, or at least providing tools to help them remove their excess energy, such as a physioball or bringing a swing or trampoline at home to prevent behavioral regression. Encourage physical activity to preserve general well-being[99].
	Provide formal and informal care with psychological and financial support for the well-being and proficiency of parents of children with autism[100].
	Provide weekly or "hotline” consultations for the parents of children with autism to help manage rising general and specific COVID-19-related issues[63].
	Allowing a caregiver or support person to attend to the individual with autism in the hospital, following all required infection control protocols[97].
	During and after the pandemic, preventive measures: to implement an intensive preventive intervention program for children with autism to reduce and prevent relapse and future physical and mental health regressions in future pandemics and/or similar situations[101].