Day 1: This’ll be fantastic. I get to stay inside and eat toast on a paper towel. Day 8: Engages in conversation with a lamp. @LizHackett

If we have learned anything from the pandemic, it is how easy it is to become home bound when you don’t leave your house for an extended period of time.  This is a problem for individuals with neurodevelopmental challenges with or without a pandemic raging in their communities.  How do you get these individuals reintegrated into societal participation?  Obviously, the best way to deal with this problem is to avoid it all together by staying active in the community.  But individuals with neurodevelopmental challenges can become home bound quickly and we cannot change the past, we can only move forward.  Here are some effective strategies for individuals who have slipped into this situation:

1.       Set smaller, achievable goals to work toward your big goal of community participation.  For example, start with a walk around the neighborhood.   Transition to a drive outside of the neighborhood.  Then, to a walk in a park that gets longer and longer as time goes by.  Followed by a walk around a fair or event where more people are around.  Moving from shorter activities that involve few people to longer activities with more people will likely be more successful than “cold turkey”.

2.       Social Stories™ explaining what will happen, how long it will last, who will be there and social expectations can also help to ease the discomfort of not being able to control everything the way you can in your home or in an online environment.

3.       Positive reinforcement.  Verbal praise for small accomplishments is helpful to all of us.  More tangible positive reinforcement might also be helpful.  A favorite or special food often makes an activity more enjoyable.  A token economy where one earns stickers or tokens for leaving the house can also help.   Once a certain amount is earned, the individual can purchase a special toy or participate in an activity they find reinforcing.

4.       “Contracts” that involve the person saying how frequently they agree to go to activities outside the house can be referred to when a person might resist the outing in the moment.

Expect this process to take some time.  The longer the person has been isolating the longer it will take to change that behavior.  While it does not always hold true, I have found that often the amount of time the individual has been participating in the undesired behavior is the same amount of time it will take to change the behavior.  If an individual has been isolating for two years, we should expect it to take two years for them to change that behavior.