This summer has been serving up extra helpings of heat that just seem to keep coming. My patience has long past its fill of this weather, but these extra toasty temps just keep stretching up and on far higher than I want every time I look at the forecast. I have for many months felt a sense of increasingly concerned urgency to do everything we can to mitigate the damage to Tony’s progress, but so much of what is happening with our COVID community spread and the heat is really quite outside of my ability to control- and there is only so much we can do inside our home to help him gain the skills necessary to safely function outside of it. Though, we certainly have been doing what we can in-home, the potential cumulative impact of decreased community safety in combination with a necessary pandemic related pause to public therapy to our ability to successfully help Tony practice public safety skills has at many points left me emotionally flayed by fears.

As I was voicing some of these concerns to Emily, she came up with a couple of really great ideas to allow us some additional opportunities to practice certain skills, and a few weeks ago (once the temperatures dropped from “blazing inferno” to a slightly more moderate roast) we started practicing some additional community safety creativity. The base idea I am going to be talking about today involves driving to different areas in our neighborhood, getting out of the car, walking a short distance of one or two blocks, and returning to our vehicle to head off to another street.

There are a couple of important considerations in picking the streets we are using. We cannot use streets that are along our typical walking routes for community safety because Tony has lost some willingness to be flexible because of the pace of ongoing pandemic related changes (emotionally he just needs some routines he can have more control of). Using roadways on our usual walking routes would increase the likelihood that he would want to finish the “normal” walk from that point on and blow up about being directed back to the car, which would be less safe to work through in the main heat of the day. The other safety element I look to satisfy is picking areas that are better shaded for as much of the walking distance as possible by trees in case our little man gets upset about something and tries to sit on the ground.

We spent a couple of weeks talking to Tony about what we would be doing before we began so that he would be prepared. The first day we tried this, his breathing was faster and he was a bit on edge because the newness of this process was making him anxious, but he only lost the impulse control battle with avoiding eloping once (that’s what his frequent attempts to run somewhere he shouldn’t are called in therapy terms). By the second day he was much more relaxed about it, though he still refuses to get out of the car safety harness for walking such a short distance. We are allowing him to keep a tablet with one of his videos playing while we walk, and we are picking different streets or sides of streets every day to promote flexibility and prevent the development of a rigid expectation for which streets we use and in what order.

I make sure to take water and a snack for him, and these are available to him as we drive from one street to the next. Right now, because of the heat, we are only picking three streets and the walking distance is kept to the one block range. We have also begun pairing practice with mask wearing for him on these outings. Once I began using the timer, he has been able to hit his goal time on nearly every single opportunity during these outings, so I walk in front of him (with me going backwards) so that he can see the timer. I generally don’t use the timer if Tony and I are doing a full community safety walk in the early hours of the morning, because we are just focusing then on putting the mask on for the time it takes us to walk past others who are out for their morning jog, etc. However, at this time he definitely is less willing to keep the mask on for anything above a few seconds unless he can actually see a timer that indicates when he can end the mask wearing.

Today we advanced to a 57 seconds expectation per trial on the mask wearing for our little man, and once we get all the way up to a minute with 100% compliance for all attempts, we will resume public therapy at non-preferred locations. That will give us just enough time to walk in and walk out. We will need to pick non-preferred locations because otherwise Tony may want to default to his typical routines for how long we stayed or which aisles we walked through, and he can’t tolerate a mask long enough yet for that to be safe. I did get a new phone case with a clip so that I could wear my phone (thus keeping the timer visible and my hands free to intervene if needed), which will help facilitate our upcoming public outings.

The pandemic has dealt us some significant therapy set-backs with what we can do for areas that are absolutely essential to helping Tony develop the necessary skills to participate in community life outside of our home, that is undoubtedly true. But with a little bit of creativity from each of us, we are doing our best to come up with workarounds that will allow us to still help our sweet son keep moving forward.