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Very often we work with students with autism who are homebound. In fact, during the pandemic many students who were not homebound became homebound. Ultimately this limits these students’ ability to grow and learn, while also impeding on their quality of life. A good SEIT or interventionist should work with families to get homebound students out into the world again, but how?
Remember when we all had to quarantine back in 2020 and couldn’t leave our houses? If you did, and are anything like me, you were probably very jumpy and scared of people coming too close to you.
Hopefully, by now that has dissipated and people are more comfortable going out and about again. However, for some students that is a constant reality, regardless of whether there is a pandemic raging.
Many children with autism have a hard time processing stimuli like loud noises and become afraid of the sources of those loud noises.
Sometimes that fear can become so strong it’s difficult for them to leave the house, and they become what SEITs and myself call homebound.
This means they can’t leave their house or learn in outside environments. Educators have no choice to but homeschool these students.
While homeschooling has its benefits, it does leave you limited in terms of growth potential. This is especially true if your students need more social skills and time with typically developing children.
So it’s important that SIETs, interventionists, and other service providers work with families to get those homebound students out into the world again!
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How Do I get them Out of the house?
The first time I worked with a homebound student, the first thing a coworker and I wanted to do was take them to the park, but that was too much too fast.
Instead, we created a system based on the treatment method for Obsessive Compulsive Disorder, exposure response prevention.
We were able to do this because of my personal experience with OCD. To read more about how I teach with OCD click here!
The idea behind it is you start small and learn to get comfortable with anxiety without giving in to your fears. So going to the park was too big.
Start Small
This particular student was homebound because of auditory sensitivity. She wore headphones wherever she went, and would even cover her ears on top of that.
The best way to work on going outside was to focus on improving her tolerance for noises. She previously had refused to let her family play the television or listen to music.
We started doing ten-minute sessions of having the TV on or playing music. Very small with a timer and an agreed-upon reward afterward.
As she got more comfortable we upped the time the noises that bothered her were on, and after a while, they stopped bothering her.
She’s actually become a big fan of music and even has a favorite band!
To get similar results, look at what is preventing your student from going outside and target small ways that affect their life.
With ERP you want to build up the ability to tolerate the thing that makes you anxious and uncomfortable on something small.
If the issue is because of too many busy visuals work on another area where that fear affects them.
Even though it’s not working directly on getting them out of the house, it’s helping them learn how to confront their fear while still being in the safety of their own home.
Starting small like this improves your chances of success.
Build Up
This student was terrified of other things too, like sirens and pigeons. Because we lived in the city these things were really unavoidable.
After she got used to the music and the TV and had some success we started a two-pronged approach to getting her out of the house.
She and I would still work on “exposures” in a safe home environment. In this case, we listened to audio recordings of sirens or videos of pigeons (gross rats with wings)
Meanwhile, a different coworker started taking her on outings and community walks. Sometimes they encountered these things and sometimes they did not.
The two sides of each of these approaches were very important. Me working on tolerating these things for set periods of time at home improved the student’s ability to tolerate them in a less controlled environment.
Meanwhile going out into the world allowed the student to build up real-world skills outside and learn that the world outside their door was not so scary.
Homebound students often forget that the outside world can be fun, and the first few trips were purely about enjoyment and getting treats.
When taking your homebound student out for the first time make sure it’s somewhere enjoyable.
You want the experience to be as positive as possible.
Expect Anxiety
No matter how good the carrot on the end of the stick is, a homebound student is never going to be happy to hear that they have to go outside.
I was not there the first day my coworker took the student out, but I heard she turned white and started shaking.
Make sure to be gentle and encouraging, but firm. And no matter what stay calm. If your students see you get upset, that will reaffirm to them that something is unsafe.
Work with Homebound Students and Families
Families will of course have to be a part of this. There is no way for one person to do this by themselves.
Before we started working on taking this girl outside we had multiple meetings with her parents to explain what we were doing and how to include them in the process.
A skill is not considered generalized until it is displayed in all environments with all kinds of people, so the student would still be considered homebound if she could only leave with her teachers and interventionists.
The parents had to be involved to see how we got her outside and accompany us on several outings once she was more familiar with the process.
They didn’t have to do any of the exposures that I did, but going places with her SEIT was an important part of the generalization process.
In my experience, parents of homebound students are eager to get their child out of the house and are very willing to work with you.
Keep them informed of the plan and what you need, as well as how it’s progressing. After your student is comfortable going out with you, include the parents.
Schedule formal times to help parents remember to stick to it, and keep things upbeat.
Final Thoughts
It was a lot of work, but my homebound student is now a going outside rock star. Just the other day I stopped by her house and she requested we go for a walk before starting class.
People who meet her know wouldn’t know she’d been stuck in her home for years. Going out has greatly improved her social skills and given her more opportunities to learn and grow.
It was totally worth all the effort and uncertainty and hours spent watching pigeons online.
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