The danger, educators warn, is not only that special needs pupils are falling further behind their peers, but that many are regressing and losing hard-earned behavioural gains. As they do so, frustration mounts for both parent and child. Meltdowns become more common and isolation takes its toll, making learning even harder.

A vicious circle forms, as without the structure of a classroom the child loses a source of regulation, while their parent loses a pressure valve. As a consequence, educators are being swamped by a new wave of problems, including rising cases of anxiety in what some describe as the invisible aftermath of Covid-19.

The importance of schools

Bree Crockett, managing director at SPOT, which provides psychology services as well as speech, language and occupational therapy, said there had been an “exponential” increase in the number of children being referred to the centre for help with self-regulation, anxiety and communication issues.

Part of the problem, Crockett said, was that online learning was simply not appropriate for children who required high levels of monitoring.

“Many have a shadow teacher working beside them in the classroom to help them remain on task, rephrase instructions and scaffold the work. With schools closed their developmental challenges are being exacerbated without this extra support,” she said.

Before the pandemic there were some 57,000 students in Hong Kong with special educational needs, according to the Education Bureau. That number includes needs as diverse as specific learning difficulties, ADHD, autism spectrum disorders, speech and language impairment, intellectual disability, hearing impairment, physical disability, visual impairment and mental illness.

But the number of children requiring these services is thought to be growing despite – or possibly partly because of – ongoing disruptions to the in-person schooling services that experts say are so vital.

“If you had asked me a year ago, I would say the situation is extremely tense. Now, I think we’re almost at a place where I would say it is dire,” said Shalini Mahtani, chief executive of the Zubin Foundation, a charity which works with ethnic minorities in Hong Kong.

“How are they going to catch up when they go back to school? Who’s going to take them through what they should have learned in the last two years?”

Asked what needed to be done, both Crockett and Mahtani identified one thing above all others: schools had to reopen.

Said Crockett: “Three years of disruptions have caused a disastrous deficit on the development of our children and in particular children with additional needs.”

Poverty and prejudice

Earlier this month, paediatricians were dealt a shocking wake-up call with the news that a high-functioning 12-year-old boy with autism had tried to hang himself on three separate occasions.

When schools were open the boy had been bullied by his classmates, but when schools closed and classes went online, his situation became worse as the bullying came from family members who did not understand him, heard a conference co-hosted by the Philippine General Hospital.

“Those with neurodevelopmental disorders are at higher risk of suicide than neurotypical ones when placed in non-friendly environments with no support,” said Dr Marie Arranz-Lim, a developmental pediatrician who attended the conference.

Hardest hit by the loss of support were the “the toddlers and younger kids who need real life face-to-face interaction, since intervention, if done early enough, can change the trajectory of a neurodevelopmental condition from very, very bad to not so bad,” she said.

Mona Veluz, national president of the Autism Society of the Philippines, said the pandemic had left people with special needs on “the cliff – they have no friends, no services, no enrichment”.

She gave as an example a 50-year-old man with autism whom she had met around five years ago. “I saw the regression in terms of his skills, he lost his verbal skills and ability talk to other people and he did not want to look at the camera.”

Students were likewise at risk of such regression, Veluz warned, cautioning that after a prolonged absence from education some might “not have the right skills when schools reopen”.

Such skills as sitting long enough to listen to the teacher are often hard-fought victories made in preschools and day care centres, all of which have been shut down by the pandemic. Many private centres offering speech and occupational therapy have closed too; before the pandemic the paediatrician Arranz-Lim would see 15 to 20 patients a week in her clinic; now her clinic is often empty because parents are afraid to leave the house.

Instead young people with special needs have become the nation’s invisible children, tucked in odd corners of the educational system and sometimes even publicly mocked.

On February 12, Pantaleon Alvarez, a sitting lawmaker and former Speaker of the House, was cheered by supporters as he called the son of a political rival “special”, “autistic” and “abnormal” during a public rally.

The Autism Society of the Philippines criticised Alvarez saying, “We expect leaders to protect vulnerable Filipinos – not use their disability to ridicule others.”

Yet educators say Alvarez’s comments reflect problems deeper than his own personal prejudices.

In the Philippines, which has a population 110 million, that is equivalent to 1.1 million people. Veluz said it was only in the past decade that public schools had introduced special education programmes, while most private schools remained resistant to the idea. She estimated that just half of children with special needs had been in the education system “at some point”.

Meanwhile, even the few schools still offering classes to special needs students are finding online teaching a struggle.

Culiat Elementary School in Quezon City has around 2,300 students but is only able to offer services to about two dozen special needs students as it has only two suitably qualified teachers.

“We can’t accept any more. Our teachers can’t cope,” said Sabrina Ongkiko, who mentors the pair. Teachers had to think up and create their own materials, Ongkiko said. “As for the kids, they find it hard to keep still while on video and they tend to talk at the same time. It’s really hard to manage the class online.”

Christina Aligada-Halal, former chair of the special needs and inclusive education department of Miriam College, said a school run by her family had to stop operating, like many small schools, because so few students had enrolled. Fortunately, her family was able to offer some therapy services online.

Children with special needs were already at a disadvantage before Covid-19, Aligada-Halal said, and were even more so now. “They are the real losers of the pandemic,” she said.

Autism, sensory overload and anxiety

The impact of the school closures on special needs children has been as varied as their conditions.

Among those most affected by the switch online, however, are children on the autistic spectrum who often struggle with social skills, communication, personal relationships and self regulation. For many of these students, learning via the laptop has been an exercise in frustration.

Such learners often find it particularly hard to focus, to concentrate, teachers say. They lose interest quickly; are easily distracted and are often most affected by the loss of physical interaction with friends and teachers, along with the routine and structure that helped to give a comforting and predictable shape to their day.

Ambika Sunder, a teacher at Vidyaniketan Academy in Bangalore, found the same problem. “For some of my autistic pupils, the sound and bright colours were troubling. Using music also didn’t work,” Sunder said.

Anjali Verma, who lives in New Delhi, said her autistic son Rajesh, 11, could not cope with online classes.

“Rajesh used to scream when I turned the computer on. All that visual stimulation was too much for him. One day, he had a seizure. His doctor said it was too stressful for him to look at the screen for a long period,” Verma said.

In Malaysia, where schools were closed for most of the first half of 2021, parents like Nur Aisyah Mazlan, 40, whose son Muhammad Fahim, 10, has a severe Autism Spectrum Disorder [ASD], have found similar problems.

Muhammad’s particular disorder greatly limits his attention span so he found it hard to cope with the switch and this took a toll on the entire family.

“ASD children need conventional learning because they need personal care and one-on-one learning,” Nur Aisyah said. “The switch to online learning did not help at all because he couldn’t focus on the screen or even recognise the teachers on camera.”

But problems extend beyond those children on the autism spectrum.

Shamini Stevenson, 60, said her hearing-impaired son Jhovan, 21, had been unable to attend his classes at St Paul’s Day Training Centre vocational school in Petaling Jaya due to the pandemic lockdowns. But he too had found it difficult to focus on his online classes because there were “too many noise distractions” at home.

As a parent, she had done her best to help him understand the classes but – like many others in his situation – what he misses the most is the interaction with his peers.

“I think what’s lacking is the time he had with his friends because in their classroom they have lunch together and play games together so he definitely missed being with people,” Stevenson said.

Child psychologist Katyana Azman, who consults at Pantai Hospital Kuala Lumpur, said that regardless of their particular condition, all the special needs children she worked with had struggled with the transition in one way or another.

Like other educators, she said the switch was not only exacerbating the disadvantages faced by children with autism and other conditions, but it was creating entirely new problems with many children now experiencing social anxiety brought about by having to transition between learning methods.

“Especially kids who are on the autism spectrum and who have things like sensory processing difficulties, having been so accustomed to studying with just themselves in a computer are now being in a classroom with all these noises and all these other people and all of these things going on, there’s just sensory overload for a lot of these kids and that impacts focus,” Katyana said.

Special-needs students overcome adversity to pursue their dreams

Parents suffer too

Parents too have found the new normal stressful, heartbreaking and exhausting. The break they used to have while children were at school was a time to finish their chores, do their work or enjoy some time on their own. Now many find they have no chance to recharge their batteries.

Back in Hong Kong, Mahtani at the Zubin Foundation said parents were “extraordinarily stressed” by the task of having to provide specialist care for children who were home all day while also helping them with online classes.

Or as Verma, the mother of Rajesh, put it: “At the start, I panicked. I had no idea how I would get through the whole day with my son.”

While it’s hard for many parents to admit they’re struggling, educators say it’s important to remember that these are trying times even for those with professional training.

Her son was at an age when he didn’t want her sitting beside him during Zoom classes, so it was hard for her to know what he was doing.

“He says he is using the laptop for homework or online learning but he could be talking to friends or playing games,” she said.

Luckily for Tang, disruption to special needs education in Singapore has been minimal compared to many other places in the region.

Apart from two months in 2020 and around two weeks last September, special needs and mainstream schools in Singapore have been operating in-person classes.

The reopening of Singapore’s schools was a relief for parents and the children. Charlene Han, whose daughter with special needs was 11 and in primary five in 2020 when schools closed for two months, said her daughter had fretted about not completing the syllabus. “She expressed concern about not learning as well over Zoom as she is easily distracted. She is also hyperactive, so not being able to work out to expend her energy resulted in more frustration and inattentiveness,” Han said.

Other developments in the city state have also helped to soften the impact on parents. Recognising how many carers were struggling with exhaustion, burnout and mental health issues, Dr Lim Hong Huay, an epidemiologist and developmental paediatrician who has two children with autism, founded an informal support group for carers called CaringSG. Their initiatives include doctors, therapists and psychologists volunteering to support carers who are placed on quarantine or home recovery for Covid-19.

On the upside

With no end in sight to home-schooling as Hong Kong’s latest coronavirus outbreak continues to grow, many parents are looking enviously at their counterparts in Singapore where schools seem likely to stay open for good in line with the city’s decision to live with the virus. Indeed, some educators in the Chinese city say they know of expatriate parents who are now asking their employers to relocate them to Singapore specifically for their child’s special educational needs.

For the vast majority of parents relocation is not an option, but therapists point out that – despite its many downsides – the switch online has upsides too, at least for some.

“Some kids thrive and do well in online learning sessions,” said behaviour therapist Stephanie C. Duke, in Kuala Lumpur.

“This is because there is less pressure and the child feels more confident learning while at home rather than in an unfamiliar space.”

It has also helped broaden the horizons of those seeking therapy by opening up the possibility of digital consultations.

Parents from as far afield as Dubai, Hong Kong, Singapore and even Switzerland now consult Arranz-Lim, the Philippine paediatrician, online.

Not only that, but “improvements are faster”, she said, because parents are often with their children 24/7 now and can implement the therapist’s advice in their child’s daily routine.

Prasad, at Step by Step in India, has noticed unexpected benefits too. One is that parents, since they are present during online classes, now have a much better understanding of their child. “By watching teachers on the screen interact with their child, they have gained fresh information about their child’s abilities, strengths and weaknesses and also understood how to improve their relationship through this knowledge,” Prasad said.

Coronavirus causing suffering for families with special needs students

Then there is the fact that in some cases, online learning is simply a good match for some disorders.

Prasad said that for some of her autistic pupils, learning online was a “fantastic experience”. Whereas they would be easily distracted in the classroom by any kind of movement or sound, they found it easier to concentrate online.

“Some autistic children don’t enjoy social stimulation or too much eye contact. They don’t like to interact too much so they were happy to be at home and enjoyed learning through videos and pictures. The visual stimulation worked wonders for some,” she said.

Marcus Antonio J. Palomares, 23, a third-year college student reading Information Technology at Diliman College in suburban Quezon City, is among those thriving.

One of his autistic traits is that he sometimes likes simply to jump about in his room – something rarely tolerated on campus. There are other benefits too.

“I am easily distracted and I hate noisy places. In the classroom, my classmates talk a lot and joke a lot. I like being online because I can focus on the lesson,” he said.

In India, Divya Surie’s 15-year-old mute daughter Muskaan is also in her element. Muskaan used to use a programme that turned text into speech so that she could communicate with her teachers at Step by Step. When classes shifted online, her mother feared this would not work and that Muskaan would struggle.

The opposite happened. “In the physical classroom she had some strange fear of speaking, of being judged or laughed at. But in the comfort of her home, with me at her side, and talking on the screen, something was unlocked. She began speaking a few words to teachers who had never even heard her say hello or thank you, first with a microphone and then without it. Audibly. I was delighted,” Surie said.

Muskaan’s confidence has continued to grow and her mother expects that when Step by Step reopens, Muskaan will return a changed student.

Still, despite the occasional rays of light, few special needs teachers would deny that overall the pandemic has opened up worrying gaps in learning. Worse, children have fallen behind. They also note that when success stories do occur they tend to happen in well-resourced private schools who have provided laptops, bandwidth, and teaching resources to their teachers.

What of the special needs children in poor families in the countless small towns and villages of Asia who cannot afford even mobile data, let alone a laptop? According to one estimate by India’s National Institute of Mental Health and Neuroscience, 29 per cent of special needs children from poor backgrounds had not even been able to access online schooling.

“For them, the educational, social, and emotional impact of the past two years will be far more serious,” Prasad said.

Even for those students who have taken online lessons in their stride, there is the loss of something less tangible, too.

Nato, a business consultant in Manila, said his son Justin, 20, who has autism, had more or less adjusted to online learning. The public school Jason goes to sends “modules” to his father, who prints them out for Justin to work on then returns them to the teacher.

But Justin has missed the physical, face-to-face interaction of the lessons of old and what he misses even more are the learning opportunities he would enjoy when travelling outside Manila with his father. The government has restricted travel into and out of Manila, effectively closing off yet one more avenue for the social interactions so vital to Justin’s development.

“He relished the idea of going on long trips. He would choose the places and we would take the bus and when we arrived at wherever we were going we would eat in a fast-food restaurant and then head back to Manila. These days the pandemic has made him clingy, less cheerful, and at times restless.”

But Nato, like many other parents of special needs children, refuses to entertain negativity. He sees his son’s recent birthday as an example of the family’s ongoing triumph over adversity.

“We surrender everything to God. Raising him and his siblings is never easy, but we wouldn’t want it any other way,” Nato said.

“Years ago the doctor said he wouldn’t last a year, he had an enlarged head with fluids that needed to be drained from his brain. At age five, he was diagnosed with autism. Yet here he is, a living miracle.”