The storm has passed, but your family's usual routine is not back yet. Maybe you evacuated and came home to damage. Maybe the power was out for a week, school is closed, and your child's therapy schedule disappeared overnight. For many autistic children, the days and weeks after a hurricane are harder than the storm itself, because so much of what made the day predictable is gone. This guide covers how to rebuild routines, what to expect from your child, how telehealth can help, and what to ask your provider and insurer.
Is it common for skills and behavior to slip after a storm?
Yes, many parents see changes after a big disruption. A child who was sleeping well may stop. A child who had stopped melting down at transitions may start again. Toileting, communication or flexibility skills can wobble. Sometimes this looks like "losing" skills, but often the skills are still there and your child is overloaded, tired, anxious or simply out of practice.
What usually helps is patience and structure, not pushing hard on new goals right away. Talk with your child's BCBA about which goals to pause and which to keep. If you see changes that worry you, such as a sudden loss of speech, eating problems, new injuries or behavior that puts your child or others at risk, tell your child's doctor as well. They decide whether a medical check is needed.
The storm may have been frightening for your whole family. The federal Disaster Distress Helpline, run by SAMHSA, offers free, confidential crisis counseling around the clock by call or text at 1-800-985-5990, including in Spanish.
How do we rebuild routines when everything is different?
You cannot recreate your old week if school, therapy and even your home are not available yet. Start smaller:
- Pick three anchors. Choose three parts of the day that can be the same every day no matter where you are, for example wake-up, meals and bedtime. Keep the order and the words the same.
- Make the day visible. A simple picture or word schedule on paper or a phone helps your child see what comes next. Our guide to visual schedules at home explains how.
- Use "first, then." "First shoes, then park." Short, clear pairings help a child get through the parts of the day that cannot be avoided, like cleanup or waiting in line. See first-then boards and waiting.
- Warn before changes. When something new is coming, such as a contractor in the house or a return to school, give a heads-up and show it on the schedule.
- Add things back one at a time. When school reopens, let that settle before adding outings or new activities.
Keep an eye on new safety risks around a storm-damaged home: open doors and gates while crews work, broken fences around pools, debris and standing water. If your child wanders, review your wandering safety plan before work starts.
When can ABA sessions start again?
That depends on your home, your provider and the people involved. Therapists and their families may also be dealing with storm damage, power loss or closed roads. Practical questions to ask your provider:
- Is in-home therapy possible yet, given damage, power and heat in our home?
- If the center is open, can we switch some sessions there for now?
- Can parent training continue by video while direct sessions are paused?
- Which goals should we focus on for the next few weeks?
- If we evacuated and are staying somewhere else, can services happen there, and does our insurance allow it?
If a Hope Center office closes after a storm, families can choose home sessions with their RBT instead. Closures go out by mass message, and BCBAs and the front desk call or text when a closure is known ahead. Parent training and BCBA supervision can continue by telehealth, though in person is preferred; RBT sessions are not done by telehealth. If your child is with us, call 561-337-8865 or email office@hopecenteraba.com and we will tell you what is possible for your family.
Can telehealth parent coaching fill the gap?
Often it can, at least for part of the program. Florida's telehealth law, section 456.47, includes in its list of telehealth providers people "licensed or certified under s. 393.17," the Florida law that recognizes behavior analyst certification, and people licensed under chapter 491, such as licensed clinical social workers. The law says:
- telehealth must meet the same professional standard of care as in-person care;
- it covers live (synchronous) and recorded (asynchronous) services, including patient education, but email and fax alone do not count; and
- records must be kept to the same standard as in-person care.
Parent coaching tends to work well by video: a BCBA watches you and your child at home, helps you adjust routines to your new situation, and plans how to restart skills. Direct teaching by video works better for some children than others. Our guide to telehealth ABA and parent coaching covers what fits video and what does not.
Two cautions. First, whether your plan pays for telehealth ABA, and at what rate, depends on your coverage. Second, if you evacuated to another state, that state's rules may apply to services delivered to you there, and some states license behavior analysts. Ask your provider before assuming sessions can continue across state lines.
What should I ask my insurer after missed sessions?
ABA is usually approved through a prior authorization that covers a set number of hours over a set period, often six months. A storm can leave a lot of approved hours unused. Things to ask your insurer or your provider's billing team:
- Can the authorization dates be extended because sessions were missed during the storm?
- If we are staying somewhere else, can services move to a new setting, such as a relative's home or the center?
- Does our plan cover telehealth parent training or other services by video?
- If our reauthorization is due soon, what will the reviewer need, given the gap in data?
Write down the date, the name of the person you spoke with and any reference number for every call. Answers depend on your plan, and self-funded employer plans can follow different rules from state-regulated plans. Our guide to ABA reauthorization every six months explains how renewals work.
For prescriptions, Florida law gives some relief during an emergency. Under section 252.358, Florida-regulated insurers that cover prescriptions must waive "refill too soon" limits and pay for at least a 30-day supply when your county is under a hurricane warning, a state of emergency or an activated county emergency plan, if you have refills left.
What helps parents in the weeks after?
- Lower the bar for a while. Getting through the day safely is enough. Skills can be rebuilt.
- Ask for help early. Tell your child's school and therapy team what happened so they can plan for the return.
- Look after yourself. Sleep, food and a few minutes of quiet make it easier to stay calm for your child. The Disaster Distress Helpline is there for parents too.
- Plan for next time. Once things settle, note what worked and what did not, and update your hurricane preparedness plan.
How does Hope Center support families after a storm?
Hope Center's programs are written by Board Certified Behavior Analysts, reviewed by our clinical director, delivered by Registered Behavior Technicians and supported by weekly parent training. That parent training is often where routines get rebuilt after a disruption, because it focuses on what you can do at home every day. We serve families from our West Palm Beach, Temple Terrace, Port Charlotte, Jacksonville and Sebring locations and in homes, schools and daycares in other areas we can staff. To talk about restarting or starting services, contact us for a free consultation and a free insurance benefits check.