On June 1, an 18-year-old boy with autism was not exempted from mandatory swabbing despite the concerns of his mother and teachers, until staff witnessed him hitting the wall out of distress and trying to drag his mother out of the swabbing tent.

Then last Friday, a 34-year-old man who has an intellectual disability struggled for 30 minutes during a swab test, unable to comprehend the situation, till he was on the brink of a meltdown.

The two incidents sparked calls for the authorities to do more to help people with disabilities deal with Covid-19 rules.

Special education teacher Amilia Koh, 26, the sister of the 34-year-old, said she shared his experience to raise awareness of the needs of people with disabilities.

Noting that people with special needs may not understand the dangers of Covid-19 and the precautions required against it, she told The Straits Times: "As this group of individuals is vulnerable to virus transmission, changes have to be implemented in the way (the authorities) approach such unique cases."

Her brother had to be quarantined after attending a session last month at MINDSville@ Napiri, where a Covid-19 cluster was detected.

Ms Koh registered to be his caregiver so that she could be with him, but she was still initially stopped from going to the quarantine facility the next day.

On the swab test at the facility, Ms Koh said the swabbers took turns trying to swab her brother, who became more frustrated. She said she was allowed to step in to help calm her brother only after 30 minutes.

Ms Koh said: "Had the Ministry of Health taken extra steps in considering the potential challenges of swabbing individuals with special needs and the time to clarify questions as well as heed the advice of caregivers, this process would have been smoother."

Ms Cindy Chee, 45, who is the mother of the 18-year-old boy, Matthew, also shared her experience to shed light on the special difficulties some people face.

She said it takes time to teach new routines, especially if they are uncomfortable, to someone with autism. Matthew needed six months before he would wear a mask and accept that his masked mother and teachers were not "bad people".

With just one night's notice to prepare for testing, Matthew was terrified and unable to sleep, even though Ms Chee tried to help her son by showing him slides to explain swabbing.

In a journal entry on the same day after the failed swab attempt, the student of Rainbow Centre Yishun Park School recalled a room with many covered heads and faces.

He wrote: "They looked so scary to me. They wanted to put (a) stick in my throat... I (wanted) to leave the room."

Ms Chee said the last time Matthew had seen people in such gear was when his father died in intensive care three years ago. "Now when he hears about swabbing, he will go 'no, no, no' and shake his head vigorously."

Ms Koh's Facebook post had drawn 3,500 reactions a day after it was posted on Monday, and Ms Chee's garnered 600 reactions in two days.

In response to the families' concerns, SG Enable, a government-linked agency that seeks to empower people with disabilities, said it empathised.

"We will continue to improve on the engagement with persons with disabilities as the Covid-19 situation evolves," it said in a Facebook post yesterday.

It said front-line workers are being trained to better understand people with special needs.

Professor Paul Tambyah, president of the Asia-Pacific Society of Clinical Microbiology and Infection, said less intrusive methods like saliva testing had been used in other countries for people with learning disabilities.

He mooted another idea, saying: "We have found wastewater surveillance to be very effective in picking up the HDB outbreaks, so perhaps stool or even wastewater testing would be a non-invasive way of determining over time whether someone with disabilities is infected."

MP Denise Phua, an advocate for people with disabilities, said there is no one-size-fits-all approach as every need is different, requiring support to be tailored.

"Some have sensory issues, and unfamiliar sights, noise, measures such as swabbing... and unfamiliar persons can potentially give rise to fear and challenging behaviour," she said.

Ms Alina Chua, principal autism consultant and psychologist at the Autism Resource Centre (Singapore), said that a quarantine order can be hard on people with autism as it disrupts their routines and removes them from familiar environments.

Caregivers need to thoroughly prepare people with disabilities for whatever measures they have to go through, she said.

"We can introduce change in small steps, for example, starting to wear a mask for two minutes, then five minutes and progressively longer," said Ms Chua.