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Luo CY, Kowalczyk ME, Msall ME, Volerman A. Social Determinants in COVID-19 Experiences of Children With Disabilities Receiving School-Based Services in Chicago: Mixed-Methods Study of Parent/Guardian Perspectives. J Dev Behav Pediatr 2024:00004703-990000000-00177. [PMID: 38905221 DOI: 10.1097/dbp.0000000000001294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 05/01/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVE To identify the impact of social determinants on the experiences of children with disabilities and their families during the COVID-19 pandemic from the perspective of parents/guardians. METHODS A mixed-methods study engaged parents/guardians of children with Individualized Education Programs (IEPs) in July to August 2021 at a developmental/behavioral pediatrics clinic in 1 urban academic medical center. All parents/guardians completed study-specific surveys on experiences and impact of COVID-19. A subset completed semi-structured interviews. Analysis included descriptive statistics and Fisher exact tests for survey questions and thematic analysis to code interviews and identify themes. Results were corroborated by experts in developmental/behavioral pediatrics and special education. RESULTS Participants included 24 parents/guardians representing 27 children (mean = 7.37 years). A majority attended public school (78%) and identified as non-White (78%). Most commonly, the children's disabilities were autism (52%), attention-deficit hyperactivity disorder (37%), and speech/language impairment (33%). The services received by children most commonly were speech/language (89%) and physical/occupational (70%) therapies. Five themes emerged about the impact of social determinants on experiences during COVID-19 related to: adapting to disruption of routines, attendance/engagement in learning, interruption of IEP services, support for children and families, and challenges with technology. CONCLUSION Social determinants, such as housing, income, insurance, and quality of education, affected the experiences of families and their ability to adapt to the needs of children with disabilities in the setting of COVID-19 pandemic-related changes.
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Affiliation(s)
- Catherine Y Luo
- Pritzker School of Medicine, University of Chicago, Chicago, IL
| | | | - Michael E Msall
- Section of Developmental and Behavioral Pediatrics, University of Chicago Kennedy Research Center and Comer Children's Hospital, Chicago, IL; and
| | - Anna Volerman
- Department of Medicine, University of Chicago, Chicago, IL
- Department of Pediatrics, University of Chicago, Chicago, IL
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Tsai JM, Bhat AN. Demographic differences in access to health/therapeutic services over first year of the pandemic: a SPARK COVID-19 impact survey analysis. FRONTIERS IN HEALTH SERVICES 2024; 4:1343636. [PMID: 38745995 PMCID: PMC11091302 DOI: 10.3389/frhs.2024.1343636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/09/2024] [Indexed: 05/16/2024]
Abstract
Introduction This analysis examined changes in services received and service recovery one-year post-pandemic compared to pre-pandemic levels in children with ASD aged between 19 months and 17 years in various subgroups based on factors such as age, income, race/ethnicity, geographic location, and sex. Methods An online, parent report survey was completed by the parents of children with ASD in the SPARK study cohort (N = 6,393). Descriptive statistics, chi-square analyses, and Spearman correlations were performed to study associations between various factors and service access, pre-pandemic and one-year, post-pandemic. Results One year after pandemic, the lag in service recovery in children with ASD was greatest for PT/OT services followed by SLT. ABA services only recovered in half of the subgroups. In contrast, SES fully recovered and MH and MED services superseded pre-pandemic levels. Across majority of the timepoints, younger children received more SLT, PT/OT, and ABA services whereas older children received more SES, MH, and MED services. Higher income families accessed more SES, SLT, and ABA whereas lower income families received more MH services. White families received less SLT compared to non-white families. Hispanic families received more SLT services compared to non-Hispanic families. Compared to rural families, urban families received more ABA services at baseline which also recovered one year after the pandemic. Certain counterintuitive findings may be attributed to home/remote schooling leading to reduced access to related services. Conclusions Future research and policy changes are needed to address the American healthcare vulnerabilities when serving children with ASD by enhancing the diversity of healthcare formats for continued service access during future pandemics and other similar crises.
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Affiliation(s)
- J.-M. Tsai
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States
| | - A. N. Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States
- Biomechanics & Movement Science Program, University of Delaware, Newark, DE, United States
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, United States
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3
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Tovin MM, Núñez-Gaunaurd A. Implementation of Peer-Assisted Physical Activity Via Telehealth for Adults on the Autism Spectrum: A Mixed Methods Feasibility Study. Phys Ther 2024; 104:pzae005. [PMID: 38236176 DOI: 10.1093/ptj/pzae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 09/02/2023] [Accepted: 12/01/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVE Adults on the autism spectrum are at risk for physical inactivity, obesity, and related health conditions. Physical activity provides physical, social, and mental health benefits across the lifespan. Previous research examined feasibility and effectiveness of physical activity intervention in autistic children, but very few studies target autistic adults. This study examined the feasibility and acceptability of Physical Activity Connections via Telehealth, implemented during the coronavirus disease 2019 (COVID-19) pandemic lockdown as an alternative to in-person programming for autistic adults aged 18 to 32. METHODS The 10-week intervention utilized telehealth and remote technologies to deliver a theoretically grounded program to improve physical activity. Strategies included peer-guidance, coaching, individualized wellness goals, customized exercise programs, and wearable activity trackers. Feasibility and acceptability were examined using a mixed-methods design including observational and survey data collection, as well as participant interviews. Data were analyzed using descriptive statistics and content analysis. RESULTS Findings support feasibility and acceptability of telehealth to promote physical activity among autistic adults who have cognitive capacity and ability to utilize remote technology, with applicability beyond pandemic-imposed challenges. CONCLUSION Telehealth delivery of physical activity interventions is a viable alternative to in-person programs and may enable autistic adults to overcome barriers to physical activity participation and access. IMPACT As the rate of autism continues to rise globally, rehabilitation professionals will play a significant role in promoting health and wellness for autistic individuals across the lifespan. Findings promote informed practice based on the health needs of this growing segment of society.
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Affiliation(s)
- Melissa M Tovin
- Department of Physical Therapy, Nova Southeastern University, Fort Lauderdale, Florida, USA
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4
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Laufer A, Isman E. Differential impact on parental quality of life: Comparing parents to children with autism spectrum disorder and those with other disabilities during the COVID-19 pandemic. Child Care Health Dev 2024; 50:e13227. [PMID: 38385572 DOI: 10.1111/cch.13227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/03/2023] [Accepted: 12/18/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND Limited research has examined parental quality of life (QoL) for caregivers of children with special needs, mostly comparing parents of children with autism spectrum disorder (ASD) to those with typical development. This study examines QoL and related variables during the COVID-19 pandemic among two comparable groups: parents of children with ASD and parents of children with other diagnoses (non-ASD). METHOD The sample included 175 Israeli parents (ASD = 101; non-ASD = 74). The parents were surveyed about the pandemic's effects on family life, child's function, and their own psychological distress, resilience, and QoL. RESULTS Parents in both groups reported deterioration in their child's academic, emotional, social, and functioning performance. However, higher psychological distress and more deterioration in child behaviour were reported in the ASD group. In both groups, QoL was positively associated with the introduction of distance learning and parental resilience and negatively associated with psychological distress, deterioration in the child's behaviour and functioning, and increased time spent with the child at home. An interaction analysis indicated that deterioration in a child's behaviour was linked to QoL solely within the ASD group, while home atmosphere was associated with QoL in the non-ASD group. CONCLUSION While the COVID-19 pandemic imposed similar challenges on both parental groups, there is evidence that it may have been more challenging for the ASD group. This calls for further examination concerning parents with special needs children, and accordingly, tailoring targeted and specific help for them.
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Affiliation(s)
- Avital Laufer
- School of Behavioral Science, Netanya Academic College, Netanya, Israel
| | - Esther Isman
- School of Education, Bar Ilan University, Ramat Gan, Israel
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Brunt S, Sadikova E, Pappagianopoulos J, Mazurek MO. The impact of COVID-19 on receipt of health services among children with and without autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:580-586. [PMID: 37243353 PMCID: PMC10225807 DOI: 10.1177/13623613231176930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
ABSTRACT TThe COVID-19 pandemic disrupted a range of health services for children across the United States. Autistic children have well-documented deficits in health-related services compared to nonautistic children. Parents of autistic children reported an increase in mental health and behavior problems with the onset of the pandemic, increasing the need for supportive services. The current study used data from the National Survey of Children’s Health from 2019 and 2020 to conduct logistic regressions predicting the likelihood of having unmet service needs before and after the onset of the pandemic. Results suggested that autistic children were more likely to have unmet medical, dental, and mental health service needs across years compared to nonautistic children, but there were no interactions by year. All children experienced an increased likelihood of having unmet needs from pre- to post-pandemic. Results suggest that although the pandemic disrupted services across the board, autistic children lacked health services regardless of the pandemic, pointing to persisting disparities in service receipt. A discussion of ongoing barriers to services and issues related to virtual services is included. Future research should further investigate the feasibility of virtual services as well as ways of reducing barriers to all services for autistic children.
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Anderson KA, Radey M, Rast JE, Roux AM, Shea L. The Economic Impacts of COVID-19 on Autistic Children and Their Families. J Autism Dev Disord 2024:10.1007/s10803-024-06280-y. [PMID: 38393434 DOI: 10.1007/s10803-024-06280-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE We used data from the National Survey of Children's Health to (1) examine differences in economic hardship and safety net program use after the implementation of federal relief efforts, and (2) assess whether the COVID-19 pandemic exacerbated autism-based disparities in hardship and program use. METHODS We examined five dimensions of economic hardship (poverty, food insecurity, medical hardship, medical costs, and foregone work) and four safety net programs (cash assistance, Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and free or reduced-cost meals). First, we calculated adjusted prevalence and odds ratios to compare pre-COVID (2018-2019) and during COVID (2021) outcomes by autism status. Next, we calculated the adjusted odds of each outcome among autistic children compared to those of children with and without other special healthcare needs at both time points. RESULTS COVID-19 exacerbated autism-based disparities in food insecurity, SNAP, and public health insurance, but alleviated inequities in medical hardship, foregone work, and cash assistance. Autistic children did not experience declines in food insecurity or increases in SNAP like other children; medical hardship and foregone work decreased more for autistic children; and the magnitude of autism-based differences in public coverage significantly increased during the pandemic. CONCLUSION Federal relief efforts likely improved economic outcomes of children; however, these effects varied according to type of hardship and by disability group. Efforts to promote economic well-being among autistic populations should be tailored to the financial challenges most salient to low-income autistic children, like food insecurity.
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Affiliation(s)
- Kristy A Anderson
- Florida State University College of Social Work, 296 Champions Way, Tallahassee, FL, 32306, USA.
| | - Melissa Radey
- Florida State University College of Social Work, 296 Champions Way, Tallahassee, FL, 32306, USA
| | - Jessica E Rast
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
| | - Anne M Roux
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
| | - Lindsay Shea
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
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Ferrante C, Sorgato P, Fioravanti M, Pacione L, Arduino GM, Ghersi S, Scattoni ML, Servili C, Salomone E. Supporting Caregivers Remotely During a Pandemic: Comparison of WHO Caregiver Skills Training Delivered Online Versus in Person in Public Health Settings in Italy. J Autism Dev Disord 2024; 54:765-784. [PMID: 36454366 PMCID: PMC9713075 DOI: 10.1007/s10803-022-05800-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 12/05/2022]
Abstract
Feasibility, acceptability and effectiveness data of a virtual adaptation of the WHO Caregiver Skills Training (CST; n = 25) were compared with those of a pilot RCT of CST delivered in person (n = 43) against treatment as usual (TAU; n = 43). Virtual CST was delivered with high levels of integrity, but received lower ratings in some caregiver- and facilitator-rated acceptability and feasibility dimensions. Qualitative analysis identified both benefits (flexibility, convenience, clinical usefulness) and challenges, (technological issues, distraction from family members, emotional distance). Virtual and in-person CST improved significantly more on caregiver competence than TAU; there were no other significant effects. Potential for use of virtual CST as a clinical response in contexts where in-person delivery is not possible is discussed.
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Affiliation(s)
- Camilla Ferrante
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy
| | - Paola Sorgato
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy
| | - Mariachiara Fioravanti
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy
| | - Laura Pacione
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Giuseppe Maurizio Arduino
- Centro Autismo e Sindrome di Asperger, Ospedale Regina Montis Regalis Mondovì, Mondovì (Cuneo), Italy
| | | | | | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Erica Salomone
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy.
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland.
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Nedungadi P, Shah SM, Stokes MA, Kumar Nair V, Moorkoth A, Raman R. Mapping autism's research landscape: trends in autism screening and its alignment with sustainable development goals. Front Psychiatry 2024; 14:1294254. [PMID: 38361829 PMCID: PMC10868528 DOI: 10.3389/fpsyt.2023.1294254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/29/2023] [Indexed: 02/17/2024] Open
Abstract
Introduction Autism Spectrum Disorder is a complex neurodevelopmental syndrome that profoundly affects social interactions, communication, and sensory perception. The research traced the evolution of autism research from 2011-2022, specifically focusing on the screening and diagnosis of children and students. Methods Through an analysis of 12,262 publications using the PRISMA framework, bibliographic coupling, science mapping, and citation analysis, this study illuminates the growth trajectory of ASD research and significant disparities in diagnosis and services. Results The study indicates an increasing trend in autism research, with a strong representation of female authorship. Open Access journals show a higher average citation impact compared to their closed counterparts. A keyword co-occurrence analysis revealed four central research themes: Child Development and Support Systems, Early Identification and Intervention, Prevalence and Etiology, and Mental Health. The pandemic's onset has prioritized research areas like mental health, telehealth, and service accessibility. Discussion Recommendations on a global level stress the importance of developing timely biological markers for ASD, amplifying Disability Inclusion research, and personalizing mental health services to bridge these critical service gaps. These strategies, underpinned by interdisciplinary collaboration and telehealth innovation, particularly in low-resource settings, can offer a roadmap for inclusive, context-sensitive interventions at local levels that directly support SDG3's aim for health and well-being for all.
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Affiliation(s)
- Prema Nedungadi
- Amrita School of Computing, Amrita Vishwa Vidyapeetham, Kollam, India
| | | | | | | | - Ajit Moorkoth
- Seed Special Education Center, Dubai, United Arab Emirates
| | - Raghu Raman
- Amrita School of Business Amritapuri, Amrita Vishwa Vidyapeetham University, Coimbatore, Tamil Nadu, India
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Pickard K, Maddox B, Boles R, Reaven J. A cluster randomized controlled trial comparing the effectiveness of two school-based interventions for autistic youth with anxiety. BMC Psychiatry 2024; 24:6. [PMID: 38166851 PMCID: PMC10763300 DOI: 10.1186/s12888-023-05441-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Recent systematic reviews have indicated that cognitive behavioral therapy (CBT) is effective in reducing anxiety symptoms for autistic and non-autistic children. However, the vast majority of CBT research for autistic youth has been implemented within university settings and primarily by mental health providers. Schools hold great promise to equitably manage the mental health symptoms of autistic youth. Although preliminary research evaluating CBT within schools has been promising, CBT has not yet been compared to another readily available school mental health program. The goal of this protocol paper is to describe a multi-site study comparing two school-based interventions, Facing Your Fears-School Based (FYF-SB) and Zones of Regulation (ZOR) via a cluster randomized controlled type 1 hybrid effectiveness-implementation trial to determine which of the two interventions will best support autistic youth with anxiety in schools. METHODS Up to 100 elementary and middle schools will be randomized into FYF-SB or ZOR. Once schools are randomized, a minimum of two interdisciplinary school providers at each school will be trained to deliver either FYF-SB or ZOR over the course of 12 weeks to groups of 2-5 autistic students ages 8-14 years. Over the course of two years, a total of 200 autistic students will receive either ZOR or FYF-SB. The primary outcome of this trial is child anxiety, as rated by masked evaluators and via caregiver- and student-report, which will be measured at baseline, post-treatment, and 6-month follow-up. Semi-structured interviews will also be conducted with a purposive sample of students, caregivers, and school providers to understand the acceptability, appropriateness, and feasibility of either ZOR or FYF-SB. Stakeholder engagement is a central component of this project via two stakeholder advisory boards that will directly inform and oversee the project. DISCUSSION Results of this study will provide evidence about the relative impact of two school-based mental health interventions on outcomes reported as meaningful by caregivers and school providers. The additional focus on evaluating factors that support the implementation of FYF-SB and ZOR will allow future studies to test targeted implementation strategies that support mental health programming uptake and implementation within public schools. TRIAL REGISTRATION This trial is registered with clinicaltrials.gov (NCT05863520).
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Affiliation(s)
- Katherine Pickard
- Emory School of Medicine Department of Pediatrics, Division of Autism and Related Disabilities, 1920 Briarcliff Road, Atlanta, GA, 30329, USA.
| | - Brenna Maddox
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Richard Boles
- University of Colorado Anschutz Medical Campus, JFK Partners, Aurora, CO, USA
| | - Judy Reaven
- University of Colorado Anschutz Medical Campus, JFK Partners, Aurora, CO, USA
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Pazol K, Tian LH, DiGuiseppi C, Durkin MS, Fallin MD, Moody EJ, Nadler C, Powell PS, Reyes N, Robinson B, Ryerson AB, Thierry JM, Tinker SC, Wiggins LD, Yeargin-Allsopp M. Health and Education Services During the COVID-19 Pandemic Among Young Children with Autism Spectrum Disorder and Other Developmental Disabilities. J Dev Behav Pediatr 2024; 45:e31-e38. [PMID: 38364085 PMCID: PMC10963045 DOI: 10.1097/dbp.0000000000001227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/29/2023] [Indexed: 02/18/2024]
Abstract
OBJECTIVE Understanding how the COVID-19 pandemic affected children with disabilities is essential for future public health emergencies. We compared children with autism spectrum disorder (ASD) with those with another developmental disability (DD) and from the general population (POP) regarding (1) missed or delayed appointments for regular health/dental services, immunizations, and specialty services; (2) reasons for difficulty accessing care; and (3) use of remote learning and school supports. METHOD Caregivers of children previously enrolled in the Study to Explore Early Development, a case-control study of children with ASD implemented during 2017 to 2020, were recontacted during January-June 2021 to learn about services during March-December 2020. Children were classified as ASD, DD, or POP during the initial study and were aged 3.4 to 7.5 years when their caregivers were recontacted during the pandemic. RESULTS Over half of all children missed or delayed regular health/dental appointments (58.4%-65.2%). More children in the ASD versus DD and POP groups missed or delayed specialty services (75.7%, 58.3%, and 22.8%, respectively) and reported difficulties obtaining care of any type because of issues using telehealth and difficulty wearing a mask. During school closures, a smaller proportion of children with ASD versus another DD were offered live online classes (84.3% vs 91.1%), while a larger proportion had disrupted individualized education programs (50.0% vs 36.2%). CONCLUSION Minimizing service disruptions for all children and ensuring continuity of specialty care for children with ASD is essential for future public health emergencies. Children may need additional services to compensate for disruptions during the pandemic.
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Affiliation(s)
- Karen Pazol
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lin H. Tian
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Carolyn DiGuiseppi
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | | | - Eric J. Moody
- University of Wyoming Institute for Disabilities, Laramie, WY
| | - Cy Nadler
- Children’s Mercy Kansas City, Kansas City, MO
| | - Patrick S. Powell
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Nuri Reyes
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Britney Robinson
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - JoAnn M. Thierry
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sarah C. Tinker
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lisa D. Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
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11
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Gu X, Shan X, Wang L, Gao WY, Liu XQ. Prevalence of psychological problems among caregivers of children and adolescents with neurodevelopmental disorders during the COVID-19 pandemic: A meta-analysis and systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 143:104632. [PMID: 37976983 DOI: 10.1016/j.ridd.2023.104632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/18/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND The COVID-19 pandemic impacted children and adolescents with neurodevelopmental disorders, which caused difficulties and increased caregivers' burden. AIM The objective of this study was to assess the prevalence of psychological problems among caregivers of children and adolescents with neurodevelopmental disorders. Methods and procedures We searched the PubMed, Embase and Web of Science databases for relevant studies published from December 2019 to March 2023. Random effects models were used to calculate the pooled prevalence of psychological problems among caregivers. Subgroup analyses were used to detect potential heterogeneity and sensitivity analyses were performed to evaluate the robustness of the included studies. Egger's and Begg's tests were used to examine publication bias. Outcomes and results Twenty studies involving 14,743 participants were included in this systematic review and meta-analysis. The main psychological problems among caregivers were anxiety (36.6%, 95% confidence interval [CI] 19.6-53.7%), depression (41.1%, 95%CI 35.4-46.8%), and stress (58.9%, 95%CI 45.1-72.7%). There were differences in prevalence by study year, national economic level, continent, and sample size. Conclusions and implications Our study showed that caregivers of children and adolescents with neurodevelopmental disorders had a high prevalence of anxiety, depression, and stress during the COVID-19 pandemic. Therefore, the psychological problems of these caregivers should not be overlooked. We recommend that the government should provide caregivers with more medical and financial assistance. What this paper adds? The current study is the first systematic review and meta-analysis focusing on parents whose children have neurodevelopmental disorders during the COVID-19 pandemic. The results show that the prevalence of psychological problems among caregivers of children with neurodevelopmental disorders is particularly prevalent, which suggests that we should attach importance to the parenting pressure and mental health of this special group.
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Affiliation(s)
- Xuan Gu
- Medical School of Nantong University, No. 19, Qi Xiu Street, Nantong 226007, China
| | - Xiao Shan
- Medical School of Nantong University, No. 19, Qi Xiu Street, Nantong 226007, China
| | - Lan Wang
- Medical School of Nantong University, No. 19, Qi Xiu Street, Nantong 226007, China
| | - Wen-Ying Gao
- Medical School of Nantong University, No. 19, Qi Xiu Street, Nantong 226007, China
| | - Xiao-Qin Liu
- Nursing Department of Affiliated Hospital of Nantong University, No. 20, Xi Si Street, Nantong 226006, China.
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12
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Romero C, Kupis L, Goodman ZT, Dirks B, Baez A, Beaumont AL, Cardona SM, Parlade MV, Alessandri M, Nomi JS, Perry LK, Uddin LQ. Pre-pandemic Executive Function Protects Against Pandemic Anxiety in Children with and Without Autism Spectrum Disorder. J Autism Dev Disord 2023:10.1007/s10803-023-06175-4. [PMID: 38038873 DOI: 10.1007/s10803-023-06175-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/02/2023]
Abstract
The COVID-19 pandemic may have exacerbated depression, anxiety, and executive function (EF) difficulties in children with autism spectrum disorder (ASD). EF skills have been positively associated with mental health outcomes. Here, we probed the psychosocial impacts of pandemic responses in children with and without ASD by relating pre-pandemic EF assessments with anxiety and depression symptoms several months into the pandemic. We found that pre-pandemic inhibition and shifting difficulties, measured by the Behavior Rating Inventory of Executive Function, predicted higher risk of anxiety symptoms. These findings are critical for promoting community recovery and maximizing clinical preparedness to support children at increased risk for adverse psychosocial outcomes.
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Affiliation(s)
- Celia Romero
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA.
| | - Lauren Kupis
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Zachary T Goodman
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Bryce Dirks
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Adriana Baez
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Amy L Beaumont
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Sandra M Cardona
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Meaghan V Parlade
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Michael Alessandri
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Jason S Nomi
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Lynn K Perry
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Lucina Q Uddin
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
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13
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Gerber AH, Keluskar J, Lerner MD. Longitudinal Impact of the Pandemic on Social Disruption and Loneliness in Autistic and Non-Autistic Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023:1-13. [PMID: 37956102 PMCID: PMC11089075 DOI: 10.1080/15374416.2023.2272933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
OBJECTIVE The coronavirus pandemic drastically increased social isolation. Autistic youth already experience elevated social isolation and loneliness, making them highly vulnerable to the impact of the pandemic. We examined trajectories of social disruption and loneliness in autistic and non-autistic youth during a six-month period of the pandemic (June 2020 until November 2020). METHOD Participants were 76 youth, ages 8 through 17, (Mage = 12.82, Nautistic = 51) with an IQ ≥ 70. Youth completed a biweekly measure of loneliness (Revised UCLA Loneliness Scale) and their parent completed a measure of pandemic-related family social disruption (Epidemic Pandemic Impacts Inventory). RESULTS There were no time trends in loneliness across all youth, however, social disruption displayed linear, quadratic, and cubic trends. Non-autistic youth reported relatively greater declines in social disruption compared to autistic youth. Additionally, autistic youth reported relatively greater declines in loneliness relative to non-autistic youth. Greater social disruption was associated with higher loneliness, however, autistic youth demonstrated a relatively stronger relationship between social disruption and loneliness compared to non-autistic youth. CONCLUSIONS The current study was one of the first to investigate social disruption and loneliness in autistic youth during the COVID-19 pandemic. Results indicated that autistic youth experienced relative decreases in loneliness during this time, perhaps due to reductions in social demands. Nonetheless, when autistic youth did experience social disruption, they reported relatively higher levels of loneliness. This work contributes to our understanding of risk factors for loneliness and highlights the need to understand the benefits, as well as the challenges, to remote schooling and social interactions.
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Affiliation(s)
- Alan H. Gerber
- Department of Psychology, Stony Brook University, Stony Brook, NY
- Child Study Center, Yale School of Medicine, New Haven, CT
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14
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Courreges A, Kouros CD, Ekas NV, Levy S. Remote vs. In-person Schooling during the COVID-19 Pandemic and Internalizing Symptoms among Children on the Autism Spectrum. RESEARCH IN AUTISM SPECTRUM DISORDERS 2023; 109:102284. [PMID: 38009124 PMCID: PMC10673621 DOI: 10.1016/j.rasd.2023.102284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
Background Children on the autism spectrum encountered interruptions to their education due to the COVID-19 pandemic (White et al., 2021). This study examined the extent to which autistic children's anxiety and depressive symptoms during the pandemic were associated with the school format they attended in October 2020 (remote, in-person/hybrid, homeschool), controlling for their pre-pandemic symptoms. Pre-pandemic peer victimization and autism symptom characteristics were tested as moderators. Method Participants were 81 verbally-fluent autistic children (Mage = 14.71 years, 77.8% males), without an intellectual disability, and their mothers; families were part of an ongoing, longitudinal study that began before the pandemic. Results School format did not significantly predict children's anxiety or depressive symptoms. Results indicated that the only significant predictors of children's anxiety and depressive symptoms during the pandemic were their pre-pandemic symptom levels. Conclusions School format did not significantly contribute to variability in children's anxiety and depressive symptoms during the pandemic, over and above their pre-pandemic symptoms. The results contribute quantitative findings to the growing body of research on pandemic-related effects on autistic children, and underscore the need to account for pre-pandemic child functioning when drawing conclusions about pandemic-level effects.
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Affiliation(s)
- Audrey Courreges
- Department of Psychology, Southern Methodist University, PO Box 750442, Dallas, TX, 75275, USA
| | - Chrystyna D. Kouros
- Department of Psychology, Southern Methodist University, PO Box 750442, Dallas, TX, 75275, USA
| | - Naomi V. Ekas
- Department of Psychology, Texas Christian University, TCU Box 298920, Fort Worth, TX, 76129, USA
| | - Sam Levy
- Department of Psychology, Southern Methodist University, PO Box 750442, Dallas, TX, 75275, USA
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15
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Sartor T, Sons S, Kunina-Habenicht O, Tröster H, Kuhn JT. Demands and stress before and during the COVID-19 pandemic of parents to children with autism spectrum disorder. Front Psychol 2023; 14:1212556. [PMID: 37854145 PMCID: PMC10580071 DOI: 10.3389/fpsyg.2023.1212556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/19/2023] [Indexed: 10/20/2023] Open
Abstract
Introduction Parents to children with Autism Spectrum Disorder (ASD) face diverse daily demands that can lead to stress. The aim of this study was to examine to which extent stress in parents to children with ASD can be explained by daily demands before and during the COVID-19 pandemic (after lockdowns; first half of 2022), and whether there are differences between the two time periods in this regard. Methods Data from parents to children with ASD living in Germany from two independent questionnaire studies (before the pandemic: N = 168, during the pandemic: N = 105) were matched for comparability. Simple and multiple linear regression analyses were used to answer the research question. Results Parental stress as well as all demands examined showed higher levels during the COVID-19 pandemic than before. Significant predictors of parental stress before and during the COVID-19 pandemic were (1) the daily demands to deal with the child's problem behavior, (2) the restriction of one's personal way of life, and (3) the challenge to cooperate with the partner. During the COVID-19 pandemic, the child's problem behavior was particularly relevant. It was also found that the demand to deal with stigmatizing reactions did not explain parental stress during the COVID-19 pandemic whereas before the pandemic it had been a significant predictor. Discussion Although parental stress and the demands of daily life increased during the pandemic, most of the stress can be explained by the same demands. It is suggested that the increased levels may be due to an increase in the child's ASD symptomatology, which is why it is advisable to install therapeutic and care structures that prepare children with ASD for future crises.
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16
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da Silva AP, Cáceres-Assenço AM. Telemonitoring of children with risk indicators for Autism Spectrum Disorder: preliminary findings. Codas 2023; 35:e20210308. [PMID: 37585895 PMCID: PMC10449090 DOI: 10.1590/2317-1782/20232021308pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 08/26/2022] [Indexed: 08/18/2023] Open
Abstract
PURPOSE monitor the development of pragmatic skills in children with clinical risk indicators for autism spectrum disorder (ASD) before and after the application of an integrated parental guidance protocol. METHODS Seven families who had children with clinical risk indicators for autism spectrum disorder and were in the diagnostic process participated in this study. The study was divided into three moments: (1) structured interview with parents and assessment of children's pragmatic skills, (2) virtual sessions with guidance to parents related to the characteristics of the condition and skills that can be developed to favor their development, and (3) reassessment of children's pragmatic skills. Statistical analysis considered occupation of communicative space, use of functions and communicative means at ground zero and post-monitoring. RESULTS There was no significant difference between the two evaluation moments, but a greater number was observed in the use of communicative acts and more interactive communicative functions as an outcome. CONCLUSION The monitoring of children's pragmatic skills suggests that they present discrete evolution, especially the more interactive ones, after the application of the integrated parental guidance protocol.
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Affiliation(s)
- Alessandra Pinheiro da Silva
- Programa Associado de Pós-graduação em Fonoaudiologia, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil.
| | - Ana Manhani Cáceres-Assenço
- Programa Associado de Pós-graduação em Fonoaudiologia, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil.
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17
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Stankova M, Kamenski T, Ivanov I, Mihova P. Emotional and Behavioral Problems of Children with ASD-The Lessons That We Learned from the Pandemic. CHILDREN (BASEL, SWITZERLAND) 2023; 10:969. [PMID: 37371201 PMCID: PMC10297218 DOI: 10.3390/children10060969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023]
Abstract
The data available for changes in the behavior and emotional state of children with ASD (autism spectrum disorder) in lockdown situations are controversial and scarce. In our research, we compare results before the first COVID-19 lockdown of 21 children with ASD and 21 typically developing children, four to five years of age with those obtained immediately after. The study attempts to answer the question of whether there are changes in the levels of emotional and behavioral problems in children with ASD after the lockdown and how these new living conditions affect some aspects of their functioning. The instruments used for data analysis are the Childhood Autism Spectrum Test (CAST); Child Behavior Checklist (CBCL); Survey on the consequences of COVID-19 on the life and development of the participants. No significant differences in the emotional and behavioral state of the participants were found, except for attention deficit/hyperactivity problems where ASD children showed lower levels after the lockdown. ASD group parents' answers to the survey pointed towards more positive consequences of staying at home. Some reported they had more time for learning together, communicating, playing, and assisting the learning process through online therapy. As negatives, the parents of ASD children reported low physical activity, increased time with electronic devices, and time spent with the same people. Caregivers of typically developing children agreed that the lockdown had only negative effects. To conclude, for children with ASD in the study, the lockdown period demonstrated that more time spent with parents in structured everyday activities is an opportunity that can lead to positive results in their behavior.
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Affiliation(s)
- Margarita Stankova
- Department of Health Care and Social Work, New Bulgarian University, 1618 Sofia, Bulgaria; (T.K.); (P.M.)
| | - Tsveta Kamenski
- Department of Health Care and Social Work, New Bulgarian University, 1618 Sofia, Bulgaria; (T.K.); (P.M.)
| | - Ivan Ivanov
- College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA;
| | - Polina Mihova
- Department of Health Care and Social Work, New Bulgarian University, 1618 Sofia, Bulgaria; (T.K.); (P.M.)
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18
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Turner KM, Weiss JA, Howe SJ, Sanguino H, Kerns CM, Ames ME, McMorris CA. Autistic characteristics and mental health symptoms in autistic youth during the first COVID-19 wave in Canada. Autism Res 2023; 16:1009-1023. [PMID: 36916420 DOI: 10.1002/aur.2914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 02/25/2023] [Indexed: 03/16/2023]
Abstract
Autistic youth are at heightened risk for mental health issues, and pandemic-related stressors may exacerbate this risk. This study (1) described caregiver-reported youth mental health prior to and during the pandemic; and (2) explored individual, caregiver, and environmental factors associated with changes in autistic characteristics, social-emotional symptoms, and overall mental health. 582 caregivers of autistic children (2-18 years old) completed an online survey between June and July 2020 in which they provided demographic information, their child's pre-COVID and current mental health, autistic characteristics, and social-emotional symptoms. Caregivers also rated their own perceived stress, and COVID-related household and service disruption. According to caregivers, youth experienced more autistic characteristics and social-emotional concerns during the pandemic. Autistic youth were also reported to experience poorer overall mental health during the pandemic than before the pandemic. Older youth whose caregiver's indicated higher perceived stress and greater household disruption were reported to experience more autistic traits during pandemic. Caregiver-reported increases in youth social-emotional symptoms (i.e., behavior problems, anxiety, and low mood) was associated with being older, the presence of a pre-existing mental health condition, higher caregiver stress, and greater household and service disruption. Finally, experiencing less household financial hardship prior to COVID-19, absence of a pre-existing psychiatric condition, less caregiver stress, and less service disruption were associated with better youth pandemic mental health. Strategies to support the autistic community during and following the pandemic need to be developed. The developmental-ecological factors identified in this study could help target support strategies to those autistic youth who are most vulnerable to mental health problems.
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Affiliation(s)
- Kailyn M Turner
- Werklund School of Education, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Stephanie J Howe
- Werklund School of Education, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada
| | - Hangsel Sanguino
- Werklund School of Education, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada
| | - Connor M Kerns
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Megan E Ames
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Carly A McMorris
- Werklund School of Education, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada
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19
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The Impacts of the COVID-19 Pandemic on Therapy Utilization Among Racially/Ethnically and Socio-Economically Diverse Autistic Children. J Autism Dev Disord 2023; 53:918-933. [PMID: 36757541 PMCID: PMC9909136 DOI: 10.1007/s10803-023-05905-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE The purpose of current study was to evaluate change in hours of Applied Behavior Analysis (ABA) therapy utilization for autistic children during the year prior to the COVID-19 pandemic, the first three months of the pandemic (crisis phase), and the following 9 months of the pandemic (mitigation phase). Additionally, this study aimed to evaluate if change in therapy utilization differed based on child race, ethnicity, and primary payer of services. Finally, we aimed to identify potential mechanisms of ABA therapy disruption by interpreting findings using an extended version of Donabedian's structure-process-outcome model. METHODS Retrospective clinical data on client demographics and therapy utilization (n = 283) were collected from ABA clinics in California and analyzed with four piecewise growth multi-level models. RESULTS We found that therapy utilization dropped during the first three months of the pandemic (-10.65 h/month; p < .001) and increased during the following 9 months (2.39 h/month; p < .001). Moderator analyses revelated that Asian, Non-Latinx and school-district funded children had significantly different trajectories of change in therapy utilization compared to white, non-Latinx participants and private insurance funded participants, respectively. CONCLUSION Findings suggest that utilization of ABA therapy was disrupted for a full year following the onset of the COVID-19 pandemic and that child race/ethnicity and primary payer influenced the degree to which autistic children were impacted by service disruption. These findings have implications for autistic children who lost therapy access during key developmental periods and for the ABA care delivery system.
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20
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Telehealth information and communication technology access for family caregivers of people with intellectual and developmental disabilities and mental health needs. Disabil Health J 2023:101463. [PMID: 37024396 DOI: 10.1016/j.dhjo.2023.101463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/02/2023] [Accepted: 03/05/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Telehealth is increasingly used to deliver mental health services. However, the potential benefits of telehealth for people with intellectual and developmental disabilities and mental health needs (IDD-MH) may not be fully realized. This study addresses gaps in knowledge about access to information and communication technologies (ICTs) for individuals with IDD-MH from the perspective of their family caregivers. OBJECTIVE What factors are associated with access to ICTs among family caregivers of people with IDD-MH who use START services? METHODS Retrospective analysis of cross-sectional interview data gathered for START use at the onset of COVID-19. START is a crisis prevention and intervention evidence-based model for people with IDD-MH implemented across the USA. To assess needs during COVID-19, START coordinators conducted interviews with 1455 family caregivers between March and July 2020. A multinomial regression model examined correlates of ICT access, as indicated by an index (poor, limited, and optimal access). Correlates included the level of IDD, age, gender, race, ethnicity, rural setting of the person with IDD-MH, and caregiver status. RESULTS Age (ages 23-30 years) and sole caregiver status were significantly associated with limited access (both p ≤ .001). Age (ages 23-30 years and ≥31 years, p < .001), race (Black or African American, p = .001), ethnicity (Hispanic, p = .004), and sole caregiver status (p < .001) were significantly associated with poor access. CONCLUSIONS Disparities existed in ICT access for adults, specific racial/ethnic groups, and sole caregiver households. Healthcare policy related to telehealth must consider how ICT access can be equitable for all users with IDD-MH.
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21
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Vibert B, Segura P, Gallagher L, Georgiades S, Pervanidou P, Thurm A, Alexander L, Anagnostou E, Aoki Y, Birken CS, Bishop SL, Boi J, Bravaccio C, Brentani H, Canevini P, Carta A, Charach A, Costantino A, Cost KT, Cravo EA, Crosbie J, Davico C, Donno F, Fujino J, Gabellone A, Geyer CT, Hirota T, Kanne S, Kawashima M, Kelley E, Kim H, Kim YS, Kim SH, Korczak DJ, Lai MC, Margari L, Marzulli L, Masi G, Mazzone L, McGrath J, Monga S, Morosini P, Nakajima S, Narzisi A, Nicolson R, Nikolaidis A, Noda Y, Nowell K, Polizzi M, Portolese J, Riccio MP, Saito M, Schwartz I, Simhal AK, Siracusano M, Sotgiu S, Stroud J, Sumiya F, Tachibana Y, Takahashi N, Takahashi R, Tamon H, Tancredi R, Vitiello B, Zuddas A, Leventhal B, Merikangas K, Milham MP, Di Martino A. CRISIS AFAR: an international collaborative study of the impact of the COVID-19 pandemic on mental health and service access in youth with autism and neurodevelopmental conditions. Mol Autism 2023; 14:7. [PMID: 36788583 PMCID: PMC9928142 DOI: 10.1186/s13229-022-00536-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/26/2022] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Heterogeneous mental health outcomes during the COVID-19 pandemic are documented in the general population. Such heterogeneity has not been systematically assessed in youth with autism spectrum disorder (ASD) and related neurodevelopmental disorders (NDD). To identify distinct patterns of the pandemic impact and their predictors in ASD/NDD youth, we focused on pandemic-related changes in symptoms and access to services. METHODS Using a naturalistic observational design, we assessed parent responses on the Coronavirus Health and Impact Survey Initiative (CRISIS) Adapted For Autism and Related neurodevelopmental conditions (AFAR). Cross-sectional AFAR data were aggregated across 14 European and North American sites yielding a clinically well-characterized sample of N = 1275 individuals with ASD/NDD (age = 11.0 ± 3.6 years; n females = 277). To identify subgroups with differential outcomes, we applied hierarchical clustering across eleven variables measuring changes in symptoms and access to services. Then, random forest classification assessed the importance of socio-demographics, pre-pandemic service rates, clinical severity of ASD-associated symptoms, and COVID-19 pandemic experiences/environments in predicting the outcome subgroups. RESULTS Clustering revealed four subgroups. One subgroup-broad symptom worsening only (20%)-included youth with worsening across a range of symptoms but with service disruptions similar to the average of the aggregate sample. The other three subgroups were, relatively, clinically stable but differed in service access: primarily modified services (23%), primarily lost services (6%), and average services/symptom changes (53%). Distinct combinations of a set of pre-pandemic services, pandemic environment (e.g., COVID-19 new cases, restrictions), experiences (e.g., COVID-19 Worries), and age predicted each outcome subgroup. LIMITATIONS Notable limitations of the study are its cross-sectional nature and focus on the first six months of the pandemic. CONCLUSIONS Concomitantly assessing variation in changes of symptoms and service access during the first phase of the pandemic revealed differential outcome profiles in ASD/NDD youth. Subgroups were characterized by distinct prediction patterns across a set of pre- and pandemic-related experiences/contexts. Results may inform recovery efforts and preparedness in future crises; they also underscore the critical value of international data-sharing and collaborations to address the needs of those most vulnerable in times of crisis.
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Affiliation(s)
- Bethany Vibert
- grid.428122.f0000 0004 7592 9033Autism Center, Child Mind Institute, 101 E 56Th Street, Third Floor, New York, NY USA
| | - Patricia Segura
- grid.428122.f0000 0004 7592 9033Autism Center, Child Mind Institute, 101 E 56Th Street, Third Floor, New York, NY USA
| | - Louise Gallagher
- grid.8217.c0000 0004 1936 9705Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Stelios Georgiades
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - Panagiota Pervanidou
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National & Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Audrey Thurm
- grid.416868.50000 0004 0464 0574Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, Bethesda, MD USA
| | - Lindsay Alexander
- grid.428122.f0000 0004 7592 9033Center for the Developing Brain, Child Mind Institute, New York, NY USA
| | - Evdokia Anagnostou
- grid.414294.e0000 0004 0572 4702Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Paediatrics, University of Toronto, Toronto, ON Canada
| | - Yuta Aoki
- grid.410714.70000 0000 8864 3422Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
| | - Catherine S. Birken
- grid.17063.330000 0001 2157 2938Department of Pediatrics, School of Medicine, University of Toronto, Toronto, ON Canada ,grid.42327.300000 0004 0473 9646Division of Paediatric Medicine, Hospital for Sick Children, Toronto, ON Canada
| | - Somer L. Bishop
- grid.266102.10000 0001 2297 6811Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, CA USA
| | - Jessica Boi
- grid.7763.50000 0004 1755 3242Department of Biomedical Sciences, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Carmela Bravaccio
- grid.4691.a0000 0001 0790 385XUOSD di Neuropsichiatria Infantile - Dipartimento di Scienze Mediche Traslazionali, Università Federico II di Napoli, Naples, Italy
| | - Helena Brentani
- grid.11899.380000 0004 1937 0722Department of Psychiatry, Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil
| | - Paola Canevini
- grid.4708.b0000 0004 1757 2822Department of Health Sciences, Università Degli Studi Di Milano, Milan, Italy ,grid.415093.a0000 0004 1793 3800Epilepsy Center - Sleep Medicine Center, Childhood and Adolescence Neuropsychiatry Unit, ASST SS. Paolo E Carlo, San Paolo Hospital, Milan, Italy
| | - Alessandra Carta
- Department of Medical, Surgical and Pharmacy, Unit of Child Neuropsychiatry, University Hospital of Sassari, Sassari, Italy
| | - Alice Charach
- grid.42327.300000 0004 0473 9646Department of Psychiatry, Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Antonella Costantino
- grid.414818.00000 0004 1757 8749Child and Adolescent Neuropsychiatric Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Katherine T. Cost
- grid.42327.300000 0004 0473 9646Department of Psychiatry, Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, ON Canada
| | - Elaine A Cravo
- grid.20736.300000 0001 1941 472XUFPR - Federal University of Paraná, Paraná, Brazil
| | - Jennifer Crosbie
- grid.42327.300000 0004 0473 9646Department of Psychiatry, Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Chiara Davico
- grid.7605.40000 0001 2336 6580Department of Public Health and Pediatric Sciences, Section of Child and Adolescent Neuropsychiatry, University of Turin, Turin, Italy
| | - Federica Donno
- grid.7763.50000 0004 1755 3242Department of Biomedical Sciences, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Junya Fujino
- grid.265073.50000 0001 1014 9130Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Alessandra Gabellone
- grid.7644.10000 0001 0120 3326Department of Precision and Regenerative Medicine and Ionian Area, (DiMePRe-J), University of Bari “Aldo Moro”, Bari, Italy
| | - Cristiane T Geyer
- grid.20736.300000 0001 1941 472XUFPR - Federal University of Paraná, Paraná, Brazil
| | - Tomoya Hirota
- grid.266102.10000 0001 2297 6811Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA USA ,grid.257016.70000 0001 0673 6172Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Aomori, Japan
| | - Stephen Kanne
- grid.5386.8000000041936877XDepartment of Psychiatry, Weill Cornell Medical College, Center for Autism and the Developing Brain, New York, NY USA
| | | | - Elizabeth Kelley
- grid.410356.50000 0004 1936 8331Department of Psychology, Queens University, Kingston, ON Canada
| | - Hosanna Kim
- grid.266102.10000 0001 2297 6811The UCSF Center for ASD & NDDs, University of California San Francisco, San Francisco, CA USA
| | - Young Shin Kim
- grid.266102.10000 0001 2297 6811The UCSF Center for ASD & NDDs, University of California San Francisco, San Francisco, CA USA
| | - So Hyun Kim
- grid.222754.40000 0001 0840 2678School of Psychology and Psychiatry, Korea University, Seoul, South Korea
| | - Daphne J. Korczak
- grid.42327.300000 0004 0473 9646Department of Psychiatry, Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Meng-Chuan Lai
- grid.42327.300000 0004 0473 9646Department of Psychiatry, Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada ,grid.5335.00000000121885934Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK ,grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, Toronto, ON Canada ,grid.412094.a0000 0004 0572 7815Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Lucia Margari
- grid.7644.10000 0001 0120 3326Department of Precision and Regenerative Medicine and Ionian Area, (DiMePRe-J), University of Bari “Aldo Moro”, Bari, Italy
| | - Lucia Marzulli
- grid.7644.10000 0001 0120 3326Department of Precision and Regenerative Medicine and Ionian Area, (DiMePRe-J), University of Bari “Aldo Moro”, Bari, Italy
| | - Gabriele Masi
- IRCCS Stella Maris Foundation, Calambrone-Pisa, Italy
| | - Luigi Mazzone
- grid.6530.00000 0001 2300 0941Child Neurology and Psychiatry Unit, Systems Medicine Department, University of Rome Tor Vergata, Rome, Italy
| | - Jane McGrath
- grid.8217.c0000 0004 1936 9705Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland ,39ADMiRE, Linn Dara Child and Adolescent Mental Health Services, Cherry Orchard Hospital, Ballyfermot, Dublin, Ireland
| | - Suneeta Monga
- grid.42327.300000 0004 0473 9646Department of Psychiatry, Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Paola Morosini
- Unita’ Operativa di Neuropsichiatria dell’ Infanzia e dell’ adolescenza, Lodi, Italy
| | - Shinichiro Nakajima
- grid.26091.3c0000 0004 1936 9959Keio University School of Medicine, Tokyo, Japan
| | | | - Rob Nicolson
- grid.39381.300000 0004 1936 8884Department of Psychiatry, University of Western Ontario, London, ON Canada
| | - Aki Nikolaidis
- grid.428122.f0000 0004 7592 9033Center for the Developing Brain, Child Mind Institute, New York, NY USA
| | - Yoshihiro Noda
- grid.26091.3c0000 0004 1936 9959Keio University School of Medicine, Tokyo, Japan
| | - Kerri Nowell
- grid.134936.a0000 0001 2162 3504Thompson Center of Neurodevelopmental Disorders, University of Missouri, Columbia, MO USA
| | - Miriam Polizzi
- grid.4691.a0000 0001 0790 385XUOSD di Neuropsichiatria Infantile - Dipartimento di Scienze Mediche Traslazionali, Università Federico II di Napoli, Naples, Italy
| | - Joana Portolese
- grid.11899.380000 0004 1937 0722Department of Psychiatry, Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil
| | - Maria Pia Riccio
- grid.4691.a0000 0001 0790 385XUOSD di Neuropsichiatria Infantile - Dipartimento di Scienze Mediche Traslazionali, Università Federico II di Napoli, Naples, Italy
| | - Manabu Saito
- grid.257016.70000 0001 0673 6172Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Aomori, Japan ,grid.257016.70000 0001 0673 6172Research Center for Child Mental Development, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan ,grid.257016.70000 0001 0673 6172Department of Clinical Psychological Science, Comprehensive Rehabilitation Science, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori, Japan
| | - Ida Schwartz
- grid.8532.c0000 0001 2200 7498Genetics Department/UFRGS, Medical Genetics Service/HCPA, Porto Alegre, Brazil
| | - Anish K. Simhal
- grid.428122.f0000 0004 7592 9033Autism Center, Child Mind Institute, 101 E 56Th Street, Third Floor, New York, NY USA ,grid.51462.340000 0001 2171 9952Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Martina Siracusano
- grid.6530.00000 0001 2300 0941Child Neurology and Psychiatry Unit, Systems Medicine Department, University of Rome Tor Vergata, Rome, Italy
| | - Stefano Sotgiu
- Department of Medical, Surgical and Pharmacy, Unit of Child Neuropsychiatry, University Hospital of Sassari, Sassari, Italy
| | - Jacob Stroud
- grid.428122.f0000 0004 7592 9033Autism Center, Child Mind Institute, 101 E 56Th Street, Third Floor, New York, NY USA
| | - Fernando Sumiya
- grid.11899.380000 0004 1937 0722Department of Psychiatry, Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil
| | - Yoshiyuki Tachibana
- grid.63906.3a0000 0004 0377 2305Division of Infant and Toddler Mental Health, Department of Psychosocial Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Nicole Takahashi
- grid.134936.a0000 0001 2162 3504Thompson Center of Neurodevelopmental Disorders, University of Missouri, Columbia, MO USA
| | | | - Hiroki Tamon
- grid.63906.3a0000 0004 0377 2305Division of Infant and Toddler Mental Health, Department of Psychosocial Medicine, National Center for Child Health and Development, Tokyo, Japan
| | | | - Benedetto Vitiello
- grid.7605.40000 0001 2336 6580Department of Public Health and Pediatric Sciences, Section of Child and Adolescent Neuropsychiatry, University of Turin, Turin, Italy
| | - Alessandro Zuddas
- grid.7763.50000 0004 1755 3242Department of Biomedical Sciences, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Cagliari, Italy ,Child & Adolescent Neuropsychiatry Unit, “A.Cao” Paediatric Hospital, Cagliari, Italy
| | - Bennett Leventhal
- grid.170205.10000 0004 1936 7822University of Chicago, Chicago, IL USA
| | - Kathleen Merikangas
- grid.416868.50000 0004 0464 0574Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, USA
| | - Michael P. Milham
- grid.428122.f0000 0004 7592 9033Center for the Developing Brain, Child Mind Institute, New York, NY USA ,grid.250263.00000 0001 2189 4777Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY USA
| | - Adriana Di Martino
- Autism Center, Child Mind Institute, 101 E 56Th Street, Third Floor, New York, NY, USA.
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22
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Woźniak-Prus M, Gambin M, Sękowski M, Cudo A, Pisula E, Kiepura-Nawrocka E, Boruszak-Kiziukiewicz J, Kmita G. Positive experiences in the parent-child relationship during the COVID-19 lockdown in Poland: The role of emotion regulation, empathy, parenting self-efficacy, and social support. FAMILY PROCESS 2023:e12856. [PMID: 36724769 DOI: 10.1111/famp.12856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 06/18/2023]
Abstract
Despite the impact of the COVID-19 outbreak being largely negative on parents and children, for some families, lockdown could also bring about some positive effects, for example, increased emotional closeness, and more time for joint activity. The aim of the current study was to investigate cross-sectionally the most important correlates of the positive experiences in the parent-child relationship among Polish mothers and fathers during the lockdown in the initial phase of the COVID-19 outbreak. In May 2020, 228 mothers and 231 fathers completed the Brief version of the Empathic Sensitivity Questionnaire, Difficulties in Emotion Regulation Scale Short Form, Social Support Scale, Parenting Self-Agency Measure, and Scale of Positive Experiences in Parent-Child Relationship during the COVID-19 lockdown. Our results showed that parenting self-efficacy and social support were the strongest correlates of positive experiences in the parent-child relationship in both mothers and fathers during the lockdown. Perspective-taking was positively related to the positive experiences in mothers, whereas personal distress was positively associated with the positive experiences in the parent-child relationship in fathers. Our results point to factors of potential importance in designing preventive and therapeutic interventions for mothers and fathers to enhance positive experiences in the parent-child relationship during the pandemic.
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Affiliation(s)
| | | | - Marcin Sękowski
- Institute of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
| | - Andrzej Cudo
- Institute of Psychology, The John Paul II Catholic University of Lublin, Lublin, Poland
| | - Ewa Pisula
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | | | | | - Grażyna Kmita
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
- Institute of Mother and Child, Warsaw, Poland
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23
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Access to Care After Autism Diagnosis During the COVID-19 Pandemic: A Quality Improvement Project. J Dev Behav Pediatr 2023; 44:e73-e79. [PMID: 36729474 DOI: 10.1097/dbp.0000000000001146] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/04/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of this study was to identify barriers and improve access to services for children diagnosed with autism spectrum disorder (ASD) during the COVID-19 pandemic. METHODS Sixty-two patients diagnosed with ASD between March 23 and June 30, 2020, at a large urban safety net hospital were identified by chart review. Patients were called from January to March 2021 and queried regarding access to services. Brief interventions were provided as part of a modified Plan-Do-Study-Act approach. A second chart review was conducted between April and May 2021 to determine whether families accessed any additional services. RESULTS At the time of initial evaluation, 12 patients (19%) had been able to access all recommended services, 32 (52%) had been able to access some recommended services, and 9 (15%) were not able to access any services. Service levels for 9 families (15%) were undetermined. Sixteen patients (26%) lacked any follow-up with their developmental behavioral pediatrician since their initial evaluation. Thirty patients (48%) reported changes to their individualized educational program or early intervention services, and 17 patients (27%) were receiving in-home applied behavior analysis. After the brief intervention, 13 patients had accessed new services, and 9 patients previously lost to follow-up had completed an appointment. CONCLUSION Patients diagnosed with ASD in the spring of 2020 had significant difficulty accessing community services. The transition to telemedicine exacerbated this hospital's difficulty contacting patients for follow-up. Additional research is needed to fully characterize the disruptions to services experienced by patients diagnosed with ASD during the pandemic and to increase accessibility and equity of care.
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24
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Hall CL, Partlett C, Valentine AZ, Pearcey S, Sayal K. Understanding the Impact of Home Confinement on Children and Young People with ADHD and ASD During the COVID-19 Pandemic. Child Psychiatry Hum Dev 2023:10.1007/s10578-022-01490-w. [PMID: 36633768 PMCID: PMC9835738 DOI: 10.1007/s10578-022-01490-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 01/13/2023]
Abstract
To understand whether the mental health of children and young people (CYP) with and without attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) were differentially affected by COVID-19. We analysed data (n = 6507) from the Co-Space study, a UK web-based longitudinal survey. CYP with ADHD (n = 160;2.5%), ASD (n = 465;7%), and ADHD + ASD (n = 155;2.4%) were compared with a reference group (n = 5727;88%) using parent-completed questionnaires [Strengths and Difficulties Questionnaire (SDQ) & Pandemic Anxiety Scale (PAS)]. Baseline to 1-month follow-up differences were compared using linear regression models. CYP with ADHD and/or ASD had higher scores at baseline than other CYP. At follow-up, CYP with ASD showed small but significant improvements in symptoms (SDQ), compared with the reference group. CYP with ASD experienced a worsening of disease anxiety (PAS) and CYP with ADHD a deterioration in functional impairment. These findings indicate a mixed pattern of pandemic-related impact for CYP with ADHD and/or ASD.
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Affiliation(s)
- Charlotte L Hall
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, Mental Health & Clinical Neurosciences, University of Nottingham, Innovation Park, Triumph Road, Nottingham, UK.
- NIHR Nottingham Biomedical Research Centre, Institute of Mental Health, Mental Health & Clinical Neurosciences, University of Nottingham, Innovation Park, Triumph Road, Nottingham, UK.
| | - Christopher Partlett
- Nottingham Clinical Trials Unit, School of Medicine, Applied Health Research Building, University Park, Nottingham, UK
| | - Althea Z Valentine
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, Mental Health & Clinical Neurosciences, University of Nottingham, Innovation Park, Triumph Road, Nottingham, UK
| | - Samantha Pearcey
- Department of Psychiatry, University of Oxford, Oxford, UK
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Kapil Sayal
- Institute of Mental Health, School of Medicine, Mental Health & Clinical Neurosciences, University of Nottingham, Innovation Park, Triumph Road, Nottingham, UK
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25
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Richard Williams NM, Hurt-Thaut C, Thaut MH. Novel Screening Tool and Considerations for Music Therapists Serving Autistic Individuals via Telehealth: Qualitative Results from a Survey of Clinicians' Experiences. J Music Ther 2023; 59:368-393. [PMID: 36592138 DOI: 10.1093/jmt/thac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
During the COVID-19 pandemic, music therapists transitioned services from in-person to telehealth due to health and safety concerns. Though online delivery of music therapy services for autistic individuals occurred prior to 2020, the number of North American music therapists using telehealth with autistic clients rose substantially during the pandemic. The current paper's objective was to delineate music therapists' perceptions regarding factors that helped or hindered autistic persons' engagement in online music therapy sessions. In total, 192 participants completed the survey. Qualitative content analysis of an open-ended question identified seven overarching themes regarding the benefits and challenges of telehealth music therapy for autistic clients. Findings were used to create a screening tool to help music therapists evaluate autistic persons' suitability for telehealth and meet the needs of those who can benefit from telehealth music therapy.
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Affiliation(s)
- Nicole M Richard Williams
- Belmont University School of Music, Nashville, TN, USA.,Music and Health Science Research Collaboratory, University of Toronto, Toronto, ON, Canada
| | - Corene Hurt-Thaut
- Music and Health Science Research Collaboratory, University of Toronto, Toronto, ON, Canada
| | - Michael H Thaut
- Music and Health Science Research Collaboratory, University of Toronto, Toronto, ON, Canada
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26
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Impact of the COVID-19 Pandemic on Autistic Adults: a Scoping Review. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2023; 10:92-122. [PMID: 36741810 PMCID: PMC9887236 DOI: 10.1007/s40474-023-00268-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 02/01/2023]
Abstract
Purpose of Review The COVID-19 pandemic and its associated restrictions have had a significant impact on people's everyday lives, including the lives of Autistic adults. We aimed to (a) synthesise all papers currently published on the impact of the COVID-19 pandemic on autistic adults and (b) identify lessons for the care and support of Autistic adults in pandemic and post-pandemic times. Recent Findings Fifty-five papers met the inclusion criteria. Most studies focused on the pandemic's impact on the wellbeing of Autistic adults. Several studies focused on the use of (telehealth) services or the risk of COVID-19 infection/hospitalisation. Summary Autistic adults were significantly impacted by the pandemic, both directly as indicated by higher COVID-19 infection and hospitalisation rates, but also indirectly due to severe service disruptions and social restrictions. Even though there were large differences observed both between as well as within individuals in terms of the negative/positive effects of the COVID-19 pandemic, most studies reported a negative effect on Autistic adults' mental health. We draw several lessons from this review for the future care and support of Autistic adults, all of which must be underpinned by participatory research methods, that is, where Autistic community members are actively involved in setting research questions, testing the acceptability of the methods and interpreting and disseminating the results. Supplementary Information The online version contains supplementary material available at 10.1007/s40474-023-00268-6.
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27
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Yarger HA, Shariq D, Hickey AC, Giacobbe E, Dziura SL, Redcay E. Examining Adolescents' Mental Health Before and During the COVID-19 Pandemic. MERRILL-PALMER QUARTERLY (WAYNE STATE UNIVERSITY. PRESS) 2023; 69:1-29. [PMID: 38098477 PMCID: PMC10720734 DOI: 10.1353/mpq.2023.a909257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
The current study characterized the impact of the COVID-19 pandemic and stay-at-home orders on adolescents' internalizing symptoms and assessed predictors of adolescents' internalizing symptoms during the pandemic. Seventy-nine adolescents (18 autistic, 61 nonautistic) and their parents who participated in a previous study and were at least 10 years old (M = 13.8, SD = 1.7) were invited to participate in three online follow-up surveys post-stay-at-home order (May through November 2020). Measures of children's anxiety and depressive symptoms, parenting practices, family togetherness, conflict, financial problems, and parental mental health during the pandemic were collected. Nonautistic adolescents experienced a significant decrease in anxiety symptoms across the beginning of the pandemic and a significant increase in depressive symptoms from pre- to post-stay-at-home order. Permissive parenting and financial problems predicted adolescents' depressive symptoms. Parental mental health difficulties and permissive parenting predicted adolescents' anxiety symptoms. Results underscore the need to support parents and youth.
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28
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Wang F, Memis I, Durocher JS, Furar E, Cavalcante L, Eshraghi RS, Samson AC, Van Herwegen J, Dukes D, Alessandri M, Mittal R, Eshraghi AA. Efficacy of coping mechanisms used during COVID-19 as reported by parents of children with autism. PLoS One 2023; 18:e0283494. [PMID: 37053138 PMCID: PMC10101447 DOI: 10.1371/journal.pone.0283494] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 03/11/2023] [Indexed: 04/14/2023] Open
Abstract
The COVID-19 pandemic's alterations to daily life have been especially challenging for families with Autism Spectrum Disorder (ASD), worsening the core features of ASD and overall mental health. With the increased need for effective coping, the current retrospective study used data from a survey regarding parent reports of how often their child with ASD used certain coping strategies (frequency), as well as the extent to which they felt their child benefitted from their use (efficacy) in mitigating stress during the pandemic. This retrospective study Repeated measures ANOVAs were conducted to evaluate whether there were significant differences in both frequency and efficacy ratings for each coping strategy, for the entire sample as well as for three children's age groups. Using Spearman's rank-order correlations, correlation coefficients between the frequency and efficacy of each coping strategy were explored. Results revealed that maladaptive strategies were used more frequently than adaptive strategies, while parent routine as the most frequently used and efficacious for all age groups. Additionally, for adaptive strategies, humor and focusing on the positive had the strongest correlations between frequency and efficacy ratings amongst all age groups. Of the maladaptive strategies, repetitive behaviors, rumination, and isolation had the strongest correlations for the youngest, middle, and oldest age groups, respectively. Further, for each age group, the adaptive coping strategies had stronger correlations between frequency and efficacy than the maladaptive ones. It is our hope that the results of this study will lay the foundation for developing adaptive coping strategies to alleviate stress in children with ASD. Further investigations using a larger cohort are warranted to determine effective coping strategies for individuals with ASD across a range of situations, including acute stressors (such as future public health emergencies and natural disasters), as well as common daily stressors.
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Affiliation(s)
- Florence Wang
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Idil Memis
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Jennifer S Durocher
- Department of Psychology, University of Miami, Coral Gables, Florida, United States of America
| | - Emily Furar
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Leylane Cavalcante
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Rebecca S Eshraghi
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Andrea C Samson
- Institute of Special Education, University of Fribourg, Fribourg, Switzerland
- Faculty of Psychology, Unidistance Suisse, Brig, Switzerland
| | - Jo Van Herwegen
- Department of Psychology and Human Development, UCL, Institute of Education, University College London, London, United Kingdom
| | - Daniel Dukes
- Institute of Special Education, University of Fribourg, Fribourg, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - Michael Alessandri
- Department of Psychology, University of Miami, Coral Gables, Florida, United States of America
| | - Rahul Mittal
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Adrien A Eshraghi
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
- Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
- Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
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29
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Therrien MCS, Biggs EE, Barton-Hulsey A, Collins SC, Romano M. Augmentative and alternative communication services during the COVID-19 pandemic: impact on children, their families and service providers. Augment Altern Commun 2022; 38:197-208. [PMID: 36285725 DOI: 10.1080/07434618.2022.2135136] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The closure of schools and healthcare facilities across the United States due to COVID-19 has dramatically changed the way that services are provided to children with disabilities. Little is known about how children who use augmentative and alternative communication (AAC), their families and their service providers have been impacted by these changes. This qualitative study sought to understand the perspectives of parents and speech-language pathologists (SLPs) on how COVID-19 has affected children, families, services providers and the delivery of AAC-related communication services. For the study, 25 parents and 25 SLPs of children who used aided AAC participated in semi-structured interviews, with data analyzed using qualitative thematic analysis. Parents and SLPs highlighted wide disparities in how children have been impacted, ranging from views of children making more progress with communication and language than before the pandemic to worries about regression. A complex system of factors and processes may explain these differences. COVID-19 will have lasting impacts on the lives of children with complex communication needs. This research highlights the crucial role of family-service provider partnerships and access to quality AAC services for children during the pandemic and into the future.
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Affiliation(s)
- Michelle C S Therrien
- School of Communication Science and Disorders, Florida State University, Tallahassee, FL, USA
| | - Elizabeth E Biggs
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
| | - Andrea Barton-Hulsey
- School of Communication Science and Disorders, Florida State University, Tallahassee, FL, USA
| | - Sara C Collins
- School of Communication Science and Disorders, Florida State University, Tallahassee, FL, USA
| | - Mollie Romano
- School of Communication Science and Disorders, Florida State University, Tallahassee, FL, USA
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30
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Al-Beltagi M, Saeed NK, Bediwy AS, Alhawamdeh R, Qaraghuli S. Effects of COVID-19 on children with autism. World J Virol 2022; 11:411-425. [PMID: 36483100 PMCID: PMC9724198 DOI: 10.5501/wjv.v11.i6.411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/12/2022] [Accepted: 10/04/2022] [Indexed: 11/23/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic affects all countries and populations worldwide, significantly impacting people with autism with a high risk of morbidity and mortality due to COVID-19. Approximately 25% of children with autism have an asymptomatic or symptomatic immune deficiency or dysfunction. In addition, they frequently have various comorbid conditions that increase the severity of COVID-19. In addition, severe COVID-19 during pregnancy may increase the risk of autism in the offspring. Furthermore, severe acute respiratory syndrome coronavirus 2 could target human nervous system tissues due to its neurotrophic effects. The COVID-19 pandemic intensely impacts many patients and families in the autism community, especially the complex management of autism-associated disorders during the complete lockdown. During the complete lockdown, children with autism had difficulties coping with the change in their routine, lack of access to special education services, limited physical space available, and problems related to food and sleep. Additionally, children with autism or intellectual disabilities are more liable to be abused by others during the pandemic when the standard community supports are no longer functioning to protect them. Early detection and vaccination of children with autism against COVID-19 are highly indicated. They should be prioritized for testing, vaccination, and proper management of COVID-19 and other infectious diseases. In this review, we discuss the various effects of COVID-19 on children with autism, the difficulties they face, the increased risk of infection during pregnancy, how to alleviate the impact of COVID-19, and how to correct the inequalities in children with autism.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt
- Department of Pediatrics, University Medical Center, Arabian Gulf University, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
- Department of Pediatrics, University Medical Center, Dr. Sulaiman Al-Habib Medical Group, Manama 26671, Manama, Bahrain
| | - Nermin Kamal Saeed
- Department of Medical Microbiology Section, Pathology Department, Salmaniya Medical Complex, Ministry of Health, Kingdom of Bahrain, Manama 12, Manama, Bahrain
- Department of Microbiology Section, Pathology Department, Irish Royal College of Surgeon, Busiateen 15503, Muharraq, Bahrain
| | - Adel Salah Bediwy
- Department of Chest Disease, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt
- Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
- Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Dr. Sulaiman Al-Habib Medical Group, Manama 26671, Manama, Bahrain
| | - Rawan Alhawamdeh
- Research and Development Department, Pediatric Occupational Therapist and Neuropsychologist, Genomics Development and Play Center (Genomisc WLL), 0000, Manama, Bahrain
- Research and Development Department, Pediatric Occupational Therapist and Neuropsychologist, Sensory Middle East (SENSORYME DWC-LLC), 282228 Dubai, United Arab Emirates
| | - Samara Qaraghuli
- Department of Pharmacognosy and Medicinal Plants, Faculty of Pharmacy, Al-Mustansiriya University, Baghdad 14022, Baghdad, Iraq
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31
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Zima BT, Edgcomb JB, Rodean J, Cochran SD, Harle CA, Pathak J, Tseng CH, Bussing R. Use of Acute Mental Health Care in U.S. Children's Hospitals Before and After Statewide COVID-19 School Closure Orders. Psychiatr Serv 2022; 73:1202-1209. [PMID: 35611510 PMCID: PMC9633407 DOI: 10.1176/appi.ps.202100582] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study aimed to examine changes in child emergency department (ED) discharges and hospitalizations for primary general medical (GM) and primary psychiatric disorders; prevalence of psychiatric disorders among acute care encounters; and change in acute mental health (MH) care encounters by disorder type and, within these categories, by child sociodemographic characteristics before and after statewide COVID-19–related school closure orders. METHODS This retrospective, cross-sectional cohort study used the Pediatric Health Information System database to assess percent changes in ED discharges and hospitalizations (N=2,658,474 total encounters) among children ages 3–17 years in 44 U.S. children’s hospitals in 2020 compared with 2019, by using matched data for 36- and 12-calendar-week intervals. RESULTS Decline in MH ED discharges accounted for about half of the decline in ED discharges and hospitalizations for primary GM disorders (−24.8% vs. −49.1%), and MH hospitalizations declined 3.4 times less (−8.0% vs. −26.8%) in 2020. Suicide attempt or self-injury and depressive disorders accounted for >50% of acute MH care encounters before and after the statewide school closures. The increase in both ED discharges and hospitalizations for suicide attempt or self-injury was 5.1 percentage points (p<0.001). By fall 2020, MH hospitalizations for suicide attempt or self-injury rose by 41.7%, with a 43.8% and 49.2% rise among adolescents and girls, respectively. CONCLUSIONS Suicide or self-injury and depressive disorders drove acute MH care encounters in 44 U.S. children’s hospitals after COVID-19–related school closures. Research is needed to identify continuing risk indicators (e.g., sociodemographic characteristics, psychiatric disorder types, and social determinants of health) of acute child MH care.
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Affiliation(s)
- Bonnie T Zima
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Juliet Beni Edgcomb
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Jonathan Rodean
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Susan D Cochran
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Christopher A Harle
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Jyotishman Pathak
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Chi-Hong Tseng
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Regina Bussing
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
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Burke MM, Cheung WC, Li C, DaWalt L, Segal J, Taylor JL. Parental Perceptions of Service Access for Transition-Aged Youth With Autism During COVID-19. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 60:369-381. [PMID: 36162047 PMCID: PMC9942276 DOI: 10.1352/1934-9556-60.5.369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/27/2022] [Indexed: 06/16/2023]
Abstract
Services are critical for youth with autism spectrum disorder (ASD), especially during the transition to adulthood. Under the best of circumstances, though, it can be difficult to access needed adult services. With COVID-19, services were more difficult to obtain and retain. In this study, we explored parent perceptions of accessing new services and maintaining current services during the first year of the COVID-19 pandemic. Structured interviews were conducted with 65 parents of transition-aged youth (aged 16-26) with ASD living in three states (IL, TN, and WI) in the United States. None of the participants reported receiving new services during the pandemic, and many struggled to access services via online applications. In addition, participants reported that service suspensions and changes in modality (e.g., from in-person to telehealth) were spearheaded by professionals and not families. Participants, especially those in TN, were more likely to pay out-of-pocket for services during the COVID-19 pandemic to compensate for service disruptions. Implications for research and practice are discussed.
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Affiliation(s)
- Meghan M Burke
- Meghan M. Burke, W. Catherine Cheung, and Chak Li, University of Illinois at Urbana-Champaign
| | - W Catherine Cheung
- Meghan M. Burke, W. Catherine Cheung, and Chak Li, University of Illinois at Urbana-Champaign
| | - Chak Li
- Meghan M. Burke, W. Catherine Cheung, and Chak Li, University of Illinois at Urbana-Champaign
| | - Leann DaWalt
- Leann DaWalt, University of Wisconsin at Madison
| | - Jordan Segal
- Jordan Segal and Julie Lounds Taylor, Vanderbilt University Medical Center
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Kaba D, Hasanlı J, Efe A, Yavuz-Çolak M, Akın-Sarı B. Predictors of burnout and distress in parents of children with autism spectrum disorder during COVID-19 home confinement. CHILDRENS HEALTH CARE 2022. [DOI: 10.1080/02739615.2022.2119974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Duygu Kaba
- Child and Adolescent Psychiatry Department, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Jamal Hasanlı
- Psychiatry Department, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Ayşegül Efe
- Child and Adolescent Psychiatry Department, Sami Ulus Maternity and Children’s Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Meriç Yavuz-Çolak
- Biostatistics Department, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Burcu Akın-Sarı
- Child and Adolescent Psychiatry Department, Başkent University Faculty of Medicine, Ankara, Turkey
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The impact of COVID-19 on individuals with ASD in the US: Parent perspectives on social and support concerns. PLoS One 2022; 17:e0270845. [PMID: 35976958 PMCID: PMC9384980 DOI: 10.1371/journal.pone.0270845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/20/2022] [Indexed: 11/19/2022] Open
Abstract
The COVID-19 pandemic’s disruptions to daily routines and services have proven especially challenging for children with autism spectrum disorder (ASD) and their families. The current retrospective study aimed to determine the impact of the COVID-19 pandemic’s social environmental changes on parental ratings of personal and child concerns about family conflict, opportunities for social interaction, and loss of institutional support (school and therapy services). Analyses of responses from families with ASD in the US determined differences in concerns across three time points which were measured simultaneously: prior to COVID-19, at the start of COVID-19, and at the time of survey completion. From our sample of 246 school-aged children, parents retrospectively reported significantly increasing levels of concern for both themselves and their children over time, with parents’ personal concern levels rated consistently higher than their ratings of their child’s level of concern. Concerns about loss of institutional support were higher for parents of children reported as having co-occurring intellectual disability. Further, parents of younger children also reported more concerns about loss of services, as well as more social concerns. For parent ratings of child concerns, children who were reportedly aware of COVID-19 were determined to have higher levels of social concerns and concerns about loss of institutional support. Meanwhile, the child’s age and gender did not impact their parent ratings of child concerns. The increased level of parental and child-perceived concerns over the course of the pandemic suggests a need for improved service delivery and support for these families. The high levels of concerns observed in the current study provide support for the need to assess families’ priorities and tailor services to best meet families’ needs. This will potentially increase the quality of life of family members, and improve ASD services across the lifespan, and improve outcomes.
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35
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Scheeren AM, Howlin P, Pellicano L, Magiati I, Begeer S. Continuity and change in loneliness and stress during the COVID-19 pandemic: A longitudinal study of autistic and non-autistic adults. Autism Res 2022; 15:1621-1635. [PMID: 35930166 PMCID: PMC9538450 DOI: 10.1002/aur.2787] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 07/15/2022] [Indexed: 12/02/2022]
Abstract
Previous studies have suggested that autistic adults may be negatively affected by the COVID‐19 pandemic and its associated restrictions. In this study, we examined continuity and change in loneliness and stress, and their predictors, in 448 autistic and 70 non‐autistic adults living in the Netherlands. Autistic participants were assessed on three occasions using the de Jong Gierveld Loneliness Scale and Perceived Stress Scale (pre‐lockdown (T0), first lockdown (T1), and second lockdown (T2)); non‐autistic participants were assessed twice (T1 and T2). Autistic adults' loneliness and stress levels remained stable across all three time points over 8 months, but were consistently higher than those of non‐autistic adults. Other predictors of higher loneliness and stress levels at the first lockdown (T1) included low perceived social support and high levels of COVID‐19 related worries. Although loneliness and stress were stable at the group level, the wellbeing of some autistic adults worsened over the course of the pandemic, while others improved. For instance, adults with a mental health diagnosis (other than autism) prior to the pandemic were more likely to increase in stress over time, whereas adults with higher perceived social support were more likely to decrease in stress over time (from T1 to T2). Factors contributing to variability in outcome require further examination. Moreover, the relatively high loneliness and stress levels in autistic adults call for attention from clinicians and service providers.
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Affiliation(s)
- Anke M Scheeren
- Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Patricia Howlin
- Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Liz Pellicano
- Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
| | - Iliana Magiati
- School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Sander Begeer
- Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
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Jacques C, Saulnier G, Éthier A, Soulières I. Experience of Autistic Children and Their Families During the Pandemic: From Distress to Coping Strategies. J Autism Dev Disord 2022; 52:3626-3638. [PMID: 34448994 PMCID: PMC8391854 DOI: 10.1007/s10803-021-05233-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 12/21/2022]
Abstract
To understand the perspectives and needs of autistic children and their families in the context of an emergency, 109 parents and 56 autistic children (5.75-18 years) from Canada completed an online survey about needs, barriers and facilitators to coping with the pandemic. Parents' concerns about their child's development and difficulties managing their child's behaviors before and during pandemic were significantly associated. Parents identified maintaining social relationships and implementing appropriate interventions to their child's characteristics as facilitators during the pandemic. Both children and parents identified lack of socialization as a main difficulty. Among children, 92.9% associated electronic devices with their well-being. This study highlighted the need to consider the child's autistic characteristics and interests to implement emergency accommodations and services.
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Affiliation(s)
- Claudine Jacques
- Present Address: Department of Psychoeducation and Psychology, Université du Québec en Outaouais, 283 Alexandre Taché Blvd, Poste 2272, Postbox 1250, Gatineau, QC J8X 3X7 Canada
- Centre intégré de sante et des services sociaux de l’Outaouais, Gatineau, QC Canada
| | - Geneviève Saulnier
- Centre intégré de sante et des services sociaux de l’Outaouais, Gatineau, QC Canada
- Present Address: Hôpital Pierre-Janet - Pavillon Juvénile, 20, rue Pharand, bureau 1106, Gatineau, QC J9A 1K7 Canada
| | - Agnès Éthier
- Present Address: Department of Psychoeducation and Psychology, Université du Québec en Outaouais, 283 Alexandre Taché Blvd, Poste 2272, Postbox 1250, Gatineau, QC J8X 3X7 Canada
| | - Isabelle Soulières
- Department of Psychology, Université du Québec à Montréal, Montreal, QC Canada
- CIUSSS du Nord-de-l’Île-de-Montréal, Hôpital en sante mentale Rivière-des-Prairies, local SU-1335, 100, rue Sherbrooke Ouest, Montréal, QC H2X 3P2 Canada
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Sabapathy T, Goss M, Borelli JL, Steinberg-Epstein R. A Pediatrician's Guide to Working with Children on the Autism Spectrum in Coronavirus Disease 2019 and Beyond: Retrospect and Prospect. Adv Pediatr 2022; 69:41-58. [PMID: 35985716 PMCID: PMC8979765 DOI: 10.1016/j.yapd.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The COVID-19 pandemic is an unprecedented event with devastating effects on children and families, highlighting and broadening disparities in the care of children with developmental disabilities, while simultaneously catalyzing innovation. Children are vulnerable to the impacts of COVID-19, resulting in increased stress, anxiety, isolation, and health challenges, further amplified in autistic children and children with other neurodevelopmental disabilities. These children are uniquely vulnerable due to communication impairments, comorbid medical disorders, reduced adaptability, and reliance on therapeutic interventions. Abrupt reduction in services and access to care during the pandemic compromised physical and mental health and led to missed intervention opportunities at critical times. It is important to examine the effects that the pandemic triggered, address deficiencies, and recognize new opportunities to improve systems of care to prepare for unforeseen futures.
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Affiliation(s)
- Thusa Sabapathy
- University of California, Irvine School of Medicine, The Center for Autism & Neurodevelopmental Disorders, 2500 Red Hill Avenue, Suite 100, Santa Ana, CA 92705, USA.
| | - Megan Goss
- UC Irvine/CHOC Children's Hospital of Orange County, 505 S. Main Street, Suite 525, Orange, CA 92868, USA
| | - Jessica L Borelli
- Department of Psychological Science, University of California, Irvine, 4201 Social & Behavioral Sciences Gateway, Irvine, CA 92697, USA
| | - Robin Steinberg-Epstein
- University of California, Irvine School of Medicine, The Center for Autism and Neurodevelopmental Disorders, 2500 Red Hill Avenue, Suite 100, Santa Ana, CA 92705, USA
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38
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Pinkerton LM, Murphy A, Bruckner E, Risser H. Therapy service delivery for children with disabilities during COVID-19: Parent perceptions and implementation recommendations. JOURNAL OF COMMUNITY PSYCHOLOGY 2022:10.1002/jcop.22899. [PMID: 35695353 PMCID: PMC9350374 DOI: 10.1002/jcop.22899] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 02/13/2022] [Accepted: 05/14/2022] [Indexed: 06/01/2023]
Abstract
This study identifies challenges and advantages parents faced in navigating therapy service delivery for their child with disabilities during the COVID-19 pandemic. As part of an online survey, 171 parents of children with disabilities answered four, free response questions regarding the therapy services their children received during the pandemic. A grounded theory approach was used to identify top challenges, barriers, advantages, and recommendations. Challenges included children's poor response to telehealth services, lack of parent training, and technological challenges. Advantages included fewer barriers to service access and increased family involvement. Parents largely recommended shorter, more frequent teletherapy sessions, and resuming in-person services. To improve parent engagement in, and the sustainability of, services, parent feedback should inform service delivery design and implementation. Incorporating parent feedback about service delivery can decrease disparities in access and increase parent engagement in child services both generally, and during periods of service disruption.
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Affiliation(s)
- Linzy M. Pinkerton
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Ashley Murphy
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Ellie Bruckner
- Widener University Institute for Graduate Clinical PsychologyChesterPennsylvaniaUSA
| | - Heather Risser
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
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Cao LL, Gaffney LK, Marcus C. Hypokalemia-Induced Rhabdomyolysis in a Child with Autism Affected by the COVID-19 Pandemic. J Dev Behav Pediatr 2022; 43:e356-e360. [PMID: 34740217 DOI: 10.1097/dbp.0000000000001035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 09/23/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Pediatric patients with autism spectrum disorder (ASD) often have coexisting feeding disorders. We hope to emphasize the significant implications that these feeding disorders can have on this patient population through a unique case of hypokalemia-induced rhabdomyolysis. METHOD We present a unique case of a 3-year-old boy with ASD and a longstanding history of food selectivity whose routine was disrupted during the COVID-19 pandemic resulting in avoidant/restrictive food intake disorder and severe undernutrition, who presented with profound hypokalemia and was subsequently found to have elevated muscle enzymes consistent with rhabdomyolysis despite only subtle complaints of difficulty walking. RESULTS The patient was treated with aggressive hydration, electrolyte therapy, and nasogastric tube feeds, which resulted in clinical and biochemical evidence of improvement. He was also reconnected to ASD-related care services that had lapsed during the COVID-19 pandemic. CONCLUSION This case exemplifies the adverse impact that feeding disorders can have on patients with ASD, particularly in the setting of stressors such as a global pandemic, and is also the first documented pediatric case of rhabdomyolysis secondary to hypokalemia from severe undernutrition. It demonstrates that physicians should have a low threshold to assess for clinical and laboratory evidence of rhabdomyolysis in patients with profound hypokalemia because symptoms of hypokalemia-induced rhabdomyolysis can often be subtle, which can delay diagnosis and thereby increase the risk for life-threatening complications from extensive muscle damage.
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Affiliation(s)
- Longyue L Cao
- Department of Pediatrics, Boston Children's Hospital, Boston, MA; and
- Department of Pediatrics, Boston Medical Center, Boston, MA
| | - Lukas K Gaffney
- Department of Pediatrics, Boston Children's Hospital, Boston, MA; and
- Department of Pediatrics, Boston Medical Center, Boston, MA
| | - Carolyn Marcus
- Department of Pediatrics, Boston Children's Hospital, Boston, MA; and
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40
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Arazi A, Koller J, Zachor DA, Golan O, Sadaka Y, Eytan D, Stolar O, Atzaba-Poria N, Golan H, Menashe I, Meiri G, Gabis LV, Dinstein I. Home-quarantine during the initial Covid-19 outbreak in Israel: parent perceived impact on children with ASD. Heliyon 2022; 8:e09681. [PMID: 35698655 PMCID: PMC9176182 DOI: 10.1016/j.heliyon.2022.e09681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/23/2022] [Accepted: 06/01/2022] [Indexed: 11/30/2022] Open
Abstract
Background Studies have reported that Covid-19 home-quarantine periods have had mostly negative psychological impact on children with ASD and their families. Here we examined parent perceived impact of a 6-week quarantine period imposed in Israel at the beginning of the Covid-19 outbreak, in mid-March 2020. Methods An anonymous online questionnaire was completed by parents of 268 children with ASD. Parents rated deterioration/improvement in their child's behaviors, abilities, mood, sleep, and anxiety along with changes in their own mood, sleep, parenting skills, and family relationships. We performed t-tests and ANOVA analyses to assess the significance of perceived impact on each domain and potential differences in the impact across families with children of different ages, genders, and levels of required support as well as families that experienced different magnitudes of economic hardships. Results Parents reported significant deterioration in their mood and sleep along with significant improvements in relationships with their spouse and child with ASD, and in their parenting skills. Parents also reported significant increases in the severity of tantrums, anxiety, and restricted and repetitive behavior symptoms along with significant improvements in social and communication abilities of their child with ASD. Ratings were significantly lower in families of ASD children who regularly require more support and in families that experienced economic hardships. Conclusions While periods of home-quarantine create numerous hardships for families of children with ASD, they may also offer an opportunity for improving parenting skills, family relationships, and children's social communication abilities with potential relevance for improving remote services.
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Affiliation(s)
- Ayelet Arazi
- Department of Cognitive & Brain Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Judah Koller
- Seymour Fox School of Education, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ditza A. Zachor
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Autism Center/ALUT, Shamir (Assaf Harofeh) Medical Center, Israel
| | - Ofer Golan
- Autism Treatment and Research Center – Association for Children at Risk, Ramat Gan, Israel
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
- Autism Research Centre, Department of Psychiatry, University of Cambridge, UK
| | - Yair Sadaka
- Neuro-Developmental Research Centre, Beer Sheva Mental Health Centre, Ministry of Health, Beer Sheva, Israel
| | - Dganit Eytan
- ALUT – The Israeli Society for Children and Adults with Autism, Ramat Gan, Israel
- School of Education, Bar-Ilan University, Ramat Gan, Israel
| | - Orit Stolar
- The Autism Center/ALUT, Shamir (Assaf Harofeh) Medical Center, Israel
| | - Naama Atzaba-Poria
- Department of Psychology, Ben Gurion University of the Negev, Beer Sheva, Israel
- Pre-School Psychiatry Unit, Soroka University Medical Center, Beer Sheva, Israel
- Duet Center, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Hava Golan
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
- Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Idan Menashe
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
- Department of Public Health, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Gal Meiri
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
- Pre-School Psychiatry Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Lidia V. Gabis
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Child Development Services, Maccabi Healthcare, Tel Aviv, Israel
| | - Ilan Dinstein
- Department of Cognitive & Brain Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
- Department of Psychology, Ben Gurion University of the Negev, Beer Sheva, Israel
- Corresponding author.
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Kreysa H, Schneider D, Kowallik AE, Dastgheib SS, Doğdu C, Kühn G, Ruttloff JM, Schweinberger SR. Psychosocial and Behavioral Effects of the COVID-19 Pandemic on Children and Adolescents with Autism and Their Families: Overview of the Literature and Initial Data from a Multinational Online Survey. Healthcare (Basel) 2022; 10:healthcare10040714. [PMID: 35455891 PMCID: PMC9028372 DOI: 10.3390/healthcare10040714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 02/04/2023] Open
Abstract
Since COVID-19 has become a pandemic, everyday life has seen dramatic changes affecting individuals, families, and children with and without autism. Among other things, these changes entail more time at home, digital forms of communication, school closures, and reduced support and intervention. Here, we assess the effects of the pandemic on quality of life for school-age autistic and neurotypical children and adolescents. First, we provide a comprehensive review of the current relevant literature. Next, we report original data from a survey conducted in several countries, assessing activities, well-being, and social life in families with autism, and their changes over time. We focus on differences between children with and without autism from within the same families, and on different outcomes for children with high- or low-functioning autism. While individuals with autism scored lower in emotional and social functioning than their neurotypical siblings, both groups of children showed comparable decreases in well-being and increases in anxiety, compared to before the pandemic. By contrast, decreases in adaptability were significantly more pronounced in autistic children and adolescents compared to neurotypical children and adolescents. Overall, although individual families reported some positive effects of pandemic restrictions, our data provide no evidence that these generalize across children and adolescents with autism, or even just to individuals with high-functioning autism. We discuss the increased challenges that need to be addressed to protect children and adolescents’ well-being under pandemic conditions, but also point out potentials in the present situation that could be used towards social participation and success in older children and young adults with autism.
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Affiliation(s)
- Helene Kreysa
- Social Potential in Autism Research Unit & Department of General Psychology and Cognitive Neuroscience, Friedrich Schiller University Jena, 07743 Jena, Germany; (A.E.K.); (S.S.D.); (J.M.R.)
- Correspondence: (H.K.); (S.R.S.)
| | - Dana Schneider
- Social Potential in Autism Research Unit & Department of Social Psychology, Friedrich Schiller University Jena, 07743 Jena, Germany; (D.S.); (C.D.)
- DFG Scientific Network “Understanding Others”, SCHN 1481/2-1, 10117 Berlin, Germany
| | - Andrea Erika Kowallik
- Social Potential in Autism Research Unit & Department of General Psychology and Cognitive Neuroscience, Friedrich Schiller University Jena, 07743 Jena, Germany; (A.E.K.); (S.S.D.); (J.M.R.)
- Early Support and Counseling Center Jena, Herbert Feuchte Stiftungsverbund, 07743 Jena, Germany;
- Department of Psychiatry, Jena University Hospital, 07743 Jena, Germany
| | - Samaneh Sadat Dastgheib
- Social Potential in Autism Research Unit & Department of General Psychology and Cognitive Neuroscience, Friedrich Schiller University Jena, 07743 Jena, Germany; (A.E.K.); (S.S.D.); (J.M.R.)
| | - Cem Doğdu
- Social Potential in Autism Research Unit & Department of Social Psychology, Friedrich Schiller University Jena, 07743 Jena, Germany; (D.S.); (C.D.)
| | - Gabriele Kühn
- Early Support and Counseling Center Jena, Herbert Feuchte Stiftungsverbund, 07743 Jena, Germany;
| | - Jenny Marianne Ruttloff
- Social Potential in Autism Research Unit & Department of General Psychology and Cognitive Neuroscience, Friedrich Schiller University Jena, 07743 Jena, Germany; (A.E.K.); (S.S.D.); (J.M.R.)
| | - Stefan R. Schweinberger
- Social Potential in Autism Research Unit & Department of General Psychology and Cognitive Neuroscience, Friedrich Schiller University Jena, 07743 Jena, Germany; (A.E.K.); (S.S.D.); (J.M.R.)
- Correspondence: (H.K.); (S.R.S.)
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Nylén-Eriksen M, Lara-Cabrera ML, Grov EK, Skarsvaag H, Lie I, Dahl-Michelsen T, Sæterstrand TM, Mandahl A, Hafstad H, Lersveen MB, Bjørnnes AK. Fighting the waves; Covid-19 family life interference in a neurodevelopmental disorder-caregiver population. BMC Health Serv Res 2022; 22:472. [PMID: 35399084 PMCID: PMC8994698 DOI: 10.1186/s12913-022-07836-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/17/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction The current COVID-19 pandemic interferes with family lives across the world, particularly families of children with neurodevelopmental disorders (NDDs) are at a greater risk for being negatively impacted by the pandemic. Together with representatives from this caregiver population the aim was to explore the interference associated with normal family life caused by the COVID-19 pandemic. Method This is a descriptive study using a cross-sectional design. Following a strategic network sampling strategy, a user-developed national survey was completed by a larger sample (N = 1,186) of parents and informal caregivers of children with NDDs. The survey utilized a combination of both closed and open-ended questions, and a logistic regression analysis was carried out to assess the association between family characteristics, characteristics of the child, and COVID-19 related family life interference. Before carrying out the regression an inductive content analysis of the open-ended question on `How has the isolation affected the family´ was carried out to construct the outcome variable. Results The initial analysis indicated that the COVID-19 pandemic induced a shift in everyday family life and a lack of guidance and support related to managing the challenges they were facing. Caregivers who reported that COVID-19 had significantly interfered with their family life, were more likely to report having anxious children, and to have experienced an increased number of conflicts at home. The logistic regression showed that both anxious children and increased conflicts considerably increased the risk for reporting family life interference compared to those that reported no increased conflicts or anxious children. Discussion Considering how the COVID-19 related increased conflicts at home and anxious children threaten the family life of the NDD caregiver population, as an external source of family stress, which might lead to negative impact on their mental and physical well-being, the need for further research in collaboration with user representatives is apparent. Our study suggests that more information should be provided to healthcare providers, social professionals, peers, people with NDDs, and caregivers of people with NDDs about the potential threats that a stressful life event such as the current pandemic can pose to their mental and physical health and their family life.
Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07836-3.
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Roberts MY, Thornhill L, Lee J, Zellner MA, Sudec L, Grauzer J, Stern YS. The Impact of COVID-19 on Illinois Early Intervention Services. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:974-981. [PMID: 35133870 DOI: 10.1044/2021_ajslp-21-00112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE We sought to understand the extent of the nationwide disruption to Part C Early Intervention services due to COVID-19 and the subsequent shift to telehealth, primarily through a focused examination of providers' perspectives on this disruption in a single state, which is Illinois. METHOD To examine the impact of coronavirus disease (COVID-19) on Early Intervention service provision and implementation, 385 Early Intervention Illinois providers completed a web-based survey. Archival data were used to determine changes in number of Illinois Early Intervention referrals following the pandemic onset and to compare Illinois' telehealth and stay-at-home policies to those of other states. RESULTS The majority (85%) of Illinois Early Intervention providers reported a disruption in service provision during COVID-19. The number of sessions delivered and the number of children per caseload decreased significantly. Provider confidence also decreased significantly. Only 28% of providers reported high confidence with telehealth. Identified benefits of telehealth included increased accessibility and caregiver involvement, whereas limitations included perceived lack of caregiver buy-in. New Illinois Early Intervention referrals and cases were lower during COVID-19 than in the previous year. Prior to 2020, 33 states did not have a permanent reimbursement policy for providing telehealth Early Intervention services. For states with a suspension of in-person Early Intervention services due to COVID-19, time to approval for telehealth reimbursement varied (0-22 days). CONCLUSIONS The shift to telehealth in Illinois resulted in decreases in service provision and provider confidence across disciplines. However, providers identified some benefits to telehealth. Telehealth may represent a means to increase Early Intervention accessibility following the pandemic. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19119539.
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Affiliation(s)
- Megan Y Roberts
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Liane Thornhill
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Jordan Lee
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Matthew A Zellner
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Laura Sudec
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Jeffrey Grauzer
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Yael S Stern
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
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Papanikolaou K, Ntre V, Gertsou IM, Tagkouli E, Tzavara C, Pehlivanidis A, Kolaitis G. Parenting Children with Autism Spectrum Disorder during Crises: Differential Responses between the Financial and the COVID-19 Pandemic Crisis. J Clin Med 2022; 11:jcm11051264. [PMID: 35268354 PMCID: PMC8911193 DOI: 10.3390/jcm11051264] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 02/04/2023] Open
Abstract
Parenting a child with autism can be particularly stressful and challenging, especially during periods of crises. This study focuses on parenting children with autism during the COVID-19 pandemic in comparison to the economic crisis, six years ago. We administered the same set of questionnaires (CES-D, F-COPES, PSI-SF, and WHOQoL-BREF), along with a demographic characteristic and a COVID-19-related questionnaire to the same group of parents of children with autism as we did six years ago. Results indicated that during the COVID-19 crisis, the level of parenting stress and the distress due to personal factors related to demands of parenting, were significantly lower compared to the economic crisis, while the environment facet of quality of life was significantly higher. The depressive symptomatology was elevated during both periods. Finally, when addressing the pandemic crisis, parents were more likely to passively accept problematic issues, less able to obtain social support, and less able to acquire and accept help from others. In our sample, findings differentiate the genre of crises through the parents’ responses regarding the sense of competence in their parental role, their quality of life, and the coping strategies they implemented. The study implies that each crisis must be confronted with particular responses to particular needs.
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Affiliation(s)
- Katerina Papanikolaou
- Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (V.N.); (I.-M.G.); (E.T.); (C.T.); (G.K.)
- Correspondence:
| | - Vassiliki Ntre
- Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (V.N.); (I.-M.G.); (E.T.); (C.T.); (G.K.)
| | - Ioanna-Maria Gertsou
- Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (V.N.); (I.-M.G.); (E.T.); (C.T.); (G.K.)
| | - Evdokia Tagkouli
- Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (V.N.); (I.-M.G.); (E.T.); (C.T.); (G.K.)
| | - Chara Tzavara
- Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (V.N.); (I.-M.G.); (E.T.); (C.T.); (G.K.)
| | - Artemios Pehlivanidis
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece;
| | - Gerasimos Kolaitis
- Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (V.N.); (I.-M.G.); (E.T.); (C.T.); (G.K.)
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Henry AR, Conner C, Zajic MC, Solari EJ. Feasibility and Initial Efficacy of an Adapted Telepractice Listening Comprehension Intervention for School-Aged Children with Autism. J Autism Dev Disord 2022; 53:1862-1872. [PMID: 35181846 PMCID: PMC8856876 DOI: 10.1007/s10803-022-05474-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 11/25/2022]
Abstract
This study evaluates the feasibility and initial efficacy of an 11-week listening comprehension intervention, Building Vocabulary and Early Reading Strategies (BVERS) that was delivered remotely to 14 elementary-aged children with autism spectrum disorder. Children were randomly assigned to one of two groups: BVERS only, or BVERS with a parent instructional component (BVERS + PC). Results indicate that the intervention was feasible to implement. All parents were satisfied with intervention implementation, and 8 of 10 stated that they were satisfied with their child’s outcomes following the intervention. Results of a Wilcoxon signed-rank test showed growth in listening comprehension following the intervention, but no growth in narrative retell or vocabulary. There were no group differences in change scores from pre- to post-test.
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Affiliation(s)
- Alyssa R Henry
- School of Education and Human Development, University of Virginia, 405 Emmet St S, Charlottesville, VA, 22903, USA.
| | - Carlin Conner
- School of Education and Human Development, University of Virginia, 405 Emmet St S, Charlottesville, VA, 22903, USA
| | - Matthew C Zajic
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York City, NY, USA
| | - Emily J Solari
- School of Education and Human Development, University of Virginia, 405 Emmet St S, Charlottesville, VA, 22903, USA
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Dekker L, Hooijman L, Louwerse A, Visser K, Bastiaansen D, Ten Hoopen L, De Nijs P, Dieleman G, Ester W, Van Rijen S, Truijens F, Van der Hallen R. Impact of the COVID-19 pandemic on children and adolescents with autism spectrum disorder and their families: a mixed-methods study protocol. BMJ Open 2022; 12:e049336. [PMID: 35078834 PMCID: PMC8795917 DOI: 10.1136/bmjopen-2021-049336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 12/03/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic is a challenge for everyone, particularly for children and adolescents with autism spectrum disorder (ASD). ASD is a developmental disorder characterised by limitations in social communication, repetitive behavioural patterns, and limited interests, and activities. It is expected that many families with children with ASD will experience more problems due to the COVID-19 pandemic and the related public health restrictions. At the same time, some may experience improved functioning, due to fewer expectations and social demands. METHODS/DESIGN In a mixed-method study to identify the impact of the COVID-19 pandemic, parents of children with ASD (ages 4-21) who were in care pre-COVID-19 at one of three large mental healthcare institutions in the region of Rotterdam participated (68 for T0, 57 for T1). The aims are (1) to investigate the impact of the COVID-19 pandemic on overall functioning and autistic symptoms of the child/adolescent with ASD, as well as parental and family functioning (QUANT-QUAL), in both the short term and longer term, and (2) to investigate risk and protective factors (in light of resilience) (QUANT-qual) and (3) to investigate care and informational needs (QUAL-quant). Pre-COVID-19 baseline data will be retrieved from clinical records. Participants will fill out two surveys (one during a COVID-19 peak-January-May 2021-and one thereafter). Survey participants were invited to participate in interviews (n=27). Surveys include measures thar were included pre-COVID-19 (ie, overall functioning and autism symptoms) as well as specific measures to identify family functioning and COVID-19 impact. The semistructured interviews focus on child, parent and family functioning and care-and informational needs. ETHICS AND DISSEMINATION The Medical Ethics Committee of the Erasmus MC has approved the study. Findings will be available to families of children with ASD, their care providers, the funders, autism societies, the government and other researchers.
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Affiliation(s)
- Linda Dekker
- Department of Psychology, Education and Child Studies, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
| | - Linde Hooijman
- Department of Psychology, Education and Child Studies, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
| | - Anneke Louwerse
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children Hospital, Rotterdam, The Netherlands
| | - Kirsten Visser
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
- SARR Expert Centre for Autism, Youz Child- and Adolescent Psychiatry, Parnassia Group, Rotterdam, The Netherlands
| | - Dennis Bastiaansen
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
- Yulius Autism, Yulius, Mental Health Organisation, Barendrecht, The Netherlands
| | - Leontine Ten Hoopen
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children Hospital, Rotterdam, The Netherlands
| | - Pieter De Nijs
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children Hospital, Rotterdam, The Netherlands
| | - Gwen Dieleman
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children Hospital, Rotterdam, The Netherlands
| | - Wietske Ester
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
- SARR Expert Centre for Autism, Youz Child- and Adolescent Psychiatry, Parnassia Group, Rotterdam, The Netherlands
- Child- and Adolescent Psychiatry, Curium-LUMC, Oegstgeest, The Netherlands
- Parnassia Bavo Group, Parnassia Bavo Academy, Erasmus MC, The Hague, The Netherlands
| | - Susan Van Rijen
- Department of Psychology, Education and Child Studies, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
| | - Femke Truijens
- Department of Psychology, Education and Child Studies, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
| | - Ruth Van der Hallen
- Department of Psychology, Education and Child Studies, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
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Eshraghi AA, Cavalcante L, Furar E, Alessandri M, Eshraghi RS, Armstrong FD, Mittal R. Implications of parental stress on worsening of behavioral problems in children with autism during COVID-19 pandemic: "the spillover hypothesis". Mol Psychiatry 2022; 27:1869-1870. [PMID: 35064235 PMCID: PMC8780050 DOI: 10.1038/s41380-021-01433-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 12/15/2021] [Accepted: 12/23/2021] [Indexed: 11/12/2022]
Affiliation(s)
- Adrien A. Eshraghi
- grid.26790.3a0000 0004 1936 8606Department of Otolaryngology, Neurotology Division, University of Miami Miller School of Medicine, Miami, FL USA ,grid.26790.3a0000 0004 1936 8606Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL USA ,grid.26790.3a0000 0004 1936 8606Department of Biomedical Engineering, University of Miami, Coral Gables, FL USA ,grid.26790.3a0000 0004 1936 8606Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL USA
| | - Leylane Cavalcante
- grid.26790.3a0000 0004 1936 8606Department of Otolaryngology, Neurotology Division, University of Miami Miller School of Medicine, Miami, FL USA
| | - Emily Furar
- grid.26790.3a0000 0004 1936 8606Department of Otolaryngology, Neurotology Division, University of Miami Miller School of Medicine, Miami, FL USA
| | - Michael Alessandri
- grid.26790.3a0000 0004 1936 8606Department of Psychology, University of Miami, Coral Gables, FL USA
| | - Rebecca S. Eshraghi
- grid.26790.3a0000 0004 1936 8606Department of Otolaryngology, Neurotology Division, University of Miami Miller School of Medicine, Miami, FL USA
| | - F. Daniel Armstrong
- grid.26790.3a0000 0004 1936 8606Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL USA
| | - Rahul Mittal
- grid.26790.3a0000 0004 1936 8606Department of Otolaryngology, Neurotology Division, University of Miami Miller School of Medicine, Miami, FL USA
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Teixeira OFB, Xavier SPL, Félix NDDC, Silva JWMD, Abreu RMSXD, Miranda KCL. Repercusiones de la pandemia de COVID-19 para las personas con autismo y sus familias: revisión de alcance. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5965.3728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Resumen Objetivo: mapear la evidencia científica disponible sobre las repercusiones de la pandemia de COVID-19 para las personas con Trastorno del Espectro Autista y sus familiares. Método: revisión de alcance realizada en las siguientes bases de datos: MEDLINE, CINAHL, SciELO, SCOPUS, EMBASE, Wiley Online Library, en agosto/septiembre de 2021. El protocolo de esta revisión fue registrado en Open Science Framework bajo DOI 10.17605/OSF.IO/JYTVD. Los datos fueron analizados y sintetizados en forma narrativa. Resultados: 46 publicaciones identificadas indican que el período de pandemia trajo numerosas repercusiones para la población con autismo y sus familiares al experimentar serias dificultades en los cambios o irregularidades en las rutinas programadas; acceso limitado a educación, terapias y apoyo social. Conclusión: la evidencia sugiere que la pandemia de COVID-19 agudizó las desigualdades que ya experimentaban las personas con autismo y sus familias, tuvo consecuencias negativas en los aspectos emocionales, psicológicos, comportamentales y sociales, que afectaron la calidad de vida y salud mental de esta población. Es fundamental que se realicen estudios futuros sobre personas con autismo y sus familias durante períodos de crisis de salud pública para planificar intervenciones psiquiátricas, psicosociales y educativas.
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Gilmore D, Longo A, Krantz M, Radford D, Hand BN. Five Ways Providers Can Improve Mental Healthcare for Autistic Adults: A Review of Mental Healthcare Use, Barriers to Care, and Evidence-Based Recommendations. Curr Psychiatry Rep 2022; 24:565-571. [PMID: 35969335 PMCID: PMC9376572 DOI: 10.1007/s11920-022-01362-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE OF REVIEW We reviewed the literature from 2017 to 2022 on autistic adults' use of mental healthcare and barriers to care. To encourage immediate improvement in mental healthcare, we provide five strategies mental health providers can use to better care for autistic adults. RECENT FINDINGS Most autistic adults use mental healthcare and use it more often than non-autistic adults. Autistic adults' experiences with mental healthcare are characterized by (1) lack of providers knowledgeable about autism, (2) use of treatments that may not be accommodating to individual needs, and (3) difficulty navigating the complex healthcare system. These barriers contribute to prevalent unmet needs for mental healthcare. Autistic adults use mental healthcare frequently but have unmet mental health needs. As necessary systemic changes develop, providers can begin immediately to better care for autistic adults by learning about their needs and taking personalized care approaches to meet those needs.
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Affiliation(s)
- Daniel Gilmore
- The Ohio State University, 228E Atwell Hall, 453 W 10th Ave., Columbus, OH 43210 USA
| | - Anne Longo
- The Ohio State University, 228E Atwell Hall, 453 W 10th Ave., Columbus, OH 43210 USA
| | - Morgan Krantz
- The Ohio State University, 228E Atwell Hall, 453 W 10th Ave., Columbus, OH 43210 USA
| | - Deondray Radford
- The Ohio State University, 228E Atwell Hall, 453 W 10th Ave., Columbus, OH 43210 USA
| | - Brittany N. Hand
- The Ohio State University, 228E Atwell Hall, 453 W 10th Ave., Columbus, OH 43210 USA
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Teixeira OFB, Xavier SPL, Félix NDDC, Silva JWMD, Abreu RMSXD, Miranda KCL. Repercussões da pandemia da COVID-19 para pessoas com autismo e aos seus familiares: revisão de escopo. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5965.3730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Resumo Objetivo: mapear as evidências científicas disponíveis sobre as repercussões da pandemia da COVID-19 para as pessoas com Transtorno do Espectro Autista e seus familiares. Método: revisão de escopo realizada nas bases de dados: MEDLINE, CINAHL, SciELO, SCOPUS, EMBASE, Wiley Online Library, nos meses de agosto/setembro de 2021. O protocolo desta revisão foi registrado em Open Science Framework sob o DOI 10.17605/OSF.IO/JYTVD. Os dados foram analisados e sintetizados de forma narrativa. Resultados: 46 publicações identificadas sinalizam que o período pandêmico trouxe inúmeras repercussões para a população com autismo e seus familiares ao vivenciarem sérias dificuldades nas mudanças ou irregularidades das rotinas programadas; limitação no acesso à educação, às terapias e apoio social. Conclusão: as evidências sugerem que a pandemia da COVID-19 exacerbou as desigualdades já vivenciadas por pessoas com autismo e seus familiares, com consequências negativas nos aspectos emocionais, psicológicos, comportamentais e sociais, interferindo na qualidade de vida e saúde mental desta população. Estudos futuros sobre indivíduos com autismo e suas famílias durante períodos de crise de saúde coletiva são de fundamental importância para o planejamento de intervenções psiquiátricas, psicossociais e educacionais.
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