The Impact of COVID-19 on Anxiety and Worries for Families of Individuals with Special Education Needs and Disabilities in the UK

Psychological Interventions and Those With Elements of Positive Psychology for Child and Youth Mental Health During the COVID-19 Pandemic: Literature Review, Lessons Learned, and Areas for Future Knowledge Dissemination

BACKGROUND

There was a marked decline in child and teenage mental health worldwide during the pandemic, with increasing prevalence of depression, anxiety, and suicide. Research indicates that positive psychological interventions may be beneficial for mental health.

OBJECTIVE

The aims of this review were to evaluate positive psychological interventions for child and youth mental health implemented during the COVID-19 pandemic and assess overall effectiveness for mental health and knowledge.

METHODS

We undertook a literature search of PubMed, MEDLINE, and Google Scholar for all eligible studies on digital and hybrid in-person psychological interventions for youth mental health during the COVID-19 pandemic. A particular emphasis was placed on positive psychological interventions or interventions that had components of positive psychology, including gratitude, acceptance, positive emotions, or resilience building.

RESULTS

A total of 41 interventions were included in this review. Most of the interventions were digital. Overall, most of the interventions assisted with one or more mental health or psychological indicators, such as depression, anxiety, posttraumatic stress disorder, stress, and resilience. However, findings were mixed when it came to targeting both depression and anxiety together. The interventions that promoted youth mental health most often had a range of diverse positive psychology components and were evidence based. Not all studies measured changes in mindfulness. Few studies examined knowledge acquired on mental health self-care, managing mental health problems, knowledge of positive psychological techniques, mindfulness knowledge, or mental health self-efficacy.

CONCLUSIONS

Diverse multicomponent interventions appear to assist with youth mental health overall, although their effects on both depression and anxiety are less clear. There is also a need for more research on knowledge gains to determine whether the interventions improved knowledge on mental health-supportive behaviors, which may be sustained beyond the intervention. Finally, more studies need to evaluate whether the interventions assisted with increasing self-efficacy for practicing positive psychological techniques as well as changes in mindfulness levels. Future studies should not only assess effectiveness for mental health outcomes but also assess knowledge translation, with valid measures of knowledge and self-efficacy for mental health-supportive behaviors and positive psychological skills acquired (eg, the ability to practice mindfulness).

School Attendance Problems Among Children with Neurodevelopmental Conditions One year Following the Start of the COVID-19 Pandemic

PURPOSE

The present study investigated school absence among 1,076 5-15 year-old children with neurodevelopmental conditions (intellectual disability and/or autism) approximately one year following the start of COVID-19 in the UK.

METHODS

Parents completed an online survey indicating whether their child was absent from school during May 2021 and the reason for each absence. Multi-variable regression models investigated child, family and school variables associated with absenteeism and types of absenteeism. Qualitative data were collected on barriers and facilitators of school attendance.

RESULTS

During May 2021, 32% of children presented with persistent absence (missing ≥ 10% of school). School refusal and absence due to ill-health were the most frequent types of absence, accounting for 37% and 22% of days missed, respectively. COVID-19 related absence accounted for just 11% of days missed. Child anxiety was associated with overall absenteeism and with days missed because of school refusal. Parent pandemic anxiety and child conduct problems were not associated with school absenteeism. Hyperactivity was associated with lower levels of absenteeism and school refusal but higher levels of school exclusion. A positive parent-teacher relationship was associated with lower levels of absenteeism, school refusal and exclusion. Child unmet need in school was the most frequently reported barrier to attendance while COVID-19 was one of the least frequently reported barriers.

CONCLUSION

COVID-19 had a limited impact on school attendance problems during this period. Findings highlighted the role of child mental health in different types of absence and the likely protective role of a positive parent-teacher relationship.

Relationship of autistic traits and the severity of fear of the COVID-19 pandemic in the general population

Background

The aim of the study was to investigate the level of fear of the COVID-19 pandemic and to detect a possible correlation between the autistic traits and the level of fear and to learn about other factors that may affect the level of fear.

Methods

The study utilised a questionnaire and was conducted online in the period from 16.02.2021 to 11.06.2021. The test group consisted of 214 respondents with an average age of 23.78 years (95%CI: 22.48 - 25.08; max: 61, min: 14) from the general population. The study used The Autism-Spectrum Quotient (AQ) questionnaire to assess the degree of autistic traits in the general population and The Fear of COVID-19 Scale, which was used to assess the level of fear of COVID-19.

Results

Among the respondents, 9 people scored ≥32 on the AQ test and were considered to have a high degree of autistic traits. In multiple regression (R2 = 0.1, p<0.0001), a positive relationship between the severity of fear of COVID-19 and the autistic traits (p=0.01) and age (p<0.001) was obtained. Additionally, a second multiple regression (R2 = 0.1, p<0.000001) including the subscales of AQ was performed and a positive relationship between the severity of fear of COVID-19 and the difficulties in attention switching (p=0.0004) and age (p=0.00001) was obtained.

Conclusion

People with higher autistic traits present greater fear of the COVID-19 pandemic. We suggest that it might be caused by cognitive stiffness and disorders in emotions regulation, according to the literature. The elderly also present higher levels of fear. The other variables did not affect the level of fear of the COVID-19 pandemic.

Effects of COVID-19 on the educational performance of children with special educational needs and disabilities: A systematic review according to children's/youth's and caregivers' perspectives

This paper aims to provide a first systematic research overview of the effects of the pandemic on the educational performance of children with SEND according to children's/youths and caregivers' perspectives following the PRISMA statement. The studies, published between February 2020 and June 2022, were identified through the search of SCOPUS, EBSCO, PubMed, PsycInfo and two preprint-servers related to Education. In determining which studies to include in the review, the selection criteria were based on (1) articles focusing on ages 4-18 years, (2) articles focusing on children with special educational needs and (3) articles focusing on student achievement during COVID-19. The exhaustive reading and quality assessment left a final sample of nine scientific papers. According to children's/youth's and caregivers' perspectives, there is clear evidence for a negative effect of COVID-19 on the educational performance of children with SEND in the areas of (1) speech and language development (2) home learning (3) academic achievement (4) learning performance and (5) remote learning. The most important findings are to be found in the difficulties faced by children in homework completion, in paying attention during online learning, in efficiently completing tasks, in managing their time and in making progress on their IEP goals during school closures.

The Impact of Culture-, Health- and Nature-Based Engagement on Mitigating the Adverse Effects of Public Health Restrictions on Wellbeing, Social Connectedness and Loneliness during COVID-19: Quantitative Evidence from a Smaller- and Larger-Scale UK Survey

Numerous UK surveys conducted during COVID-19 examined the pandemic's detrimental effects on health, and the consequences of lockdown and other public health restrictions on mental health. Some surveys considered specific populations and social inequities exacerbated during COVID-19. Fewer surveys examined the ways in which the adverse effects of public health restrictions, such as lockdown, shielding and social distancing, might be alleviated. Drawing upon self-determination theory, the purpose of the current study was to assess whether culture-, health- and nature-based engagement would mitigate the effects of these restrictions on psychological wellbeing, social connectedness and loneliness. Quantitative data from a smaller-scale survey (n = 312) and a subset of questions embedded in a larger-scale survey (n = 3647) were analyzed using univariate and multivariate methods. Frequency of engagement, whether participation was online or offline and with or without other people, and the extent to which type of participation was associated with psychological wellbeing, social connectedness and loneliness were examined. Sports and fitness, gardening and reading occurred frequently in both surveys. For the smaller-scale survey, increases in connectedness and frequency of participation and decreases in loneliness were significantly associated with improved wellbeing, whereas the type of participation and age range were not significant predictors. Outcomes from the smaller-scale survey approximated the larger-scale survey for measures of loneliness, type and frequency of participation and proportion of respondents in each age range. As the frequency of participation was a significant predictor of wellbeing, but the type of participation was not significant, the findings implied that any type of participation in a sufficient quantity would be likely to boost wellbeing.

Anxiety, concerns and COVID-19: Cross-country perspectives from families and individuals with neurodevelopmental conditions

Background

The COVID-19 pandemic had a major impact on the mental health and well-being of children with neurodevelopmental conditions (NDCs) and of their families worldwide. However, there is insufficient evidence to understand how different factors (e.g., individual, family, country, children) have impacted on anxiety levels of families and their children with NDCs developed over time.

Methods

We used data from a global survey assessing the experience of 8043 families and their children with NDCs (mean of age (m) = 13.18 years, 37% female) and their typically developing siblings (m = 12.9 years, 45% female) in combination with data from the European Centre for Disease Prevention and Control, the University of Oxford, and the Central Intelligence Agency (CIA) World Factbook, to create a multilevel data set. Using stepwise multilevel modelling, we generated child-, family- and country-related factors that may have contributed to the anxiety levels of children with NDCs, their siblings if they had any, and their parents. All data were reported by parents.

Results

Our results suggest that parental anxiety was best explained by family-related factors such as concerns about COVID-19 and illness. Children's anxiety was best explained by child-related factors such as children's concerns about loss of routine, family conflict, and safety in general, as well as concerns about COVID-19. In addition, anxiety levels were linked to the presence of pre-existing anxiety conditions for both children with NDCs and their parents.

Conclusions

The present study shows that across the globe there was a raise in anxiety levels for both parents and their children with NDCs because of COVID-19 and that country-level factors had little or no impact on explaining differences in this increase, once family and child factors were considered. Our findings also highlight that certain groups of children with NDCs were at higher risk for anxiety than others and had specific concerns. Together, these results show that anxiety of families and their children with NDCs during the COVID-19 pandemic were predicted by very specific concerns and worries which inform the development of future toolkits and policy. Future studies should investigate how country factors can play a protective role during future crises.

Examining the Impact of COVID-19 on Education and Service Access for Diverse Families of Young Children With and Without Developmental Delays

The rapid transition to virtual learning due to the COVID-19 pandemic created unprecedented challenges that significantly impacted caregivers of young children, particularly those with developmental delays and children from non-English speaking households (Valicenti-McDermott et al., 2022). The current study aims to describe caregivers' concerns regarding the COVID-19 pandemic in general and specific educational concerns following school closures, and to determine whether their concerns varied as a function of whether the child had a developmental delay or the parent's ethnicity. Results revealed that caregivers of children with DD endorsed a greater number of general and education-specific COVID-19 concerns compared to caregivers of TD children, and non-Latinx caregivers of children with DD reported more general COVID-19 concerns compared to Latinx caregivers of children with DD. With respect to education-specific concerns, caregivers of children with DD reported a greater impact from the loss and/or delay of services and reported feeling significantly less capable of conducting educational activities in the home compared to caregivers of TD children. However, almost all caregivers in the study endorsed some level of stress from remote instruction. These findings suggest there is a specific need for attention to caregiver mental health and an examination of long-term educational outcomes resulting from extended school closures during the COVID-19 pandemic.

Experiences of parents of children with rare neurogenetic conditions during the COVID-19 pandemic: an interpretative phenomenological analysis

BACKGROUND

The Coronavirus disease 2019 (COVID-19) pandemic has impacted parental and child mental health and wellbeing in the UK. This study aimed to explore the experiences of parents of children with rare neurological and neurodevelopmental conditions with a known or suspected genetic cause (neurogenetic) across the first year of the pandemic in the UK.

METHODS

Semi-structured interviews were conducted with 11 parents of children with rare neurogenetic conditions. Parents were recruited via opportunity sampling from the CoIN Study, a longitudinal quantitative study exploring the impact of the pandemic on the mental health and wellbeing of families with rare neurogenetic conditions. Interviews were analysed using Interpretative Phenomenological Analysis.

RESULTS

Four main themes were identified: (1) "A varied impact on child wellbeing: from detrimental to 'no big drama'"; (2) "Parental mental health and wellbeing: impact, changes, and coping"; (3) "'The world had shut its doors and that was that': care and social services during the pandemic"; and (4) "Time and luck: abstract concepts central to parents' perspectives of how they coped during the pandemic". The majority of parents described experiencing an exacerbation of pre-pandemic challenges due to increased uncertainty and a lack of support, with a minority reporting positive effects of the pandemic on family wellbeing.

CONCLUSIONS

These findings offer a unique insight into the experiences parents of children with rare neurogenetic conditions across the first year of the pandemic in the UK. They highlight that the experiences of parents were not pandemic-specific, and will continue to be highly relevant in a non-pandemic context. Future support should to be tailored to the needs of families and implemented across diverse future scenarios to promote coping and positive wellbeing.

The impact of COVID-19 (Coronavirus) on children and young people with Down syndrome in the United Kingdom

The COVID-19 pandemic had a profound impact across the globe. Evidence suggests children with Special Educational Needs and Disabilities and their families experienced impacts on well-being and disruptions in support from education and health services. This study investigated the impact of measures associated with the COVID-19 pandemic on children and young people (CYP) with Down syndrome in the United Kingdom, specifically changes in speech, language and communication abilities, behavior, social, emotional and mental health and access to education and healthcare services. Forty-six parents/carers of CYP with Down Syndrome (aged 2-25 years) completed an online survey between June and September 2020. Parents/carers frequently reported deterioration in speech, language and communication, literacy and attention skills since the onset of the pandemic. Deterioration in social and emotional wellbeing and behavior, including greater reliance on adults were also reported for some CYP with Down syndrome. Parents reported challenges with home-schooling and reductions in support from education and community services. Preferences for support during COVID-19 were for professional support or from other parents. These findings have implications for the support that is now needed for CYP with Down syndrome and their families and for periods of social restrictions in the future.

Efficacy of coping mechanisms used during COVID-19 as reported by parents of children with autism

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.

Perceived Anxiety in Family Caregivers of Individuals with Autism Spectrum Disorder, Down Syndrome and Williams Syndrome during the Lockdown of the First COVID-19 Wave in Spain

The lockdown during the first wave of COV- ID-19 in Spain has been related to higher levels of anxiety in the general population. However, the emotional impact on Spanish caregivers of individuals with neurodevelopmental disorders (NDD) has not been studied so far.

Reflections, resilience and recovery: a qualitative study of Covid-19's impact on an international adult population's mental health and priorities for support

The impact of the coronavirus 2019 (Covid-19) pandemic on different countries and populations is well documented in quantitative studies, with some studies showing stable mental health symptoms and others showing fluctuating symptoms. However, the reasons behind why some symptoms are stable and others change are under-explored, which in turn makes identifying the types of support needed by participants themselves challenging. To address these gaps, this study thematically analysed 925 qualitative responses from five open-ended responses collected in the UCL-Penn Global COVID Study between 17 April and 31 July 2021 (Wave 3). Three key themes that comprised 13 codes were reported by participants across countries and ages regarding the impact of Covid-19 on their health, both mental and physical, and livelihoods. These include: (1) Outlook on self/life, (2) Self-improvement, and (3) Loved ones (friends and family). In terms of support, while 2.91% did not require additional support, 91% wanted support beyond financial support. Other unexpected new themes were also discussed regarding vulnerable populations suffering disproportionately. The pandemic has brought into sharp focus various changes in people's mental health, physical health and relationships. Greater policy considerations should be given to supporting citizens' continued access to mental health when considering pandemic recovery.

An exploratory study on emotion regulation strategy use in individuals with Williams syndrome, autism spectrum disorder and intellectual disability

Background

Individuals with neurodevelopmental disorders often have atypical emotion profiles, but little is known about how they regulate their emotions. While several studies have examined emotion regulation strategy use in autism spectrum disorder (ASD), only a few have included individuals with intellectual disability (ID) or focused on specific syndromes such as Williams syndrome (WS).

Methods

A parent-reported survey launched during the first months of the COVID-19 pandemic allowed to exploratorily study emotion regulation strategy use and its link to anxiety in individuals with ASD with (N=785) and without ID (N=596), WS (N=261), and Intellectual Disability not otherwise specified (N=649).

Results

Using multilevel analyses, besides revealing specific group differences in emotion regulation strategy use, a variety of strategies (e.g., rumination, avoiding information, repetitive behaviors) were found to be linked to elevated levels of anxiety, while focusing on the positive was linked to lower anxiety levels in all groups. Moreover, only autistic people without ID used humor more frequently while experiencing lower anxiety levels.

Conclusion

This study sheds light on an underexplored area of emotion regulation strategy use in different neurodevelopmental disorders. It also paves the way to further examine emotion regulation in more rigorous ways to better understand emotion regulation in different neurodevelopmental disorders as well as the impact on outcome measures such as anxiety. This exploratory study may help to develop and validate adequate measures to study a broad array of ER strategies used by individuals with neurodevelopmental disorders.

Parental concern for clinically vulnerable child during first 18 months of the COVID pandemic

BACKGROUND

The uncertainties surrounding the COVID-19 pandemic have been associated with increased parental concern. The aim of this study is to explore if this increased level of concern is associated with certain individual/household characteristics or if parents adapted to the ever-changing realities of the COVID-19 pandemic over time.

METHODS

This prospective study explored COVID-19 concern trajectories and associated family characteristics of 765 UK parents caring for an immunosuppressed child during the first 18 months of the pandemic using growth mixture modelling. Qualitative analysis was performed to examine in more detail the source of concern.

RESULTS

Four different trajectories of parental COVID-19 concern were identified. Ongoing very high concern was associated with caring for children with nephrotic or respiratory disease; having a child on an organ transplant waiting list; residency in the North of England; or parental vocational inactivity. Explicit concerns voiced by the parents generally followed national trends, but vulnerable status specific concerns were also reported.

CONCLUSION

Diagnosis and prescribed medication of the immunosuppressed child, geographical location, household composition, and employment status of parent were associated with the different concern trajectories. This information can be helpful in targeting psychological family care where it is most needed.

IMPACT

Many British parents caring for a clinically vulnerable child during the first 18 months of the COVID-19 pandemic showed high levels of concern with little sign of psychological adaptation. Consistent with findings from non-vulnerable populations, parents mentioned the impact of shielding and repeated isolation on their child's education, social life, and mental health. Unique to the clinically vulnerable population, parents were worried about child's health status, impact of delayed healthcare, and were confused by the contradictory information received from government, doctors, and media. Psychological family care can be targeted to those parents at greater risk for high levels of concern.

Mental health impact of COVID-19 on Saudi families and children with special educational needs and disabilities in Saudi Arabia: A national perspective

Introduction

The COVID-19 pandemic revealed a multidimensional impact on mental health due to health concerns, social distancing and lockdowns, job loss, and limits in institutional support. Accordingly, COVID-19 may disproportionally impact families with special educational needs and disabilities (SEND) due to the already high prevalence of mental health conditions in children with SEND and their parents. Hence, it is essential to determine the short-term impact of the pandemic on the mental health of families with SEND to identify their ongoing health, including psychological wellbeing and support needs. The current study examines the anxiety level and concerns of children with SEND and their parents living in Saudi Arabia.

Methodology

A cross-sectional national study design was utilized as a part of an international consortium using an online Arabic survey. Data were collected from the Ministry of Human Resources and Social Development beneficiaries from May to July 2020. The sample consisted of 1,848 parents of children with SEND aged between 1 and 18 years (mean = 9.66; SD = 4.31). A descriptive and bivariant analysis is reported.

Results

Parental worries on all those concerns when the pandemic started were significantly higher than before the pandemic, p < 0.050. Parental-perceived general anxiety had risen significantly across time, p < 0.001, and their perceived anxiety when the pandemic started exceeded their anxiety before the pandemic, p < 0.001. The general anxiety of children with SEND had risen significantly across time (from before the pandemic to when it had started to during the pandemic), p < 0.001. The children's general worries at the start of the pandemic had correlated significantly and positively with their anxiety, adaptive, maladaptive, and coping efficacies, and parental anxiety scores, p < 0.010 each.

Conclusion

Anxiety levels were high in SEND and their caregivers before and during COVID-19. At the start of the pandemic, the anxiety, adaptive, maladaptive, coping efficacies, and parental anxiety scores of children with SEND were significantly and favorably correlated. These findings support the notion of SEND-specific anxiety and patterns of coping in SEND and their caregivers. The notion also attests to the institutional support required for this specifically vulnerable population during epidemics.

The impact of COVID-19 on individuals with ASD in the US: Parent perspectives on social and support concerns

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.

The effects of the COVID-19 pandemic on the well-being of children with autism spectrum disorder: Parents' perspectives

The COVID-19-related lockdown interrupted children's learning progress and discontinued social learning and regular activities that children with autism spectrum disorder (ASD) rely on socially and physically. Negative consequences for children with ASD were reported far and wide. To investigate this problem in Kazakhstan, we conducted a mixed-methods study that drew on data from an online survey with 97 parents and semi-structured interviews with 14 parents. While parent-report quantitative results suggest that children were likely to experience negative impacts of the pandemic due to disrupted educational and therapeutic services, qualitative findings confirm that they have experienced an elevated mental health and behavioral challenges during the lockdown. Remote educational and therapeutic services were not helpful as families coped with pandemic-caused problems on their own. We highlight that continued support and care during and after a crisis is vital not only for children with ASD but also for the families under-resourced mentally and socially.

Accelerated HE digitalisation: Exploring staff and student experiences of the COVID-19 rapid online-learning transfer

In the UK, the first 'lockdown' of the COVID-19 pandemic necessitated a rapid shift to online learning and digital technologies in Higher Education (HE). While the situation was unprecedented, extant literature on online learning suggested there would be challenges, opportunities, and benefits to this transition, and we sought to understand these via a case study of one UK HEI department at this time. To draw out in-depth and nuanced accounts of this (at time of investigation-unstudied) scenario, qualitative data were collected via semi-structured online interview or written reflection. To explore, identify and understand the experiences from both sides, and with a diverse sample, we purposively recruited both staff (n = 10) and students (n = 12), from various roles and backgrounds, including those with additional learning and/or mental health needs. The 'bricolage' data were analysed inductively, utilising a latent reflexive approach, and organised into a framework around five core themes: 'methods and means of engagement'; 'learning maintenance, destruction and construction'; 'remote education and resource accessibility and literacy'; 'support and communication'; and 'life and learning: responses, adaptations and impacts'. Within these, a range of challenges, successes and, most importantly, future learning and innovation outcomes were identified by staff and students, particularly relevant to working with and supporting students with additional needs in the online learning forum. These discoveries informed a set of practical recommendations, provided here in Box 1, for (rapid implementation of) online learning (in times of stress).

Anxiety and Worries of Individuals with Down Syndrome During the COVID-19 Pandemic: A Comparative Study in the UK

The present study explored the effects of the pandemic on individuals with Down Syndrome (DS; n = 67) compared to other groups with Special Education Needs and Disabilities (SEND; n = 48) and their Typically Developing Siblings (TDS; n = 56). In total, 115 caregivers reported on their own anxiety and worries and of their children. Anxiety levels for individuals with DS appeared to be lower compared to other SEND populations and to TDS. In terms of worries, individuals with DS worried more about social-related worries but worried less about family-related aspects compared to the other groups. In sum, individuals with DS might show less anxiety but still worried more about specific aspects related to the impact of COVID-19 pandemic on their lives.

Brief Report: A Cross-Sectional Study of Anxiety Levels and Concerns of Chinese Families of Children With Special Educational Needs and Disabilities Post-first-wave of COVID-19

The COVID-19 pandemic has a multifaceted impact on mental health due to ill health, restrictions and lockdowns, and loss of employment and institutional support. COVID-19 may disproportionally impact families with special educational needs and disabilities (SEND) due to the already higher prevalence of mental health conditions in children with SEND and their parents. Therefore, it is essential to determine the short-term impact of the pandemic on the mental health of families with SEND in order to identify their ongoing health support needs. The current study aims to examine the anxiety level and concerns of children with SEND and their parents living in China. The sample consisted of 271 parents of children with SEND aged between 6 and 17 years (M _age = 8.37; SD _age = 2.76). Parents completed an online survey between 10 April to 8 June 2020. Both child and parental anxiety levels and various concerns increased after the initial wave of COVID-19 when compared with retrospective pre-COVID-19 levels. Parental anxiety and concern levels were significantly higher for those living in rural areas compared to urban areas. In addition, parental and child anxiety and concern levels were significantly correlated with each other. Parental anxiety at the lowest level made a unique and significant statistical contribution to children's anxiety levels. The implications of the study findings are discussed.