The Association of Mental Health Problems With Preventive Behavior and Caregivers' Anxiety About COVID-19 in Children With Neurodevelopmental Disorders

Caregivers' anxiety and perception of their children's wellbeing: a year into the COVID-19 pandemic

The COVID-19 pandemic and related social restrictions disrupted family routines affecting millions of youths and their caregivers worldwide. This study explored the relationship between caregivers' anxiety and their children's emotional states 1 year after COVID-19, as well as differences between caregivers' perceptions of their children's emotional states and reality. Sixty-eight caregiver-child pairs completed an online survey between March 31 and May 31, 2021. Our analysis showed positive correlations between caregivers' anxiety and children's wellbeing, worries about children's use of time, and a variety of negative emotional states in their children. Caregivers' anxiety about their children's wellbeing was negatively correlated with their children's perceptions of self-control. Caregivers' anxiety about their personal wellbeing was negatively correlated with children's feelings of busyness and positively associated to their children's fear. Caregivers' perception of COVID-19 as a challenging experience was positively associated with some of their children's negative emotions. Overall, caregivers were accurate about children's emotional experiences in the previous 3 months with some exceptions: their children felt lonelier and more worried about schoolwork and grades than their caregivers realized. These findings will help researchers and practitioners further explore the sources of caregivers' anxiety and their relationship with children's emotions and stress management as countries move toward a new normal.

Relationship between children with neurodevelopmental disorders and their caregivers and friends during early phase of COVID-19 school closure in Japan: Association with difficulty in implementing infection prevention measures

BACKGROUND

Due to the COVID-19 pandemic people had to implement various infection prevention measures. Researchers have reported the difficulties experienced by children with neurodevelopmental disorders in implementing these measures and their caregivers' resultant anxiety and stress. This study examined the relationship between these difficulties and the deterioration of the children's relationships with their caregivers and friends during school closure and after school reopened.

METHODS

A total of 150 caregivers of children with neurodevelopmental disorders answered a questionnaire asking about parent‒child relationships, their child's friendships, and the presence or absence of difficulty in implementing infection prevention measures at three time points: before the pandemic, while schools were closed, and after school reopened. The frequency and percentages of the child's behavioral problems, deterioration in their relationships, and difficulty implementing infection control measures were calculated. Using the relationship deterioration scores, independent and multiple regression analyses were performed for the presence or absence of difficulty implementing infection control measures, presence or absence of caregivers' mental health concerns, and the presence or absence of deterioration of one or more problematic behaviors.

RESULTS

Overall, 84.1% of the children displayed difficulties implementing infection prevention measures. No relationship was observed between difficulty with infection prevention measures and deterioration in their relationships with parents and friends when schools were closed. After school reopened, however, deterioration in parent‒child relationships correlated positively with difficulty in hand-washing, and deterioration of friendships correlated positively with the maintenance of social distancing and difficulty in hand-washing. Deterioration of friendships correlated negatively with difficulty in voluntarily complying with stay-at-home requests.

CONCLUSION

Difficulty in implementing infection prevention measures was related to deterioration in social relationships with parents and friends of children with neurodevelopmental disorders during the school reopening period, following COVID-19 school closure in Japan. Under a condition requiring heightened infection control, close monitoring may be necessary for the social relationships in children with neurodevelopmental disorders.

Impact of the COVID-19 Pandemic on Children With Neurodevelopmental Disorders When School Closures Were Lifted

Human activities have been changing in conjunction with the status of the coronavirus disease 2019 (COVID-19) pandemic, with school closures and activity cancellations becoming commonplace. As such, the COVID-19 pandemic likely also has had a detrimental impact on the behavioral problems of children with neurodevelopmental disorders (NDD). In Japan, the government issued a stay-at-home order causing children to stop participating in school activities following the first declaration of a state of emergency (April 7 to May 25, 2020). During winter 2020, the stay-at-home order and school closures were lifted. Using longitudinal data of children with NDD, we compared the behavioral problems of children with NDD between October 1 and December 31, 2020 (i.e., winter 2020) with their behavioral problems before the COVID-19 pandemic (pre-COVID-19). In this study, 143 caregivers of children with NDD evaluated their behavioral problems using the Japanese version of the Aberrant Behavior Checklist (ABC-J) in the pre-COVID-19 period and winter 2020. We found no scores that were higher in winter 2020 compared to pre-COVID-19. Moreover, irritability and hyperactivity scores were significantly lower in winter 2020 compared to pre-COVID-19. These findings suggest weak negative impacts of the COVID-19 pandemic on the behavioral problems of children with NDD. In schools and clinical practice, children learned knowledge about COVID-19 and related preventive behaviors. Therefore, these practices may have alleviated the negative impact of the COVID-19 pandemic on children with NDD.