Bhat Anjana
Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.
Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, USA.
Autism Res. 2021 Nov;14(11):2454-2470. doi: 10.1002/aur.2618. Epub 2021 Sep 30.
Children with ASD receive a multitude of educational, medical, and therapeutic services. At the onset of the COVID-19 pandemic, all of these services came to a complete halt following strict lockdowns. Many services have resumed in a hybrid format using face to face and virtual modes of delivery. This study describes findings from the COVID-19 impact survey administered at the onset of the pandemic in a subgroup of families from the SPARK cohort (N = 6393), one of the largest ASD cohorts in the US. The differential early impact of COVID-19 on various subgroups of children with ASD and their families was examined. Caregivers of children and adolescents with ASD between 19 months and 18 years completed an online survey inquiring about the impact of COVID-19 pandemic on access to services, parent concerns about the same, impact on child's ASD-related behaviors, child, and parent mental health, and the benefits/potential benefits of online/future online services. Analysis revealed that certain demographic (age, income/SES) and child-related factors (repetitive behaviors, language, functional, cognitive, and motor impairments, and child's understanding), as well as parent's past mental health were associated with/predicted greater service disruptions, greater ASD-related behaviors, and greater negative impact on parent mental health. In conclusion, younger children, children from low-income families, and children with greater impairment severity (more severe repetitive behaviors, language, cognitive, function, language, and motor impairments) were more negatively impacted by the pandemic through service disruptions, increased ASD-related behaviors, parent health/family impact, and found online interactions to be less beneficial. LAY SUMMARY: The SPARK study impact survey shows that at the onset of the COVID-19 pandemic, parents reported significant service disruptions, negative impact on their child's ASD-related behaviors as well as their own mental health; which was greater in families with younger children, children with greater ASD severity, and children from low-income families. Majority of families did not report significant benefits of online services whereas some families did. Low-income families were hopeful about receiving benefits through future online services. Overall, these findings have important implications for future clinical care delivery and healthcare policies to ensure that healthcare services are not interrupted during a potential resurgence of COVID-19 or other pandemics. A combination of in-person and online healthcare and family support services must be implemented to prevent negative health impacts in the future.
患有自闭症谱系障碍(ASD)的儿童会接受大量的教育、医疗和治疗服务。在新冠疫情爆发之初,随着严格的封锁措施实施,所有这些服务都完全停止了。许多服务已恢复为混合模式,采用面对面和虚拟交付方式。本研究描述了在疫情爆发之初对SPARK队列(N = 6393)中的一个家庭亚组进行的新冠疫情影响调查结果,SPARK队列是美国最大的自闭症谱系障碍队列之一。研究考察了新冠疫情对不同亚组自闭症谱系障碍儿童及其家庭的早期差异影响。年龄在19个月至18岁之间的自闭症谱系障碍儿童和青少年的照料者完成了一项在线调查,询问新冠疫情对服务获取的影响、家长对此的担忧、对孩子与自闭症谱系障碍相关行为的影响、孩子和家长的心理健康,以及在线/未来在线服务的益处/潜在益处。分析表明,某些人口统计学因素(年龄、收入/社会经济地位)和与孩子相关的因素(重复行为、语言、功能、认知和运动障碍,以及孩子的理解能力),以及家长过去的心理健康状况与更大的服务中断、更多与自闭症谱系障碍相关的行为以及对家长心理健康的更大负面影响相关/可预测这些情况。总之,年龄较小的孩子、低收入家庭的孩子以及障碍严重程度较高的孩子(重复行为、语言、认知、功能、语言和运动障碍更严重)受到疫情的负面影响更大,表现为服务中断、与自闭症谱系障碍相关的行为增加、对家长健康/家庭的影响,并且发现在线互动的益处较少。简要概述:SPARK研究影响调查显示,在新冠疫情爆发之初,家长报告服务出现重大中断,对孩子与自闭症谱系障碍相关的行为以及他们自己的心理健康产生负面影响;在年龄较小的孩子、自闭症谱系障碍严重程度较高的孩子以及低收入家庭中,这种影响更大。大多数家庭没有报告在线服务有显著益处,而一些家庭则报告有。低收入家庭对通过未来在线服务获得益处抱有希望。总体而言,这些发现对未来的临床护理提供和医疗政策具有重要意义,以确保在新冠疫情或其他大流行可能再次出现期间,医疗服务不会中断。必须实施面对面和在线医疗保健及家庭支持服务相结合的方式,以防止未来对健康产生负面影响。