Azrieli Centre for Autism Research, Montreal Neurological Institute-Hospital, Montreal, Quebec, Canada.
Biostatistics and Health Informatics, Kings College London, London, United Kingdom.
PLoS One. 2022 Jul 29;17(7):e0271229. doi: 10.1371/journal.pone.0271229. eCollection 2022.
There is evidence of negative impact of social distancing and confinement measures to manage the COVID-19 pandemic on children, including increased anxiety and depression and behaviour difficulties. Paradoxically, positive impacts like increased support and more self-care activities have also been documented. Little is known about the impact of the COVID-19 pandemic on the children with disability and the potential role of familial, environmental, and biological factors on mitigating this impact. The aims of the study were 1) identifying profiles of functioning across multiple domains during the COVID-19 pandemic and 2) examining the extent to which parenting self-efficacy, support in accessing schooling, and type of diagnosis predict the likelihood of resilience among children with disability, after controlling for household income and single-parent status. An online survey developed from COVID-19 guidance recommendations, was available from June 11- July 21, 2020, and resulted in a convenience sample of caregivers across Canada (n = 883) of children with disability (mean age of 9.4 years old, SDage = 5.7, 58% male). We conducted latent class analysis to examine the number of latent profiles on caregiver-reported changes of 12 functioning domains, as either 'worsening', 'no change', or 'improving'. Most participants belonged to 'stable' or 'worsening' profiles. However, we identified a small subgroup with improvements in child functioning, a pattern indicative of a 'resilient' profile. Using a multinomial logistic regression, we found that diagnosis type, parenting self-efficacy and support in accessing schooling were associated with membership in the Resilient or Stable profiles compared to the Worsening profile, after controlling for single-parent status and income. Taken together, our findings identified variability in responses to adversity that is dependent on the child's diagnosis type, parenting self-efficacy, and support in accessing schooling. By identifying potentially modifiable predictors of resilience, namely parenting self-efficacy and support in accessing schooling, we signal the potential for tailored supports for different diagnoses, through interventions that enhance caregiver empowerment, access to schooling, access to health and social services, and/or mitigate disparities resulting from social disadvantage.
有证据表明，为管理 COVID-19 大流行而采取的社交距离和禁闭措施对儿童产生了负面影响，包括焦虑和抑郁增加以及行为困难。矛盾的是，也有记录表明存在积极影响，例如增加了支持和更多的自我保健活动。关于 COVID-19 大流行对残疾儿童的影响以及家庭、环境和生物因素在减轻这种影响方面的潜在作用，人们知之甚少。本研究的目的是：1）确定在 COVID-19 大流行期间跨多个领域的功能状况；2）在控制家庭收入和单亲状况后，考察育儿自我效能感、获得学校教育的支持以及诊断类型对残疾儿童适应能力的预测程度。从 COVID-19 指导建议中开发的在线调查于 2020 年 6 月 11 日至 7 月 21 日开放，结果是加拿大各地的残疾儿童照顾者（n=883）的便利样本（平均年龄为 9.4 岁，标准差为 5.7，58%为男性）。我们进行潜在类别分析，以检查照顾者报告的 12 个功能领域变化的潜在类别数量，即“恶化”、“无变化”或“改善”。大多数参与者属于“稳定”或“恶化”类别。然而，我们发现一小部分儿童的功能有改善，这表明存在“适应良好”的类别。使用多项逻辑回归，我们发现，在控制单亲状况和收入后，与“恶化”类别相比，诊断类型、育儿自我效能感和获得学校教育的支持与“适应良好”或“稳定”类别有关。综上所述，我们的研究结果确定了对逆境的反应存在变异性，这种变异性取决于儿童的诊断类型、育儿自我效能感和获得学校教育的支持。通过确定适应能力的潜在可调节预测因素，即育儿自我效能感和获得学校教育的支持，我们表明通过增强照顾者的权能、获得学校教育、获得卫生和社会服务以及/或减轻社会劣势导致的差距，可以为不同的诊断提供有针对性的支持。
