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COVID-19 大流行期间自闭症谱系障碍和其他发育障碍儿童的健康和教育服务。

Health and Education Services During the COVID-19 Pandemic Among Young Children with Autism Spectrum Disorder and Other Developmental Disabilities.

机构信息

National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.

Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO.

出版信息

J Dev Behav Pediatr. 2024 Jan 1;45(1):e31-e38. doi: 10.1097/DBP.0000000000001227. Epub 2023 Oct 23.

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.

摘要

目的

了解 COVID-19 大流行如何影响残疾儿童对于未来公共卫生紧急情况至关重要。我们比较了自闭症谱系障碍(ASD)儿童与其他发育障碍(DD)儿童和普通人群(POP)儿童,比较了(1)定期健康/牙科服务、免疫接种和专科服务的预约错过或延迟;(2)难以获得护理的原因;以及(3)远程学习和学校支持的使用情况。

方法

我们重新联系了之前参加过探索早期发育研究的儿童的照顾者,这是一项在 2017 年至 2020 年期间实施的 ASD 儿童病例对照研究,以便在 2021 年 1 月至 6 月期间了解 2020 年 3 月至 12 月期间的服务情况。在最初的研究中,儿童被分类为 ASD、DD 或 POP,当他们的照顾者在大流行期间被重新联系时,他们的年龄为 3.4 至 7.5 岁。

结果

超过一半的儿童错过了或延迟了常规健康/牙科预约(58.4%-65.2%)。与 DD 和 POP 组相比,ASD 组更多的儿童错过了或延迟了专科服务(分别为 75.7%、58.3%和 22.8%),并报告因使用远程医疗和戴口罩困难而难以获得任何类型的护理。在学校关闭期间,与另一个 DD 相比,ASD 儿童接受现场在线课程的比例较小(84.3%对 91.1%),而受个人教育计划中断影响的儿童比例较大(50.0%对 36.2%)。

结论

尽量减少所有儿童的服务中断,并确保 ASD 儿童的专科护理连续性,对于未来的公共卫生紧急情况至关重要。儿童可能需要额外的服务来弥补大流行期间的中断。

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