Families of Children/Youth with Complex Needs Before, During, and After COVID-19 Pandemic Restrictions.

During the COVID-19 pandemic, families with children who had complex special needs faced many obstacles and had less resources available to them. Little published research has described post-lockdown family functioning in clinical samples. The current study investigated caregiver well-being, family functioning, and child/youth symptomatology in three Canadian samples of families with children/youth who had pre-existing, complex, emotional, behavioural, developmental, and mental health needs pre-pandemic (clinic intake within 1 year prior to March 2020), COVID pandemic (clinic intake 1 year during societal lockdowns), and post-restrictions (clinic intake between summer 2022 and summer 2023). Cross-sectional archival data ( > 300 in each cohort) were compared from assessments completed by families as standard of care at a tertiary children's service agency. As predicted, the pandemic intake sample reported significantly more parental mental health challenges, stress, conflicts, and went on fewer recreational outings than the pre-pandemic sample. While parent stress levels and family outing rates in the post-restriction sample resembled the pre-pandemic sample, post-lockdown parental mental health symptoms, family conflict, and family respite levels indicate that families are still recovering. Child symptom levels were high in all three samples, likely a result of intake criteria at this tertiary mental health agency. Research recommendations are offered. Clinical agencies should be mindful that some families of children with complex needs may still be impacted by the COVID-19 pandemic changes and consider using a family oriented, trauma-informed care approach to assess the effect of the pandemic.