Experience of Autistic Children and Their Families During the Pandemic: From Distress to Coping Strategies

Where I am from matters: factors influencing behavioral and emotional changes in autistic individuals during COVID-19 in Latin America

Background

The COVID-19 pandemic brought an increased incidence of disease and mortality in the world at large, making it a particularly salient and stressful life event. For those individuals residing in Latin America, the pandemic was met with fragmented healthcare systems, economic downturn, and sociopolitical crisis which puts autistic individuals at risk for more detrimental outcomes. Behavioral and emotional challenges experienced by autistic individuals at the beginning of the pandemic could later develop into more severe symptomatology as the pandemic progresses. The present study aimed to explore changes in dysregulated (overt and internalizing) behaviors and preoccupation with getting sick during the COVID-19 pandemic among autistic children in 7 Latin American countries.

Method

Sample consisted of 1,743 caregivers, residing in: Argentina (n = 677, 38.8%) Brazil (n = 156, 9%), Chile (n = 251, 14.4%), Dominican Republic (n = 171, 9.8%), Mexico (n = 126, 7.2%), Uruguay (n = 259, 14.9%) and Venezuela (n = 103, 5.9%). The majority of caregivers who completed the questionnaire were mothers (85.1%), and most had a male autistic child (81.6%). A series of independent sample t-tests were conducted to assess country differences in dysregulated behaviors and preoccupation with getting sick. Linear regressions were conducted to identify which demographic characteristics and micro-level contextual factors predicted dysregulated overt behaviors and psychological changes.

Results

Contextual factors, such as country of residence, were related to preoccupation with getting sick and dysregulated behavior. Particularly, residing in Mexico and Brazil were related to changes in preoccupation with getting sick and mental health concerns. Coexistence predicted dysregulated internalizing behaviors, while being older significantly predicted preoccupation with getting sick. Increased screen time only predicted anxiety.

Conclusion

Our findings highlight differences and predictions of behavioral challenges and psychological changes based on certain contextual factors and individual characteristics while experiencing severe life stressors such as a worldwide pandemic. This knowledge could help inform policies and decrees aimed at protecting those most vulnerable due to their increased difficulty adapting to change.

The educational and psychosocial needs of students with additional provisions during COVID-19 in Greece: Parents' perspectives against schools' crisis management

BACKGROUND

The sudden breakdown of educational and care services following the COVID-19 outbreak caused severe implications to the educational and psychosocial well-being of students with additional needs.

AIM

The present study investigates the perspectives of parents of students requiring additional provisions in relation to the schools' responsiveness against their children's educational and psychosocial needs during the COVID-19 pandemic, with a focus on (non-) applied inclusive and empowerment practices of parenthood.

METHODS AND PROCEDURES

A sample of 125 parents in Greece filled out a self-reported questionnaire providing information on four main themes: school organisation in accordance with the COVID-19 measures; distance education; support on transition from quarantine and remote education back to school; and parental empowerment.

OUTCOMES AND RESULTS

The data revealed that most of the participating parents felt poorly supported during the pandemic. The feeling of being left alone in supporting their children and in fully meeting their personal needs and emotions was also identified. The demographics of the participating parents with children with additional needs revealed an experiences mosaic in relation to the parents' level of education, the number of children who were present in their households, the children's gender as well as their level of school education (preschool- and primary school-aged or secondary school-aged pupils) and attendance of the school programme in regular or special schools.

CONCLUSIONS AND IMPLICATIONS

Data suggest that regular and special schools in Greece, as orchestrated by the Ministry of Education, deployed practices that left students requiring additional provisions unsupported in relation to their educational and psychosocial needs while their parents felt disempowered during the whole period of the COVID-19 pandemic. A range of implications on a more effective support for families and their children with additional needs in alignment with the principles of inclusive education is detailed and discussed.

WHAT THIS PAPER ADDS

The focus of research on the schools' responsiveness to the needs of students requiring additional provisions from the perspective of their parents is of critical importance as it may offer valuable insights pertaining to the school's inclusive policy practices and the promotion of empowering parent partnerships during crisis times. The knowledge gained by exploring parents' experiences will contribute significantly to inform modifications and changes in education delivery in crisis times so as school, as a social system, become more inclusive, supportive, and effective for pupils with additional needs. So far, little attention has been paid to the above-mentioned issues. In the current paper, the parents perspectives were explored through a self-reported questionnaire to reflect on the way schools responded to theirs and their children's educational and psychosocial needs during the COVID-19 pandemic. Most of the participating parents felt poorly supported. The feeling of being left alone in supporting their children and in fully meeting their personal needs and emotions was also identified. The demographics of the participating parents with children requiring additional provisions revealed an experiences mosaic in relation to the parents' level of education, the number of children who were present in their households, the children's gender as well as their level of school education (preschool and primary school or secondary school education) and attendance of the school programme in regular or special schools. A range of implications on a more effective support for families and their children with additional needs in alignment with the principles of inclusive education is detailed and discussed.

Longitudinal Impact of the Pandemic on Social Disruption and Loneliness in Autistic and Non-Autistic Youth

OBJECTIVE

The coronavirus pandemic drastically increased social isolation. Autistic youth already experience elevated social isolation and loneliness, making them highly vulnerable to the impact of the pandemic. We examined trajectories of social disruption and loneliness in autistic and non-autistic youth during a six-month period of the pandemic (June 2020 until November 2020).

METHOD

Participants were 76 youth, ages 8 through 17, (Mage = 12.82, Nautistic = 51) with an IQ ≥ 70. Youth completed a biweekly measure of loneliness (Revised UCLA Loneliness Scale) and their parent completed a measure of pandemic-related family social disruption (Epidemic Pandemic Impacts Inventory).

RESULTS

There were no time trends in loneliness across all youth, however, social disruption displayed linear, quadratic, and cubic trends. Non-autistic youth reported relatively greater declines in social disruption compared to autistic youth. Additionally, autistic youth reported relatively greater declines in loneliness relative to non-autistic youth. Greater social disruption was associated with higher loneliness, however, autistic youth demonstrated a relatively stronger relationship between social disruption and loneliness compared to non-autistic youth.

CONCLUSIONS

The current study was one of the first to investigate social disruption and loneliness in autistic youth during the COVID-19 pandemic. Results indicated that autistic youth experienced relative decreases in loneliness during this time, perhaps due to reductions in social demands. Nonetheless, when autistic youth did experience social disruption, they reported relatively higher levels of loneliness. This work contributes to our understanding of risk factors for loneliness and highlights the need to understand the benefits, as well as the challenges, to remote schooling and social interactions.

Autism in Preschool-Aged Children: The Effects of COVID-19 Lockdown

The COVID-19 lockdown affected children, especially those with autism spectrum disorder, due to the disruption in rehabilitation and educational activities. We conducted a cross-sectional study of 315 preschool-aged children, 35 of which had autism, to investigate this impact. A questionnaire was administered to explore socio-demographic status, familiar/home environment, and COVID-19 exposure. The clinical features of autistic subjects were also examined. Seven variables were considered to describe the effect of pandemic: Remote learning, Behavior changes, Home activities, Sleep habits, Night awakenings, Physical activity, Information about the virus. The lockdown had a significant impact on Remote learning, Behavior changes, and Information about the virus in participants with autism. Moreover, we found a worsening in repetitive movements, echolalia, restricted interests, and aggressive behaviors.

Impacts of health care service changes implemented due to COVID-19 on children and young people with long-term disability: A mapping review

AIM

To identify the research on childhood disability service adaptations and their impact on children and young people with long-term disability during the COVID-19 pandemic.

METHOD

A mapping review was undertaken. We searched the World Health Organization Global COVID-19 database using the search terms 'children', 'chronic/disabling conditions', and 'services/therapies'. Eligible papers reported service changes for children (0-19 years) with long-term disability in any geographical or clinical setting between 1st January 2020 and 26th January 2022. Papers were charted across the effective practice and organization of care taxonomy of health system interventions and were narratively synthesized; an interactive map was produced.

RESULTS

Reduction of face-to-face care and usual provision had a huge impact on children and families. Adoption of telehealth provided continuity for the care and management of some conditions. There was limited evidence of changes to mental health services, transitions of care, social care, or child-reported satisfaction or acceptability of service changes.

INTERPRETATION

The long-term impacts of service change during the pandemic need full evaluation. However, widespread disruption seems to have had a profound impact on child and carer health and well-being. Service recovery needs to be specific to the individual needs of children with a disability and their families. This should be done through coproduction to ensure that service changes meet needs and are accessible and equitable.

Mental health impact of COVID-19 on Saudi families and children with special educational needs and disabilities in Saudi Arabia: A national perspective

Introduction

The COVID-19 pandemic revealed a multidimensional impact on mental health due to health concerns, social distancing and lockdowns, job loss, and limits in institutional support. Accordingly, COVID-19 may disproportionally impact families with special educational needs and disabilities (SEND) due to the already high prevalence of mental health conditions in children with SEND and their parents. Hence, it is essential to determine the short-term impact of the pandemic on the mental health of families with SEND to identify their ongoing health, including psychological wellbeing and support needs. The current study examines the anxiety level and concerns of children with SEND and their parents living in Saudi Arabia.

Methodology

A cross-sectional national study design was utilized as a part of an international consortium using an online Arabic survey. Data were collected from the Ministry of Human Resources and Social Development beneficiaries from May to July 2020. The sample consisted of 1,848 parents of children with SEND aged between 1 and 18 years (mean = 9.66; SD = 4.31). A descriptive and bivariant analysis is reported.

Results

Parental worries on all those concerns when the pandemic started were significantly higher than before the pandemic, p < 0.050. Parental-perceived general anxiety had risen significantly across time, p < 0.001, and their perceived anxiety when the pandemic started exceeded their anxiety before the pandemic, p < 0.001. The general anxiety of children with SEND had risen significantly across time (from before the pandemic to when it had started to during the pandemic), p < 0.001. The children's general worries at the start of the pandemic had correlated significantly and positively with their anxiety, adaptive, maladaptive, and coping efficacies, and parental anxiety scores, p < 0.010 each.

Conclusion

Anxiety levels were high in SEND and their caregivers before and during COVID-19. At the start of the pandemic, the anxiety, adaptive, maladaptive, coping efficacies, and parental anxiety scores of children with SEND were significantly and favorably correlated. These findings support the notion of SEND-specific anxiety and patterns of coping in SEND and their caregivers. The notion also attests to the institutional support required for this specifically vulnerable population during epidemics.

COVID-19 Pandemic and Autism Spectrum Disorder, Consequences to Children and Adolescents - a Systematic Review

In this systematic review, we aimed to identify the impact of the COVID-19 pandemic on children/adolescents with a diagnosis of autism spectrum disorder (ASD). The protocol was registered on PROSPERO CRD42021255848. Articles were selected from PubMed, Embase, and LILACS according to these characteristics: patients from zero to 18 years old, exposed to the COVID-19 pandemic, impact on social communication/interaction and restricted/repetitive behavior domains. The Newcastle-Ottawa Scale was used to assess methodological quality and the risk of bias. Of the 351 articles initially identified, 26 were finally included with information on 8,610 patients. Although the studies were heterogeneous, they indicated that the pandemic-related issues experienced by patients with ASD were mostly manifested in their behavior and sleep patterns.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40489-022-00344-4.

Parents as Nomads: Journeys, In-Betweenness and Identity

When considering the parent voice as an individual subjective reality, it is observed as unique to the parent and not shared by others. This research sought to explore if parent voices could constitute intersubjective realities; inviting narratives from parents and professionals that may reveal a shared existence. The first theme explored the journeys of the parent as a nomad in their search for services to support their children. The second theme describes the position of the parent during the period of their child’s assessment, diagnosis and intervention, as that of ‘in-betweenness’. The third theme describes parents’ experiences as those of journeys, during which their identities change. Qualitative, in-depth, longitudinal case studies were undertaken with parents of young children with ASD and professionals over eighteen months. Semi-structured interviews (n-83) were conducted. Autoethnography was critical as a methodological tenet in defense of a position that states that research is an extension of our lives. The findings of this research show evidence of parental isolation and marginalization when procuring services for their children or when children failed to experience inclusion. This research suggests that nomads navigate (difficult) ways of forming new multiple selves and identities.