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

The Impact of COVID-19 on the Language Skills of Preschool Children: Data from a School Screening Project for Language Disorders in Greece

Background/Objectives: The COVID-19 pandemic has significantly affected children's lives, particularly preschool-aged children who undergo rapid biological and psychosocial development. This study aimed to investigate the effects of the COVID-19 pandemic on the language skills of preschool children in Greece. Methods: To that end, a widely used screening tool was applied in a screening project involving 213 preschoolers. Language skills were assessed in three groups of children aged 2-4 years old before, during and after the pandemic. Results: A significant increase in the number of children with atypical language skills profile was identified in relation to the preschoolers after the pandemic versus those before or during the pandemic period. A higher prevalence of atypical profiles was observed in girls than in boys. Interestingly, an increase in the number of successfully produced or repeated words and pseudowords, along with enhanced expressive abilities, was observed during the pandemic compared to the periods before and after. Conclusions:Our findings suggest that post-pandemic preschool children exhibit higher rates of atypical language skill profiles compared to those assessed before and during the pan-demic. Given the importance of language development as a critical aspect of children's overall personality and well-being, further research is needed to explore the impact of specific pandemic-related factors on language competency. These factors include mask-wearing, increased screen time, reduced social interaction and exposure to language-rich environments, as well as impaired mental health and parental distress. Additionally, personalized interventions should be developed to support healthier developmental outcomes.

Economic impacts of the COVID-19 pandemic on families of children with autism and other developmental disabilities

Background

To control the spread of the coronavirus disease (COVID-19), many jurisdictions throughout the world enacted public health measures that had vast socio-economic implications. In emergency situations, families of children with developmental disabilities (DDs), including autism, may experience increased difficulty accessing therapies, economic hardship, and caregiver stress, with the potential to exacerbate autism symptoms. Yet, limited research exists on the economic impacts of the COVID-19 pandemic on families of children with autism or another DD compared to families of children from the general population.

Objectives

To assess impact of the COVID-19 pandemic related to parental employment and economic difficulties in families of children with autism, another DD, and in the general population, considering potential modification by socioeconomic disadvantage before the pandemic and levels of child behavioral and emotional problems.

Methods

The Study to Explore Early Development (SEED) is a multi-site, multi-phase, case-control study of young children with autism or another DD as compared to a population comparison group (POP). During January-July 2021, a COVID-19 Impact Assessment Questionnaire was sent to eligible participants (n=1,789) who had enrolled in SEED Phase 3 from September 2017-March 2020. Parents completed a questionnaire on impacts of the pandemic in 2020 and completed the Child Behavior Checklist (CBCL) to measure behavioral and emotional health of their child during this time. Multiple logistic regression models were built for employment reduction, increased remote work, difficulty paying bills, or fear of losing their home. Covariates include group status (autism, DD, POP), household income at enrollment, child's race and ethnicity, and binary CBCL Total Problems T-score (<60 vs. ≥60). Unadjusted and adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated.

Results

The study included 274 children with autism, 368 children with another DD, and 385 POP children. The mean age of 6.1 years (standard deviation, 0.8) at the COVID-19 Impact Assessment did not differ between study groups. Parents of children with autism were less likely to transition to remote work (aOR [95% CI] = 0.6 [0.4, 1.0]) and more likely to report difficulty paying bills during the pandemic (1.8 [1.2, 2.9]) relative to parents of POP children. Lower income was associated with greater employment reduction, difficulty paying bills, and fear of losing their home, but inversely associated with transitioning to remote work. Parents of non-Hispanic (NH) Black children experienced greater employment reduction compared to parents of NH White children (1.9 [1.1, 3.0]). Parents from racial and ethnic minority groups were more likely to experience difficulty paying bills and fear losing their home, relative to NH White parents. Caregivers of children with CBCL scores in the clinical range were more likely to fear losing their home (2.1 [1.3, 3.4]).

Conclusion

These findings suggest that families of children with autism, families of lower socio-economic status, and families of racial and ethnic minority groups experienced fewer work flexibilities and greater financial distress during the pandemic. Future research can be used to assess if these impacts are sustained over time.