Children with Autism Spectrum Disorder in Times of COVID-19: Examining Emotional and Behavioral Problems, Parental Well-Being, and Resilience.
Donna A de Maat, Ruth Van der Hallen, Pieter F A de Nijs and 8 others
PMID 37213037WHAT IT FOUND
Children with autism did not show a larger increase in emotional and behavioral problems during the COVID-19 lockdown than typically developing peers.
Parental mental health and social connectedness were not associated with how children’s problems changed. Individual variability was high, meaning some children worsened while others remained stable or improved.
Key findings
01The change in emotional and behavioral problems from pre-pandemic to lockdown did not differ significantly between children with ASD and matched controls.
02Parental mental health and social connectedness were not significantly related to the change in child problems, nor did they differ between children whose problems increased versus those whose problems remained stable or decreased.
03Children with ASD showed significantly larger interindividual variability in emotional and behavioral problems than controls both before and during the pandemic.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
Informant discrepancy: EB-problems were reported by parents for the ASD group but by the adolescents themselves for the control group, which may affect comparability. Self-selection bias: Parents of children with ASD reported relatively high mental health and low loneliness, possibly because more distressed parents were less likely to participate. Temporal limitation: Parental mental health and social connectedness were measured only during the lockdown, not before, so it is unclear if these factors were stable or changed due to the pandemic. Outcome scope: The study focused on emotional and behavioral problems as markers of resilience, excluding other adaptive outcomes like positive affect or self-efficacy. Sample size: The ASD sample was small (n=62), which may limit the power to detect smaller associations between parental factors and child outcomes.
Declared interests
Funded by ZonMw, NWO, Dutch Ministries of Health and Youth, and Erasmus Initiatives. No specific conflicts of interest regarding commercial entities were declared in the provided text.
The easy way to misread this
Do not conclude that the pandemic had no impact on children with ASD. While the group average change was not significantly different from controls, children with ASD had much higher absolute levels of problems and significantly greater variability. This means a substantial number of children with ASD did deteriorate, even if others remained stable or improved. The null finding for parental well-being also should not be interpreted as evidence that parental stress is irrelevant; it may reflect measurement limitations or the specific nature of the ASD population's response to parental distress.