CRISIS AFAR: an international collaborative study of the impact of the COVID-19 pandemic on mental health and service access in youth with autism and neurodevelopmental conditions.
Bethany Vibert, Patricia Segura, Louise Gallagher and 66 others
PMID 36788583WHAT IT FOUND
Youth with autism or neurodevelopmental conditions split into four pandemic impact groups.
Only 20% had broad symptom worsening, and this group did not have the greatest service loss. Sleep problems worsened on average, while service losses varied widely.
Key findings
01The analysis identified four outcome subgroups: broad symptom worsening only (20%), primarily modified services (23%), primarily lost services (6%), and average symptom/service changes (53%).
02Across the whole sample, sleep problems worsened from prior 4.9 to current 5.2, and higher scores indicate greater severity.
03On average, youth lost 1.2 school services and 1.3 outside-school services, while continuing 1.1 school services and 0.8 outside-school services; most continued services were via telehealth or email (88% in school, 69% outside school).
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was cross-sectional and covered the first six months of the pandemic, so it cannot show long-term outcomes or whether the subgroups stayed the same over time. It used parent report only, and it did not assess social communication, parent mental health, or every possible domain of pandemic impact. The sample was a convenience sample with 88% male youth, 64% of caregivers having at least a college degree, and no preschoolers, so it may not represent all families. Prior diagnosis and severity information varied by contributing sample, and baseline severity was partly based on parent responses. No treatment was assigned, so lost or continued services cannot be treated as causes of symptom worsening.
Declared interests
No author conflict-of-interest declaration appears in the supplied article text. The publication types indicate NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that losing therapy services caused broad symptom worsening. The subgroup with broad worsening had marginal service changes, while a separate subgroup had the most services lost.