Growing Up Through a Pandemic: A Mixed-Methods Study of How the COVID-19 Pandemic Shaped the Transition to Adulthood for Youth With Special Healthcare Needs and Their Families.
Lin Li, Jan Willem Gorter, Karen Cook and 10 others
Loss of in-person therapies was the most commonly reported harm for youth with special healthcare needs during the pandemic.
Virtual appointments and family closeness were the most valued benefits. Impact varied by condition type and age.
Key findings
1The most endorsed positive pandemic factors were family support (67.4%), positive coping strategies such as physical activity and hobbies (60.1%), and friendships (45.2%). The most endorsed negative factors were lack of in-person services (56.4%), exposure to negative news (56.0%), and social distancing (51.2%).
2Youth with mental healthcare needs were more likely to report both a positive impact of virtual services (aOR 1.92, 95% CI 1.17–3.15) and a negative impact from the absence of in-person services (aOR 1.88, 95% CI 1.18–2.98). Youth with developmental needs were also more likely to endorse positive virtual-service impacts (aOR 1.58, 95% CI 1.01–2.47).
3No youth characteristic (age, gender, type of healthcare need, or level of service needs) was significantly associated with reporting a negative impact of virtual services.
Still to come
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The survey is cross-sectional, so no causal claims can be made about what caused the reported experiences. The qualitative phase involved only 21 interviews from four provinces, limiting the range of perspectives captured. The survey sample was recruited through an online consumer panel, which may exclude youth with significant communication barriers, limited technology access, or lower engagement with health systems. Women were overrepresented in the survey sample relative to the Canadian YSHCN population. Proxy reporting (14.3% of survey respondents) may not accurately reflect the youth's own perspective. The two phases had different samples and eligibility criteria (ages 16–24 vs 17–28), so integrated findings describe shared patterns across related but not identical groups. The inferential analyses were exploratory and did not examine interaction effects between variables.
Declared interests
Funded by the Canadian Institutes of Health Research (grant UIP 178856). The authors declare no conflicts of interest.
The easy way to misread this
Do not read this as evidence that virtual care is inferior to in-person care for all patients. The survey found no youth characteristic that predicted a negative virtual-service experience, and 32.6% of respondents valued virtual appointments. The harm was concentrated in the loss of in-person options for those who needed them. The cross-sectional design also means none of the associations shown are causal.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →