The impact of COVID-19 pandemic social restrictions on individuals with autism spectrum disorder and their caregivers in the Stateof Qatar: A cross-sectional study.

Only 58 caregivers were analysed, and 41 of 99 eligible caregivers did not participate, so findings may not represent all families. Caregivers reported their dependents' behaviour before and during restrictions retrospectively; no independent observation or clinical assessment was used. The aggression and burden scales were investigator-adapted for pandemic comparison, so the before-during change may not be fully validated. Data were collected months after restrictions began, so early behavioural disturbance may have been missed. The sample was from one health service in Qatar, and all caregivers were parents; it may not apply to other services, cultures, or non-parent caregivers. Caregivers with a known mental disorder were excluded, so caregiver strain may be underestimated. Subgroup comparisons, especially the 15 adult caregivers, were small, and some differences were not statistically significant. The Discussion describes positive outcomes for aggression, but the overall aggression score change was not statistically significant (p = 0.30). The study cannot show that COVID-19 restrictions caused changes in aggression or caregiver burden.

No specific grant was received, and the authors declared no conflict of interest.

Do not conclude that COVID-19 restrictions improved autistic individuals' aggression. The overall aggression score change was not statistically significant (p = 0.30), and 24 of 58 caregivers reported a clinically significant rise in burden.