Psychosocial and Behavioral Impact of COVID-19 in Autism Spectrum Disorder: An Online Parent Survey

TLDR

COVID‑19 has heightened psychological distress, especially for those with pre‑existing mental health conditions, and young people with autism spectrum disorder are particularly vulnerable to the pandemic’s unpredictable changes. This study examined how the COVID‑19 pandemic affected individuals with ASD, sought to identify pre‑pandemic sociodemographic or clinical predictors of negative outcomes, and described their emergent needs. Parents and guardians of 527 ASD children completed an online 40‑question survey assessing socio‑demographic and clinical characteristics, the pandemic’s impact on wellbeing, and required support. The survey revealed that 93.9 % of families faced challenges, daily activity management worsened (free time 78.1 %, structured 75.7 %), 35.5 % and 41.5 % of children experienced more intense and frequent behavior problems, pre‑existing behavior issues increased the risk (OR = 2.16 and 1.67), and many families reported unmet needs for healthcare (47.4 %), in‑home support (29.9 %) and quarantine interventions (16.8 %).

Abstract

The 2019 coronavirus disease (COVID-19) outbreak could result in higher levels of psychological distress, especially among people suffering from pre-existing mental health conditions. Young individuals with autism spectrum disorders (ASD) are particularly at risk due to their vulnerability to unpredictable and complex changes. This study aimed to investigate the impact of the COVID-19 pandemic on ASD individuals, whether any pre-pandemic sociodemographic or clinical characteristics would predict a negative outcome, and to narratively characterize their needs. Parents and guardians of ASD individuals filled out an online survey consisting of 40 questions investigating socio-demographic and clinical characteristics of their children, impact of the COVID-19 outbreak on their wellbeing and needs to deal with the emergency. Data were available on 527 survey participants. The COVID-19 emergency resulted in a challenging period for 93.9% of families, increased difficulties in managing daily activities, especially free time (78.1%) and structured activities (75.7%), and, respectively, 35.5% and 41.5% of children presenting with more intense and more frequent behavior problems. Behavior problems predating the COVID-19 outbreak predicted a higher risk of more intense (odds ratio (OR) = 2.16, 95% confidence interval (CI) 1.42-3.29) and more frequent (OR = 1.67, 95% CI 1.13-2.48) disruptive behavior. Even though ASD children were receiving different types of support, also requiring specialist (19.1%) or emergency (1.5%) interventions in a relatively low proportion of cases, a number of needs emerged, including receiving more healthcare support (47.4%), especially in-home support (29.9%), as well as interventions to tackle a potentially disruptive quarantine (16.8%). The COVID-19 outbreak has undoubtedly resulted in increased difficulties among ASD individuals.