Academic articles exploring the impact of COVID-19 on individuals with neurodevelopmental conditions focus on how the pandemic’s disruptions have affected these individuals in various ways. With the shift to online learning, many children with conditions like autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD) faced significant challenges. Remote education often exacerbated difficulties with attention, organization, and communication, making it harder for these children to engage with their studies effectively. Additionally, social isolation during lockdowns and social distancing measures led to reduced opportunities for social interaction and extracurricular activities, which are crucial for developing social skills and maintaining emotional well-being. The articles also discuss the increased stress on families, who had to navigate new routines and support their children’s learning while dealing with their own challenges. The ongoing effects of these disruptions include persistent gaps in learning, long-term social and emotional impacts, and continued difficulties with transitioning back to in-person settings. By examining these impacts through surveys, interviews, and case studies, researchers aim to understand the unique difficulties faced by individuals with neurodevelopmental conditions during the pandemic and provide recommendations for improving support and resources in future emergencies.
Article Summery:
By Shefaly Shorey, Lydia Siew Tiang Lau, Jia Xuan Tan, Esperanza Debby, and Ramkumar Aishworiya
What is the authors’ objective?
The authors examined current research literature on the challenges faced by caregivers of children with neurodevelopmental disorders during the COVID-19 pandemic. Additionally, they collected parenting interventions and guidelines.
Relevant background information…
During extended periods of isolation/quarantine, psychological issues, like PTSD symptoms, anger, depression, etc., can arise. For children, increased time at home can often lead to an increase in screen time, which may result in low self-esteem or internet addiction.
During COVID-19, children with neurodevelopmental disorders experienced a disruption in their daily routines. This was distressing, especially for children with autism. Additionally, the closure of schools, special education centres, and rehabilitation centres meant that children with NDD experienced learning loss. The shift to online school was particularly difficult for children with NDD as they lost the ability to participate consistently.
What did they find?
Firstly, they found that COVID-19 raised behavioral and health concerns for many children with NDD. Surveys revealed that families with children with NDD found it more challenging to manage during COVID-19 than before. They had a higher rate of emotional symptoms, increased behavioral problems, and less social tendencies during the early stages of the pandemic. Parents of children with autism reported an increase in intensity and frequency of problem behaviours, and struggled to manage their free time. Lockdown also sparked other health concerns, like an increased sedentary lifestyle, impaired diet, weight gain, sleep disorders, and technology addiction.
COVID-19 also disrupted many lifelines and daily routines. Kids with NDD lost the main components of their social support systems, which increased their risk of social withdrawal, isolation, and regression. In one study, parents of children with autism mentioned their need for more in-home healthcare support. There was a noticeable silver lining as more family members were at home and involved in children’s education. As a result, parents noticed an improvement of family relationships and better communication with their children.
In most of the reviewed articles, authors emphasized the importance of continuity of care. Telehealth (virtual ways to see a doctor) models were the most common solution offered. They were well-received by most families, though there were issues like poor internet connections, web literacy gaps, session interruption, and difficulty in following instructions.
What did they recommend?
Based on the studies they reviewed, the authors of this article suggested that parents a) schedule regular online consultations with educators/therapists/doctors, b) maintain online therapy using telehealth, c) educate children on COVID-19 and preventative behaviours, d) create a structured daily routine, and e) find activities for their children, including physical exercise.
Anything else?
At the time the article was written, there was a lack of evidence-based studies on the COVID-19 pandemic. The ones they found focused on autism and ADHD and excluded other neurodevelopmental conditions.
Article Summery:
By Christiano Termine, Linda Greta Dui, Laura Borzaga, Vera Falli, Rossella Lipari, Marta Vergani, Valentina Berlusconi, Massimo Agosti, Francesca Lunardini, and Simona Ferrant
What is the authors’ purpose?
The authors sent out an online questionnaire to investigate the effects of neurodevelopmental conditions, identity, home environment, and COVID-19 on the lives of children with and without neurodevelopmental conditions.
They defined different areas of intervention: remote learning, lifestyle, anxiety, social, and scolding.
Relevant background information…
Italy was one of the most affected countries at the start of the COVID-19 pandemic. In their experiences working at hospitals in Italy, they noticed parents asking for specialist support for worsening behavioral symptoms in their children, noncompliance with online school, and change in their everyday lives. Some neuropsychiatrists used telehealth services, but assessment and treatment of neurodevelopmental disorders requires cooperation of several specialists, which was hard to coordinate during isolation.
What did they find?
They distinguished their findings based on the area of intervention.
For remote learning, they found that kids from lower socio-economic backgrounds were disadvantaged. The presence of siblings had a negative effect on lessons and homework, whereas only children received more attention from their parents. Younger children found online school more difficult as they were less confident using technology and couldn’t pay as much attention as older students. Children with NDD struggled more with remote learning than children without. Many lacked the assistance to follow online programs and required individualized education plans. One Italian study showed that at least 1 out of every 4 disabled students got left behind during remote learning.
For lifestyle, they observed significant weight gain in younger populations during lockdown. Children went to bed and woke up later, reducing their exposure to sunlight and increasing their time working bed which led to trouble falling asleep. Their use of the internet increased dramatically, potentially as a way to escape reality.
For social, they found that older students missed their peers less, probably due to the use of social media. The family environment was a fundamental place for socializing, and having siblings reduced the impacts of a lack of friends. However, they found a significant difference between children with NDD and those without. Children with NDDs said they missed their friends less, which could be due to deficits in social communication and being used to having less contact with their peers.
For anxiety, children expressed fear of having direct contact with people with COVID-19. The authors believed that having an outdoor space could help lessen fears, as well as improve physical wellbeing and quality of life. Parents of children with NDDS perceived their kids to be slightly more stressed than parents of children without. Children with NDD also reported higher self-perception of stress and anxiety, though this could be due to the comorbidity between most neurodevelopmental conditions and anxiety disorders.
Lastly, for scolding, the authors asked parents and kids how often scolding took place during COVID-19. The results indicated a 30% increase in family disputes. Research has shown that domestic violence increases in families during lockdown caused by health crises, and economic crises can be another risk factor. Children with NDDs said they were scolded more often than children without. The authors reasoned this could be because an increase in behavioural problems due to unexpected chagnes.
Anything else?
The survey compared pre-pandemic situations to current ones, but they acknowledge that it is impossible to establish a baseline. There was also a chance of parents influencing their child’s responses to the survey.
What did they recommend?
They recommended that care should be informed by long-term studies that focus on the life experiences of autistic TGD individuals across their life, not just during adolescence. They should also incorporate the experiences of those who de-transitioned, re-transitions, or reported regret in transitioning.
Anything else?
They did not examine other neurodevelopmental conditions, or guidance for autistic individuals in relation to gender identity. They also excluded documents not written in English.