More than half of autistic children experienced lockdown induced diminished mental health: PCH study

More than half of autistic children experienced mental health (MH) deterioration, and person-specific (pre-existing MH, COVID related stress), parent-specific (Parent MH), and system-level (loss of services and material deprivation) characteristics were associated with such decline, providing clinical and policy opportunities for intervention at multiple levels, according to latest research published in Paediatrics & Child Health.

Children with pre-existing mental health conditions/neurodevelopmental disorders have been particularly vulnerable to increases in stress, and internalizing and externalizing behaviours in children and youth.

Disruptions in various educational and health care services (e.g., academic supports, psychology/social work services, and allied health and medical services) were primary stressors for children and their families during the pandemic. According to parental reports, the loss of educational and health care services may be particularly detrimental to both autistic children and their families, due to difficulties with changes in routines, but also overall increased need for continuous access to such services.

The purpose of the study conducted by Marina Charalampopoulou et. al was to identify sub-groups of autistic children who are most at risk of poor MH outcomes during the COVID-19 pandemic, and to characterize sub-group membership using child, parent, and system factors to inform clinical and policy decision making.

Data were drawn from a large Canadian cohort across Ontario, resulting in 265 autistic children. K-means clustering analyses were employed to partition distinct MH profiles in six MH measures (mood, anxiety, OCD symptoms, irritability, inattention, hyperactivity) and group differences were examined with reference to the above factors. Additionally, we investigated the characteristics of children who accessed acute MH services.

The researchers noted the following results:

The optimal number of clusters was two; one included those experiencing MH deterioration across all six MH measures, and a second included youth that did not experience MH changes.

Child-specific factors associated with MH deterioration included higher pre-existing internalizing symptoms, high levels of COVID stress.

Parental MH challenges and system-specific factors, such as the loss of learning supports, access to physicians and material deprivation, were also associated with MH deterioration.

Access to acute MH services were primarily associated with financial insecurity and loss of services.

"In conclusion, more than half of autistic children experienced mental health deterioration during the pandemic, and person-specific, parent- and system-level characteristics were associated with such deterioration, and may present opportunities for future interventions," the authors wrote.