Impact of the COVID-19 pandemic on therapy service delivery and functioning for school-aged children with disabilities in the United States
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ABSTRACT: Background
The COVID-19 pandemic caused wide-scale disruptions to therapy services for children with disabilities in the United States. Objective/Hypothesis
We evaluated changes in therapy service delivery during the first four months of the pandemic, examined the impact of these changes on children's functioning, and analyzed factors predicting the loss of in-person services and receipt of teletherapy services. Methods
We undertook an anonymous cross-sectional online survey of parents/caregivers of children with a disability aged 5–17 years. Changes in therapy service delivery and children's functioning were descriptively summarized. Logistic regressions examined individual and contextual predictors of loss of therapy services or receipt of teletherapy services. Results
402 parents of children aged 5–17 years old with one or more disabilities participated; 42% of children lost access to all therapy services, and 34% of children received at least one therapy service via telehealth. Children receiving a greater number of services pre-COVID and having access to more technological devices pre-COVID were significantly more likely to receive teletherapy. Over 40% of parents attributed declines in their child's motor, behavior, social, and communication skills to changes in therapy services; this impact was greater for children with multiple diagnoses. Conclusions
Findings underscore the negative impact of therapy service disruptions on children with disabilities.
SUBMITTER: Allison K
PROVIDER: S-EPMC8730530 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThere is concern about the effect of the COVID-19 pandemic on psychosocial functioning among school-age children, who have faced unusual stressors during this time. Our goal was to assess mental health symptoms and social risks during COVID-19, compared to before the pandemic, for urban, racial and ethnic minority school-age children, and investigate the relationship between mental health and social risks.MethodsWe conducted a cohort study from September 2019 until January 2021 of children age 5-11 years old recruited from an urban safety net hospital-based pediatric primary care practice. We measured emotional and behavioral symptoms (including attention, internalizing, and externalizing symptoms) before and during the pandemic with the Pediatric Symptom Checklist (PSC-17). We measured social risks (including food and housing insecurity) before and during the pandemic with the THRIVE screener. We measured additional mid-pandemic COVID-related stressors with items on school participation, screens/media use, illness exposure, and caregiver mental health. We compared pre- and mid-pandemic PSC-17 symptom scores across 4 domains (total, attention, internalizing, and externalizing) and used path analysis to examine the relationship between mental health and social risks pre- and mid-pandemic.ResultsCaregivers of 168 children (54% non-Hispanic Black, 29% Hispanic, and 22% non-English speaking) completed the study. Children had significantly higher levels of emotional and behavioral symptoms midpandemic- vs. pre-pandemic in all domains. Significantly more children had a positive PSC-17 total score (18% vs. 8%, p < 0.01) and internalizing (depression and anxiety) score (18% vs. 5%, p < 0.001) during the pandemic vs. before, indicating clinical concerns in these areas. Caregivers reported significantly more social risks during vs. before the pandemic (p < 0.001). Mental health symptoms significantly correlated with number of social risks before the pandemic, but not during the pandemic. Less school assignment completion, increased screen time, and caregiver depression were all significantly associated with worse mid-pandemic mental health in children.ConclusionThe COVID-19 pandemic has led to a dramatic increase in depression/anxiety problems and social risks among urban, racial and ethnic minority school-age children compared to before the pandemic. More research is needed to understand if these changes will persist.
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