Behavioral Implications of the Covid-19 Process for Autism Spectrum Disorder, and Individuals' Comprehension of and Reactions to the Pandemic Conditions

Abstract

During disasters and pandemics, vulnerable populations such as patients with mental conditions are known to be overly influenced. Yet, not much is known about how the individuals with autism spectrum disorder (ASD), one of the most common neurodevelopmental conditions globally with a prevalence of 1%, are affected from health-related disasters, especially the current Covid-19 pandemic. Therefore, we conducted an investigation of how individuals with ASD responded to Covid-19 in terms of comprehension and adherence to implemented measures; changes in their behavioral problems; and how their caregivers' anxiety levels relate with these behavioral changes. Our sample consisted of 87 individuals with ASD (15 girls; ages ranged from 3–29, with an average of 13.96 ± 6.1). The majority of our sample had problems understanding what Covid-19 is and the measures it requires. They also had challenges in implementing social distance and hygiene-related regulations of the pandemic. The majority stopped receiving special education during this period. We observed a Covid-19-related clinical presentation that resembled PTSD in individuals with ASD in terms of increased stereotypies, aggression, hypersensitivity, behavioral problems, and sleep and appetite alterations. All subscales of Aberrant Behavior Checklist (ABC) differed significantly between before and after the pandemic conditions. The number of hours the children slept significantly decreased from before to during Covid-19. The anxiety levels of caregivers were high and correlated with the current behavioral problem levels of their children, but not with the level of their behavioral problems before the pandemic. The difference in ABC total score and specifically the lethargy/social withdrawal subscale score predicted parents' anxiety score. Our results suggest that the Covid-19 period inflicts specific challenges to individuals with ASD and their caregivers, underlining the need for targeted, distance special education interventions and other support services for this population.

The Impact of COVID-19 on the Adaptive Functioning, Behavioral Problems, and Repetitive Behaviors of Italian Children with Autism Spectrum Disorder: An Observational Study

“…Moreover, they found that the presence of disruptive behaviors preceding the pandemic was related to a worse outcome. Concordant with this, a Turkish study [ 7 ] on children and young adults with autism reported increased stereotypies, aggression, hypersensitivity behavioral problems, sleep, and appetite alterations after the pandemic, describing in their sample clinical symptoms similar to post-traumatic stress disorder. However, to our knowledge, neither study employed standardized quantitative tools—administered before and after the lockdown—in order to measure the actual behavioral outcome of the children with ASD.…”

“…On a Turkish sample of 87 ASD individuals (3–29 years old) [ 7 ], the authors found an increase in behavioral problems measured by the parental questionnaire aberrant behavior checklist (ABC). Although employing a standardized measure, authors asked parents during the pandemic to answer in reference to both before and after the COVID-19 measures.…”

The psychological impact of the COVID-19 pandemic on adults with autism: a survey study across three countries

“…Furthermore, the majority of caregivers in the autism group reported that quarantine negatively impacted emotion management in their children, whereas the majority of parents without autism reported no impact or even a positive impact of quarantine on emotion management in their children. Studies on behavioral problems during the COVID-19 pandemic have found an increase in behavioral problems in children with autism since the pandemic [ 28 ], and that preexisting behavioral problems predict a higher risk of more intense and frequent behavioral problems during the pandemic [ 29 ]. The commentary of Ameis et al [ 22 ] highlights the potential negative impact of changes to everyday routines and restrictions to regular services on children with autism.…”

COVID-19 pandemic effects in people with Autism Spectrum Disorder and their caregivers: Evaluation of social distancing and lockdown impact on mental health and general status

“…Moreover, prior diagnosed behavior difficulties predicted worse outcome of behavioral problems during lockdown period. When addressing parents/caregivers’ stress, higher levels have been reported since the onset of the COVID-19 pandemic ( Manning, Billian, Matson, Allen, & Soares, 2020 ; Mutluer, Doenyas, & Genc, 2020 ). Identified stress factors were mostly related with therapeutical services shutdown and behavioral problems of ASD children during lockdown period.…”