Comparing the impact of the first and second wave of COVID-19 lockdown on Slovak families with typically developing children and children with autism spectrum disorder

Abstract

The aim of this research was to compare the mental health of families with children diagnosed with autism spectrum disorder or typically developing children, during the first and the second wave of COVID-19 outbreak in Slovakia. The study is mainly focused on the prevalence of depression, anxiety, and stress among the parents and maladaptive behavior or sleep disturbances of their children. Our research sample consisted of 332 caregivers, 155 of which have children with autism spectrum disorder; 179 surveyed during the first wave and 153 during the second wave. Extensive online parent questionnaire was created, including demographic and specific topic–related questions; Depression, Anxiety, and Stress Scale–42 questionnaire; and two subscales of Vineland Adaptive Behavior Scales—internalizing and externalizing maladaptive behavior. During the first wave, high levels of anxiety were found in parents of autism spectrum disorder children. During the second wave, all parents experienced increased levels of anxiety, stress, and depression, but especially severe for parents of children with autism spectrum disorder. Internalizing maladaptive behavior of children with autism spectrum disorder grew significantly between the waves. Parental depression, anxiety, and stress positively correlated with maladaptive behavior in both autism spectrum disorder and neurotypical children, suggesting a need for therapy options for whole families. Lay abstract A global pandemic caused by a new coronavirus (severe acute respiratory syndrome coronavirus 2) affected everyday lives of all people, including individuals with special needs, such as autism spectrum disorder. The aim of this research was to compare the mental health of families with children with autism spectrum disorder to families with typically developing children, and between the first and the second wave of COVID-19 outbreak in Slovakia. This mainly included symptoms of depression, anxiety, and stress of parents and problem behavior or sleeping difficulties of their children. The research sample consisted of 332 parents (155 of which have children with autism spectrum disorder), 179 surveyed during the first wave and 153 during the second wave. Online parent questionnaire was created, including demographic and specific topic questions, Depression Anxiety and Stress Scale–42 questionnaire, and internalizing and externalizing maladaptive behavior subscales from Vineland Adaptive Behavior Scales. Our results show that during the first wave, parents of autism spectrum disorder children suffered high levels of anxiety. During the second wave, both groups of parents suffered increased anxiety, stress, and depression, but especially severe for parents of children with autism spectrum disorder. Internalizing maladaptive behavior of autistic children grew significantly between the waves. Parental depression, anxiety, and stress were interconnected with maladaptive behavior of both autism spectrum disorder and typically developing children, suggesting the importance of the therapy options for whole families.

The Role of Self-Care Activities (SASS-14) in Depression (PHQ-9): Evidence From Slovakia During the COVID-19 Pandemic

“…From a mental health perspective, depression is a huge burden on health ( 11 ). In Slovakia, together with the COVID-19 pandemic, depressive symptoms also appeared across the population ( 12 , 13 ), while depression is considered not only a health but also an economic burden in this country ( 14 ). In addition, it has been proven that Slovak family members of patients in intensive care units report a higher prevalence of depression ( 15 ), which can also be expected in COVID-19 disease.…”

COVID-19 Pandemic and Autism Spectrum Disorder, Consequences to Children and Adolescents — a Systematic Review

“…The domain behavior was addressed in 22 articles, all of which described changes in behavior (Amorim et al, 2020 ; Berard et al, 2021 ; Bhat, 2021 ; Colizzi et al, 2020 ; Corbett et al, 2021 ; Hosokawa et al, 2021 ; Jacques et al, 2022 ; Kawabe et al, 2020 ; Lugo-Marín et al, 2021 ; Mete Yesil et al, 2022 ; Morris et al, 2021 ; Mumbardó-Adam et al, 2021 ; Mutluer et al, 2020 ; Nuñez et al, 2021 ; Panjwani et al, 2021 ; Polónyiová et al, 2022 ; Rabbani et al, 2021 ; Sergi et al, 2021 ; Tokatly Latzer et al, 2021 ; Türkoğlu et al, 2020 , 2021 ; Vasa et al, 2021 ). Medium level of evidence was observed in eight papers (Berard et al, 2021 ; Bhat, 2021 ; Colizzi et al, 2020 ; Corbett et al, 2021 ; Hosokawa et al, 2021 ; Nuñez et al, 2021 ; Türkoğlu et al, 2021 ; Vasa et al, 2021 ) and the hypothesis of worsening behavior was confirmed by six articles, Bhat, 2021 ; Colizzi et al, 2020 ; Corbett et al, 2021 ; Hosokawa et al, 2021 ; Nuñez et al, 2021 ; and Türkoğlu et al, 2021 .…”

“…Medium level of evidence was observed in eight papers (Berard et al, 2021 ; Bhat, 2021 ; Colizzi et al, 2020 ; Corbett et al, 2021 ; Hosokawa et al, 2021 ; Nuñez et al, 2021 ; Türkoğlu et al, 2021 ; Vasa et al, 2021 ) and the hypothesis of worsening behavior was confirmed by six articles, Bhat, 2021 ; Colizzi et al, 2020 ; Corbett et al, 2021 ; Hosokawa et al, 2021 ; Nuñez et al, 2021 ; and Türkoğlu et al, 2021 . Most articles (n = 13) observed an resurgence of previous behavioral problems (Berard et al, 2021 ; Bhat, 2021 ; Hosokawa et al, 2021 ; Mete Yesil et al, 2022 ; Mutluer et al, 2020 ; Nuñez et al, 2021 ; Panjwani et al, 2021 ; Polónyiová et al, 2022 ; Sergi et al, 2021 ; Tokatly Latzer et al, 2021 ; Türkoğlu et al, 2020 , 2021 ; Vasa et al, 2021 ), while others (n = 5) observed the emergence of new behavioral issues (Corbett et al, 2021 ; Mete Yesil et al, 2022 ; Mumbardó-Adam et al, 2021 ; Mutluer et al, 2020 ; Vasa et al, 2021 ).…”

“…Eight papers (Berard et al, 2021 ; Bhat, 2021 ; Hosokawa et al, 2021 ; Mumbardó-Adam et al, 2021 ; Mutluer et al, 2020 ; Sergi et al, 2021 ; Tokatly Latzer et al, 2021 ) reported worsening or the emergence of new stereotyped behaviors, including speaking in a louder tone of voice, pulling their ears, and tics (Mumbardó-Adam et al, 2021 ; Mutluer et al, 2020 ). Compared with control children, patients showed significantly higher changes in behavior (Amorim et al, 2020 ; Corbett et al, 2021 ; Hosokawa et al, 2021 ; Polónyiová et al, 2022 ).…”

“…Five articles described therapies received or missed during the pandemic, such as speech-language, physical/occupational, and behavioral therapies (Bhat, 2021 ; Colizzi et al, 2020 ; Lugo-Marín et al, 2021 ; Mumbardó-Adam et al, 2021 ; Polónyiová et al, 2022 ). Of those, only two reached the medium evidence quality level (Bhat, 2021 ; Colizzi et al, 2020 ).…”