Psychosocial and Behavioural Effects of the COVID-19 Pandemic on Children with Autism and their Families: A Systematic Review and Initial Data from a Multinational Online Survey

Abstract

Background: Since COVID-19 has become pandemic, everyday life has seen dramatic changes affecting individuals, families, and children with and without autism. These entail, among other things, more time at home, digital forms of communication, school closures, and reduced support and intervention. Aim: Here we aim to systematically assess the effects of the pandemic on autistic and neurotypical (NT) children, and pursue a pre-registered hypothesis suggested by initial observations that some children with autism might respond comparatively well to a situation of constrained, predictable, and digital social communication during the pandemic. Methods: We provide a systematic review of current relevant work, including 76 papers selected from a database search until February 1, 2021. We then report survey data from several countries assessing activities, well-being (PedsQLTM), and social life in families with autism, and their respective change at various stages of the pandemic. We focus on differences between children with and without autism from within the same families, and on different outcomes for children with high- or low-functioning autism. Results: While children with autism scored lower in emotional and social functioning than their NT siblings, comparable decreases in well-being and increases in anxiety were seen for both groups, compared to before the pandemic. By contrast, decreases in adaptability were significantly more pronounced in autistic than NT children. Preliminary results suggest that changes were comparable for children with high- and low-functional autism overall, but individual differences prevail. Conclusions: Overall, although individual families do report some positive effects of pandemic restrictions, our data give no clear evidence that these generalize across children with autism, or even just to children with high-functioning autism. We discuss significant challenges for children with and without autism that need to be addressed to protect childrens’ well-being under pandemic conditions but also point to potential in the present situation that could be used towards social participation and success in older children and young adults with autism.