Telerehabilitation and Wellbeing Experience in Children with Special Needs during the COVID-19 Pandemic

Abstract

Social distancing due to the COVID-19 pandemic represented a golden opportunity to implement telerehabilitation for clinical groups of children. The present study aims to show the impact that telerehabilitation had on the experience of well-being of children with special needs being treated at the Foundation IRCCS Neurological Institute ‘C. Besta’ in Milan (Specific Learning Disorders and Cerebral Palsy diagnosis); it aims to do so by comparing it with experiences of those who did not undertake telerehabilitation despite the diagnosis during the pandemic, and with typically developing children. Results show that the three groups differed in the Support, Respect and Learning dimensions of well-being experience. Post hoc comparisons revealed that children with Specific Learning Disorders and Cerebral Palsy scored higher than normotypical children in Support and in Respect scales. Furthermore, children who experienced telerehabilitation showed the highest scores on the Learning scale in comparison with the other two groups. These results support the importance of reorganizing care and assistance by integrating telemedicine, which seems to have fostered a positive experience of well-being in people with special needs, particularly in the perception of a supportive environment that respects psychological needs.

Interventions to improve well-being among children and youth aged 6–17 years during the COVID-19 pandemic: a systematic review

“…A total of 5449 records were retrieved after removing duplicates; 39 were reviewed in full text. Here, we report findings from 19 studies on well-being interventions for children and youth (Table 2) [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]. Studies involved a total of 7492 children and youth and 954 parents, all of which occurred • Agency: has self-esteem; a sense of agency and of being empowered to make meaningful choices and to influence their social, political, and material environment; and capacity for self-expression and self-direction appropriate to their evolving capacities and stage of development • Identity: feels comfortable in their own self and with their identity(s), including their physical, cultural, social, sexual, and gender identity • Purpose: has a sense of purpose, desire to succeed, and optimism about the future • Resilience: equipped to handle adversities both now and in the future, in a way that is appropriate to their evolving capacities and stage of development • Fulfilment: feels that they are fulfilling their potential now and that they will be able to do so in the future during the first year of the COVID-19 pandemic (March 2020 to March 2021).…”

“…Chen and colleague's mindfulness meditation and aerobic exercise RCT resulted in decreased anxiety (on the Self-Rating Anxiety Scale) at 1-month follow-up [34] while the Philosophy for Children intervention and Mindfulness-Based Intervention conducted by Malboeuf-Hurtubise and colleagues improved anxiety symptoms (on the Behavior Assessment Scale for Children-3rd edition) for children at 1-week follow-up [43]; no decrease in anxiety nor depression symptoms were observed by the art therapy experiential interventions described in another included study [43]. The three-group telerehabilitation program conducted by Sarti and colleagues revealed that children with specific learning disorders and cerebral palsy scored higher than typically developing children in the Respect Scale (of the Comprehensive Inventory for Thriving Children) of well-being experience [45]. Compared to controls, the SSI Intervention deployed by Schlieder and colleagues reduced 3-month depressive symptoms (on the Children's Depression Inventory) and 3-month restrictive eating (measured using the Dietary Restriction Screener), while the Heartfulness Meditation and Brainwave Entrainment interventions by Yadav and colleagues decreased anger, improved mood, and decreased stress (on the Perceived Stress Scale, Patient Health Question-9, and the Profile of Mood States), but only for adolescents who received the 4-week Heartfulness Meditation intervention [48].…”

“…All but three studies [38,39,44] assessed the effect of an intervention on the health and nutrition of 7201 collective children and youth during the COVID-19 pandemic; this included 12 person-level RCTs, three cluster RCTs, and one quasi-experimental study. Reported findings included slowed myopia progression [35]; decreased anxiety and depression with increased sleep quality [37]; decreased anxiety, depression, and Internet addiction [41]; improved learning [45]; decreased anxiety and depression with increased life satisfaction [47]; decreased anger and improved mood [48]; decreased anxiety and depression [49]; decreased anxiety with increased selfefficacy [51], decreased hyperactivity [43]; decreased anxiety and depression [42]; decreased anxiety [34,50]; increased balance, muscular strength, fitness, and flexibility [40]; improved anthropometrics with increased fitness and self-efficacy [33]; increased agency with decreased depression [46]; increased income [39]; and decreased depression and loneliness with increased wellbeing [36].…”

“…Three complex cluster RCTs and three complex personlevel RCTs focused on improving the connectedness of children and youth during the COVID-19 pandemic. These six included studies reported increased well-being [45]; increased positive affect and decreased negative affect [34]; decreased hopelessness [46]; increased kindness, generosity, and positive emotions [44]; decreased inattention [42]; and increased satisfaction [43].…”

“…The intervention deployed by Sarti and colleagues (described above) resulted in children with specific learning disorders and cerebral palsy scoring higher than typically developing children in Support and in Respect scales of the Comprehensive Inventory of Thriving Children [45].…”