COVID-19 and behaviors in children with autism spectrum disorder: Disparities by income and food security status.
COVID-19 behavior fallout hit autistic kids in low-income, food-insecure homes hardest—so screen family resources at every intake.
01Research in Context
What this study did
Researchers sent an online survey to 238 U.S. caregivers of autistic children. They asked how COVID-19 changed the child’s behavior and if the family earned under $50 K or worried about food.
The survey ran from April to June 2020, right after schools first closed.
What they found
Three out of four caregivers saw moderate-to-large negative behavior changes. Low-income families were three times more likely to report big worsening. Food-insecure families were four times more likely.
Sleep, tantrums, and repetitive behaviors were the top problems named.
How this fits with other research
Pondé et al. (2023) extends the story: when kids struggled, parents also crumbled. Their 2023 Brazil survey shows caregiver anxiety and depression skyrocketed during the second wave.
Lee et al. (2022) looks at the same U.S. spring but from the teacher angle. Educators told of creative IEP tweaks and some kids actually liking virtual classes. This seems to clash with the heavy home-side behavior worsening A et al. found. The gap is viewpoint: teachers saw learning format; caregivers saw living-room meltdowns.
Pickard et al. (2022) used a similar health-event design with fever instead of COVID-19. Both studies flag that medical stressors usually make autistic behaviors worse, not better.
Why it matters
If your client’s family earns under $50 K or uses food banks, expect sharper behavior dips during any crisis. Build shorter sessions, add sleep and meal routines, and hook parents up with local food pantries and respite funds. A two-minute intake screen for income and food security can guide your crisis plan today.
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02At a glance
03Original abstract
BACKGROUND: Research on the impact of the COVID-19 pandemic on behaviors of children with autism spectrum disorder (ASD) is lacking. AIMS: This study investigates the relationship between COVID-19 and behaviors of children with ASD living in the United States. METHODS AND PROCEDURES: Parents and caregivers (n = 200) across the United States, as proxies for children 2-17 years of age with ASD, participated in an online survey querying changes in overall behavior and 15 specific behaviors during the COVID-19 pandemic. Logistic regression was used to assess the association of a moderate-to-large impact on the child's overall behavior with household income level and food security status. OUTCOMES AND RESULTS: A majority of respondents reported a moderate-to-large impact on the child's overall behavior (74 %) due to COVID-19. Several specific behaviors were also affected. Stratifying by income level and food security status revealed disparities in the impact on overall behavior and most specific behaviors. Compared to a household income ≥$100 K, an income <$50 K was associated with an increased risk of moderate-to-large impact on the child's overall behavior (odds ratio (OR): 4.07, 95 % CI: 1.60, 10.38). Food insecurity also significantly impacted this risk, even after adjusting for potential confounding factors (OR: 3.31, 95 % CI: 1.13, 9.66). CONCLUSIONS AND IMPLICATIONS: Our findings show a large proportion of caregivers reporting moderate-to-large changes post-COVID-19 in the behaviors of U.S. children with ASD, particularly in families with low income and/or food insecurity. This study highlights the effects of existing disparities on children with ASD and their families during this unprecedented time.
Research in developmental disabilities, 2021 · doi:10.1101/2021.03.30.21254339