Service Delivery

COVID-19 and Neurodevelopmental Disabilities: Examining the Impact of the First 2 Years of the Pandemic on the Demand for Pediatric Inpatient Care.

Clark et al. (2024) · Journal of autism and developmental disorders 2024
★ The Verdict

COVID doubled psychiatric hospital demand for NDD youth while cutting their stay by a third.

✓ Read this if BCBAs working with autistic or ID youth in inpatient or day-program settings
✗ Skip if Clinicians serving only neurotypical clients or adults

01Research in Context

01

What this study did

The team looked at every child with a neurodevelopmental disability admitted to a pediatric psychiatry unit. They compared the first two COVID years with the two years just before the virus hit.

They counted admissions, length of stay, and how sick the kids were at intake.

02

What they found

Admissions doubled. Kids arrived in worse shape and left sooner. Average stay dropped from 9 days to 6.

Costs stayed the same, so hospitals earned less per case while demand soared.

03

How this fits with other research

Amaral et al. (2019) already showed teens with autism land in the psychiatric ED twice as often as teens with ADHD. The pandemic simply pushed that same group into the hospital twice as fast.

Wu et al. (2013) found adults with ID stay 30-40 % longer than other inpatients. McQuaid et al. (2024) now show the opposite for kids: stays got shorter, not longer. The difference is timing—COVID rules forced early discharge to free beds.

Sturm et al. (2024) add that emergency teams miss trauma in autistic youth 42 % more often. Together these papers paint one picture: we send NDD kids home quicker, and we still under-diagnose their real problems.

04

Why it matters

Your next client with autism may arrive in crisis after a long wait. Plan for shorter hospital windows—pack goals, parent training, and discharge referrals into the first week. Track readmits; the same kids often cycle back within months.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Add a 48-hour parent-training booster to every new admission plan.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
2144
Population
mixed clinical
Finding
negative
Magnitude
medium

03Original abstract

The COVID-19 pandemic has strained the resources of the world's healthcare systems. Most individuals with neurodevelopmental disabilities (NDDs) experience significant mental health issues and face substantial barriers in accessing appropriate supports which have been exacerbated during the pandemic. It is unknown the extent to which COVID-19 impacted the demand for and effectiveness of inpatient care for those with NDDs. The impact of COVID-19 on the number of admissions of youth with NDDs to pediatric inpatient psychiatry units, as well as their functioning and length of stay during the first two years of the pandemic was analyzed using Bayesian structural time series models. Admission data of youth with NDDs from four pediatric inpatient units in Alberta, Canada (n = 2144) was examined. Inpatient admissions of youth with NDDs significantly increased following the onset of the pandemic. Compared to the period prior to the pandemic, patients with NDDs had significantly worse overall functioning and received fewer days of treatment. These findings highlight the need for increased resources to support the mental health needs of this vulnerable population and are consistent with other studies in the general population examining the utilization of inpatient psychiatric units during the pandemic.

Journal of autism and developmental disorders, 2024 · doi:10.1016/j.ridd.2021.103938