COVID-19 and Neurodevelopmental Disabilities: Examining the Impact of the First 2 Years of the Pandemic on the Demand for Pediatric Inpatient Care.
COVID doubled psychiatric hospital demand for NDD youth while cutting their stay by a third.
01Research in Context
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.
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.
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.
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.
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02At a glance
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