CRISIS AFAR: an international collaborative study of the impact of the COVID-19 pandemic on mental health and service access in youth with autism and neurodevelopmental conditions
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Published:2023-02-14
Issue:1
Volume:14
Page:
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ISSN:2040-2392
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Container-title:Molecular Autism
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language:en
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Short-container-title:Molecular Autism
Author:
Vibert Bethany, Segura PatriciaORCID, Gallagher LouiseORCID, Georgiades Stelios, Pervanidou PanagiotaORCID, Thurm AudreyORCID, Alexander LindsayORCID, Anagnostou EvdokiaORCID, Aoki YutaORCID, Birken Catherine S.ORCID, Bishop Somer L.ORCID, Boi Jessica, Bravaccio CarmelaORCID, Brentani HelenaORCID, Canevini PaolaORCID, Carta AlessandraORCID, Charach AliceORCID, Costantino AntonellaORCID, Cost Katherine T.ORCID, Cravo Elaine AORCID, Crosbie JenniferORCID, Davico ChiaraORCID, Donno Federica, Fujino JunyaORCID, Gabellone AlessandraORCID, Geyer Cristiane TORCID, Hirota TomoyaORCID, Kanne StephenORCID, Kawashima Makiko, Kelley ElizabethORCID, Kim HosannaORCID, Kim Young Shin, Kim So Hyun, Korczak Daphne J.ORCID, Lai Meng-ChuanORCID, Margari LuciaORCID, Marzulli LuciaORCID, Masi GabrieleORCID, Mazzone LuigiORCID, McGrath JaneORCID, Monga SuneetaORCID, Morosini Paola, Nakajima ShinichiroORCID, Narzisi AntonioORCID, Nicolson RobORCID, Nikolaidis AkiORCID, Noda YoshihiroORCID, Nowell KerriORCID, Polizzi MiriamORCID, Portolese JoanaORCID, Riccio Maria PiaORCID, Saito ManabuORCID, Schwartz Ida, Simhal Anish K.ORCID, Siracusano MartinaORCID, Sotgiu StefanoORCID, Stroud Jacob, Sumiya FernandoORCID, Tachibana YoshiyukiORCID, Takahashi NicoleORCID, Takahashi Riina, Tamon HirokiORCID, Tancredi RaffaellaORCID, Vitiello BenedettoORCID, Zuddas AlessandroORCID, Leventhal BennettORCID, Merikangas KathleenORCID, Milham Michael P.ORCID, Di Martino AdrianaORCID
Abstract
Abstract
Background
Heterogeneous mental health outcomes during the COVID-19 pandemic are documented in the general population. Such heterogeneity has not been systematically assessed in youth with autism spectrum disorder (ASD) and related neurodevelopmental disorders (NDD). To identify distinct patterns of the pandemic impact and their predictors in ASD/NDD youth, we focused on pandemic-related changes in symptoms and access to services.
Methods
Using a naturalistic observational design, we assessed parent responses on the Coronavirus Health and Impact Survey Initiative (CRISIS) Adapted For Autism and Related neurodevelopmental conditions (AFAR). Cross-sectional AFAR data were aggregated across 14 European and North American sites yielding a clinically well-characterized sample of N = 1275 individuals with ASD/NDD (age = 11.0 ± 3.6 years; n females = 277). To identify subgroups with differential outcomes, we applied hierarchical clustering across eleven variables measuring changes in symptoms and access to services. Then, random forest classification assessed the importance of socio-demographics, pre-pandemic service rates, clinical severity of ASD-associated symptoms, and COVID-19 pandemic experiences/environments in predicting the outcome subgroups.
Results
Clustering revealed four subgroups. One subgroup—broad symptom worsening only (20%)—included youth with worsening across a range of symptoms but with service disruptions similar to the average of the aggregate sample. The other three subgroups were, relatively, clinically stable but differed in service access: primarily modified services (23%), primarily lost services (6%), and average services/symptom changes (53%). Distinct combinations of a set of pre-pandemic services, pandemic environment (e.g., COVID-19 new cases, restrictions), experiences (e.g., COVID-19 Worries), and age predicted each outcome subgroup.
Limitations
Notable limitations of the study are its cross-sectional nature and focus on the first six months of the pandemic.
Conclusions
Concomitantly assessing variation in changes of symptoms and service access during the first phase of the pandemic revealed differential outcome profiles in ASD/NDD youth. Subgroups were characterized by distinct prediction patterns across a set of pre- and pandemic-related experiences/contexts. Results may inform recovery efforts and preparedness in future crises; they also underscore the critical value of international data-sharing and collaborations to address the needs of those most vulnerable in times of crisis.
Publisher
Springer Science and Business Media LLC
Subject
Psychiatry and Mental health,Developmental Biology,Developmental Neuroscience,Molecular Biology
Cited by
3 articles.
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