COVID-19 has changed our lives considerably. It has prevented most children around the world from accessing face-to-face education at school. Children with special needs could be particularly affected, as most rehabilitation training programs have been interrupted. This may negatively influence the progress of training or even lead to regression in some cases.1
According to a recent study conducted in the United Kingdom, both parents and their children with special needs reported deterioration in mental health due to COVID-19. They have experienced loss, worry, and changes in mood and behaviour.2 Children have experienced loss of daily routine while parents struggle to manage without their usual support networks. Children may not understand and worry about the situation, while parents worry about their child’s training progress. Some children may engage in disruptive behaviours at home while parents feel helpless to handle the situation.2
Although COVID-19 has created difficulties for most people, families with children who have special needs are particularly vulnerable. Autism Spectrum Disorder is a neurodevelopmental disorder associated with persistent social communication challenges, restricted and repetitive behaviours and interests, and hypersensitivity or hyposensitivity to sensory input.3 During COVID-19, some autistic children may experience anxiety due to disruption of daily routines and high levels of discomfort while wearing masks due to tactile hypersensitivity. In addition, sleep problems have disproportionately affected autistic children.4 A study conducted in Turkey found that autistic children exhibited significantly more sleep problems and autistic symptoms when they were forced into home confinement due to COVID-19 than during the normal non-home confinement state.5 The mental health of families with children who have special needs requires our attention.
For a small proportion of families — particularly those with children who have a hard time at school — social distancing and quarantine during COVID-19 may be providing a time of respite.2 The impact of COVID-19 on mental health for these families can be minimal or even lead to improvement in some cases.
Some therapists and teachers now offer online rehabilitation training and phone consultation. A study conducted in India found that caregivers of children with special needs who did not use tele-rehabilitation or who perceived homecare therapy as difficult, held negative perceptions about tele-rehabilitation and were at greater risk for poor mental health.6 More education on the importance of home training — including encouraging families to attend rehabilitation in a different format and setting appropriate tasks for home training — may help these families.2,6 However, it is undeniable that certain children may be less suitable to participate in training using online formats.
Are there any recommendations for improving mental health for families who have children with special needs?
If you are a parent tending a child with special needs, one of the most important suggestions is to take good care of yourself first. It is common for parents to put all their focus on the needs of children and the family — for instance, home training for children and ensuring everything at home is sterilized during the pandemic. However, parents’ own mental health may be overlooked.
Other suggestions for parents include considering your child’s behaviour as a form of communication, taking time to notice your own feelings, pausing before responding to your child, making time to relax (e.g., meditation, yoga, long baths), staying in touch with your social network, and reaching out to a healthcare professional if your mental health becomes a concern.7 Since blue light suppresses the production of melatonin, using electronic devices in the evening will likely affect sleep quality.8 Parents may try to limit screen time — for themselves and their children — for better sleep quality and better mental health overall. When arranging activities for your child, try to maintain a routine while including a mix of different activities. Some examples include free play, art activities, story time, and physical activities.9
For parents of children with special needs, it is important to remember that self-care is not selfish. Instead, it helps to ensure that we are physically and emotionally capable to care for our children.7
Edited by Isayah Alman & Curtis D'Hollander
1. Chen SQ, Chen SD, Li XK, Ren J. Mental health of parents of special needs children in China during the COVID-19 pandemic. International Journal of Environmental Research and Public Health. 2020 Jan;17(24):9519.
2. Asbury K, Fox L, Deniz E, Code A, Toseeb U. How is COVID-19 affecting the mental health of children with special educational needs and disabilities and their families?. Journal of Autism and Developmental Disorders. 2020 Jul 31:1-9.
3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub; 2013 May 22.
4. Sivertsen B, Posserud MB, Gillberg C,Lundervold AJ, Hysing M. Sleep problems in children with autism spectrum problems: a longitudinal population-based study. Autism. 2012 Mar;16(2):139-50.
5. Türkoğlu S, Uçar HN, Çetin FH, Güler HA, Tezcan ME. The relationship between chronotype, sleep, and autism symptom severity in children with ASD in COVID-19 home confinement period. Chronobiology International. 2020 Aug 2;37(8):1207-13.
6. Dhiman S, SahuPK, Reed WR, Ganesh GS, Goyal RK, Jain S. Impact of COVID-19 outbreak on mental health and perceived strain among caregivers tending children with special needs. Research in Developmental Disabilities. 2020 Dec 1;107:103790.
7. Zero To Three. 2020, Apr 14. Young Children at Home during the COVID-19 Outbreak: The Importance of Self-Care. Retrieved from: https://www.zerotothree.org/resources/3262-young-children-at-home-during-the-covid-19-outbreak-the-importance-of-self-care
9. Imran N, Zeshan M, Pervaiz Z. Mental health considerations for children & adolescents in COVID-19 Pandemic. Pakistan Journal of Medical Sciences. 2020 May;36(COVID19-S4):S67.