A longitudinal study of the mental health of autistic children and adolescents and their parents during COVID-19: Part 2, qualitative findings.

This study looked at how the first 6 months of COVID-19 affected the mental health of autistic children and their families. Researchers found that while all children with special needs experienced worry and stress, autistic children were affected most severely. Unlike other children whose anxiety improved over time, autistic children remained highly anxious throughout the period. However, some autistic children actually benefited from staying home and not having to go to school during lockdowns.

This qualitative study examined mental health impacts of COVID-19's first 6 months on autistic children/adolescents and their parents, comparing them to families with other special educational needs. Using parents' written descriptions, researchers found strong evidence of worry and distress across all groups, but most prominently in autistic children. While distress declined over time for children with other special educational needs, it remained persistently high for autistic pupils throughout the study period. Some autistic pupils benefited from reduced demands during lockdown, particularly not having to attend school.

The findings suggest autistic children's mental health was disproportionately affected during early COVID-19, highlighting needs for tailored support from both health and education sectors.

Findings suggest autistic children require sustained, tailored mental health support during crisis periods as their distress does not naturally decline over time. Educational settings should consider flexible approaches that reduce demands for some autistic pupils who may benefit from alternative schooling arrangements.

Sample size not reported. Qualitative design limits generalizability. Data collection period limited to first 6 months of COVID-19. Reliance on parent-reported measures may introduce bias. No comparison with neurotypical children included.

We know that autistic children and young people, and their caregivers, are at increased risk of mental ill health. We asked whether the first 6 months of COVID-19 exacerbated that risk, and whether the implications were different for autistic pupils and their caregivers, than for those with other special educational needs and difficulties. In a linked paper, we found that caregivers of autistic pupils reported higher levels of depression and anxiety symptoms in their children than parents of children with other special educational needs and difficulties (Toseeb & Asbury, 2022). For pupils with other special educational needs and difficulties, their parent-reported anxiety symptoms eased over time while remaining high throughout for autistic pupils.

There were no differences in mental health and wellbeing between caregivers of autistic pupils and those with other special educational needs and difficulties. Here, we used parents' written descriptions of their own and their child's mental health during the first 6 months of COVID-19 to explore these linked findings in greater depth. We identified strong evidence of worry and distress for all, but most prominently autistic children and young people. Our finding that worry and distress declined over time for pupils with other special educational needs and difficulties, but not for autistic pupils, was supported and we observed a few differences between caregivers.

We also found evidence of wellbeing throughout the sample, and examples of some (mainly autistic) pupils benefitting from a reduction in demands (e.g. going to school). This has implications for our understanding of the school experience for autistic pupils. Findings suggest that the mental health of autistic children and young people may have been disproportionately affected during the first 6 months of COVID-19 and that careful consideration of optimal support, from both health and education perspectives, is vital.