The Impacts of the COVID-19 Pandemic on Therapy Utilization Among Racially/Ethnically and Socio-Economically Diverse Autistic Children.

This study looked at how COVID-19 affected ABA therapy hours for 283 autistic children in California. During the first three months of the pandemic, children lost about 10.7 hours of therapy per month. Hours slowly increased over the next 9 months but didn't fully recover. Asian children and those funded by school districts were affected differently than white children and those with private insurance, showing that the pandemic's impact wasn't equal for all families.

This retrospective study analyzed ABA therapy utilization patterns among 283 autistic children from California clinics during COVID-19. The research examined three periods: pre-pandemic, crisis phase (first 3 months), and mitigation phase (following 9 months). Results showed significant therapy disruption with a 10.65 hour monthly decrease during the crisis phase, followed by partial recovery with 2.39 hour monthly increases during mitigation. Notably, Asian non-Latinx children and those with school-district funding experienced different trajectories compared to white non-Latinx children and privately insured participants.

The study utilized piecewise growth multi-level modeling and Donabedian's structure-process-outcome framework to interpret findings, revealing persistent service disruption throughout the full year following pandemic onset.

Results highlight need for pandemic preparedness in autism services, with particular attention to equity in service delivery. Providers should develop contingency plans that address racial/ethnic and socioeconomic disparities. Extended recovery periods suggest need for enhanced service models during crisis mitigation phases.

Single-state retrospective design from California limits generalizability. The study does not specify outcome measures beyond service utilization. Mechanisms of disruption are interpreted rather than directly measured. Sample characteristics and demographic breakdown are not fully detailed in the abstract.

The purpose of current study was to evaluate change in hours of Applied Behavior Analysis (ABA) therapy utilization for autistic children during the year prior to the COVID-19 pandemic, the first three months of the pandemic (crisis phase), and the following 9 months of the pandemic (mitigation phase). Additionally, this study aimed to evaluate if change in therapy utilization differed based on child race, ethnicity, and primary payer of services. Finally, we aimed to identify potential mechanisms of ABA therapy disruption by interpreting findings using an extended version of Donabedian's structure-process-outcome model. Retrospective clinical data on client demographics and therapy utilization (n = 283) were collected from ABA clinics in California and analyzed with four piecewise growth multi-level models.

We found that therapy utilization dropped during the first three months of the pandemic (-10.65 h/month; p < .001) and increased during the following 9 months (2.39 h/month; p < .001). Moderator analyses revelated that Asian, Non-Latinx and school-district funded children had significantly different trajectories of change in therapy utilization compared to white, non-Latinx participants and private insurance funded participants, respectively. Findings suggest that utilization of ABA therapy was disrupted for a full year following the onset of the COVID-19 pandemic and that child race/ethnicity and primary payer influenced the degree to which autistic children were impacted by service disruption. These findings have implications for autistic children who lost therapy access during key developmental periods and for the ABA care delivery system.