Autistic characteristics and mental health symptoms in autistic youth during the first COVID-19 wave in Canada.

This study looked at how COVID-19 affected the mental health of 582 autistic children and teens in Canada. Parents reported that their children showed more autism traits, behavioral problems, anxiety, and low mood during the pandemic compared to before. Older children, those with existing mental health issues, and families experiencing more stress and disruption were most affected. The research shows autistic young people need extra support during difficult times like pandemics.

This cross-sectional survey study examined mental health outcomes in 582 autistic children and adolescents (ages 2-18) during the first COVID-19 wave in Canada through caregiver reports collected in June-July 2020. Caregivers reported increased autistic characteristics, social-emotional symptoms, and poorer overall mental health in their children during the pandemic compared to pre-pandemic levels. Multiple risk factors were identified for worsening outcomes, including older youth age, pre-existing mental health conditions, higher caregiver stress, and greater household and service disruption. Protective factors included better pre-pandemic financial stability, absence of psychiatric conditions, lower caregiver stress, and less service disruption.

The study highlights the vulnerability of autistic youth to pandemic-related stressors.

Findings suggest need for proactive mental health screening and support for autistic youth during crises. Priority should be given to older youth and those with pre-existing conditions. Family-centered interventions addressing caregiver stress and service continuity may be beneficial for improving youth outcomes.

Cross-sectional design limits causal inference. Reliance on retrospective caregiver reports may introduce recall bias. Single time point during pandemic may not capture longer-term impacts. Sample may not be representative of all autistic youth populations.

Autistic youth are at heightened risk for mental health issues, and pandemic-related stressors may exacerbate this risk. This study (1) described caregiver-reported youth mental health prior to and during the pandemic; and (2) explored individual, caregiver, and environmental factors associated with changes in autistic characteristics, social-emotional symptoms, and overall mental health. 582 caregivers of autistic children (2-18 years old) completed an online survey between June and July 2020 in which they provided demographic information, their child's pre-COVID and current mental health, autistic characteristics, and social-emotional symptoms. Caregivers also rated their own perceived stress, and COVID-related household and service disruption. According to caregivers, youth experienced more autistic characteristics and social-emotional concerns during the pandemic.

Autistic youth were also reported to experience poorer overall mental health during the pandemic than before the pandemic. Older youth whose caregiver's indicated higher perceived stress and greater household disruption were reported to experience more autistic traits during pandemic. Caregiver-reported increases in youth social-emotional symptoms (i.e., behavior problems, anxiety, and low mood) was associated with being older, the presence of a pre-existing mental health condition, higher caregiver stress, and greater household and service disruption. Finally, experiencing less household financial hardship prior to COVID-19, absence of a pre-existing psychiatric condition, less caregiver stress, and less service disruption were associated with better youth pandemic mental health.

Strategies to support the autistic community during and following the pandemic need to be developed. The developmental-ecological factors identified in this study could help target support strategies to those autistic youth who are most vulnerable to mental health problems.