Changes in Mental Health during Three Waves of the COVID-19 Pandemic in Slovakia: Neurotypical Children versus Children with Autism Spectrum Disorder and Their Parents
Abstract
:1. Introduction
COVID-19 Pandemic and Children with Autism Spectrum Disorder
2. Materials and Methods
2.1. Measures and Instruments
2.2. Study Design
2.3. Research Sample
2.4. Data Collection
2.5. Statistical Analysis
3. Results
3.1. Differences between Families with Neurotypical Children and Children with ASD during the Third Wave
3.2. Development from the First to the Third Pandemic Wave
3.2.1. Depression, Anxiety and Stress of Parents
3.2.2. Parental Stressors
3.2.3. Maladaptive Behavior of Children
3.2.4. Interventions
4. Discussion
4.1. First Wave
4.2. Second Wave
4.3. Third Wave
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Cooke, J.E.; Eirich, R.; Racine, N.; Madigan, S. Prevalence of Posttraumatic and General Psychological Stress during COVID-19: A Rapid Review and Meta-Analysis. Psychiatry Res. 2020, 292, 113347. [Google Scholar] [CrossRef]
- Sagan, A.; Bryndova, L.; Kowalska-Bobko, I.; Smatana, M.; Spranger, A.; Szerencses, V.; Webb, E.; Gaal, P. A Reversal of Fortune: Comparison of Health System Responses to COVID-19 in the Visegrad Group during the Early Phases of the Pandemic. Health Policy 2022, 126, 446–455. [Google Scholar] [CrossRef] [PubMed]
- Hajduk, M.; Dancik, D.; Januska, J.; Strakova, A.; Turcek, M.; Heretik, A.; Pecenak, J. Depression and Anxiety among College Students in Slovakia—Comparison of the Year 2018 and during COVID-19 Pandemic. Bratisl. Lek. Listy 2021, 123, 44–49. [Google Scholar] [CrossRef] [PubMed]
- Ochnik, D.; Rogowska, A.M.; Kuśnierz, C.; Jakubiak, M.; Schütz, A.; Held, M.J.; Arzenšek, A.; Benatov, J.; Berger, R.; Korchagina, E.V.; et al. Mental Health Prevalence and Predictors among University Students in Nine Countries during the COVID-19 Pandemic: A Cross-National Study. Sci. Rep. 2021, 11, 18644. [Google Scholar] [CrossRef]
- Rogowska, A.M.; Ochnik, D.; Kuśnierz, C.; Chilicka, K.; Jakubiak, M.; Paradowska, M.; Głazowska, L.; Bojarski, D.; Fijołek, J.; Podolak, M.; et al. Changes in Mental Health during Three Waves of the COVID-19 Pandemic: A Repeated Cross-Sectional Study among Polish University Students. BMC Psychiatry 2021, 21, 627. [Google Scholar] [CrossRef] [PubMed]
- Gavurova, B.; Popesko, B.; Ivankova, V.; Rigelsky, M. The Role of Self-Care Activities (SASS-14) in Depression (PHQ-9): Evidence From Slovakia During the COVID-19 Pandemic. Front. Public Health 2022, 9, 803815. [Google Scholar] [CrossRef] [PubMed]
- Tomšik, R.; Rajčániová, E.; Ferenčíková, P. Experiences of Anxiety, Stress, Loneliness and Well-Being of Parents during the First and Second Wave of Coronavirus Pandemic in Slovakia. Disk. V Psychol. 2021, 3, 9–21. [Google Scholar] [CrossRef]
- Kučera, D.; Stuchlíková, I.; Mrhálek, T. Impacts of COVID-19 Pandemic on the Mental Health of Working Adults in the Czech Republic: Analysis of Self-Report Psychological Data in a One Year Perspective. Eur. J. Investig. Health Psychol. Educ. 2021, 11, 1061–1072. [Google Scholar] [CrossRef]
- Stuchlikova, I.; Kučera, D.; Potužníková, E.; Mrhálek, T.; Plassová, M. Temporal Dynamics of COVID-19’s Psychological Impact in the Czech Republic: From the Outbreak to the Stabilization. PsyArXiv 2020, preprint. [Google Scholar] [CrossRef]
- Winkler, P.; Mohrova, Z.; Mlada, K.; Kuklova, M.; Kagstrom, A.; Mohr, P.; Formanek, T. Prevalence of Current Mental Disorders before and during the Second Wave of COVID-19 Pandemic: An Analysis of Repeated Nationwide Cross-Sectional Surveys. J. Psychiatr. Res. 2021, 139, 167–171. [Google Scholar] [CrossRef]
- Esterwood, E.; Saeed, S.A. Past Epidemics, Natural Disasters, COVID19, and Mental Health: Learning from History as We Deal with the Present and Prepare for the Future. Psychiatr. Q 2020, 91, 1121–1133. [Google Scholar] [CrossRef]
- Pachner, O.; Aranyi, G. Challenges for Children and Adolescents with Autism and Their Families during the Covid-19 Pandemic. J. Glob. Aware. 2021, 2, 4. [Google Scholar] [CrossRef]
- Polónyiová, K.; Belica, I.; Celušáková, H.; Janšáková, K.; Kopčíková, M.; Szapuová, Ž.; Ostatníková, D. Comparing the Impact of the First and Second Wave of COVID-19 Lockdown on Slovak Families with Typically Developing Children and Children with Autism Spectrum Disorder. Autism 2022, 26, 1046–1055. [Google Scholar] [CrossRef]
- World Health Organization. International Statistical Classification of Diseases and Related Health Problems, 10th ed.; World Health Organization: Geneva, Switzerland, 2016. [Google Scholar]
- Spain, D.; Mason, D.; Capp, S.J.; Stoppelbein, L.; White, S.W.; Happé, F. “This May Be a Really Good Opportunity to Make the World a More Autism Friendly Place”: Professionals’ Perspectives on the Effects of COVID-19 on Autistic Individuals. Res. Autism Spectr. Disord. 2021, 83, 101747. [Google Scholar] [CrossRef]
- Kaku, S.; Chandran, S.; Roopa, N.; Choudhary, A.; Ramesh, J.; Somashekariah, S.; Kuduvalli, S.; Rao, V.; Mysore, A. Coping with Autism during Lockdown Period of the COVID-19 Pandemic: A Cross-Sectional Survey. Indian J. Psychiatry 2021, 63, 568. [Google Scholar] [CrossRef]
- Vasa, R.A.; Singh, V.; Holingue, C.; Kalb, L.G.; Jang, Y.; Keefer, A. Psychiatric Problems during the COVID-19 Pandemic in Children with Autism Spectrum Disorder. Autism Res. 2021, 14, 2113–2119. [Google Scholar] [CrossRef]
- Genova, H.M.; Arora, A.; Botticello, A.L. Effects of School Closures Resulting From COVID-19 in Autistic and Neurotypical Children. Front. Educ. 2021, 6, 761485. [Google Scholar] [CrossRef]
- O’Sullivan, K.; Clark, S.; McGrane, A.; Rock, N.; Burke, L.; Boyle, N.; Joksimovic, N.; Marshall, K. A Qualitative Study of Child and Adolescent Mental Health during the COVID-19 Pandemic in Ireland. Int. J. Environ. Res. Public Health 2021, 18, 1062. [Google Scholar] [CrossRef]
- Ameis, S.H.; Lai, M.-C.; Mulsant, B.H.; Szatmari, P. Coping, Fostering Resilience, and Driving Care Innovation for Autistic People and Their Families during the COVID-19 Pandemic and Beyond. Mol. Autism 2020, 11, 61. [Google Scholar] [CrossRef]
- Martínez-González, A.E.; Moreno-Amador, B.; Piqueras, J.A. Differences in Emotional State and Autistic Symptoms before and during Confinement Due to the COVID-19 Pandemic. Res. Dev. Disabil. 2021, 116, 104038. [Google Scholar] [CrossRef]
- Boterberg, S.; Zanatta, A.; Moerman, F.; Schaubroeck, S.; Siew, J.; De Schryver, M.; Roeyers, H. The Impact of COVID-19 Measures on Parent-Reported Restricted and Repetitive Behaviours in Pre-School Children with Autism. Heliyon 2022, 8, e09727. [Google Scholar] [CrossRef]
- Alonso-Esteban, Y.; López-Ramón, M.F.; Moreno-Campos, V.; Navarro-Pardo, E.; Alcantud-Marín, F. A Systematic Review on the Impact of the Social Confinement on People with Autism Spectrum Disorder and Their Caregivers during the COVID-19 Pandemic. Brain Sci. 2021, 11, 1389. [Google Scholar] [CrossRef]
- Guller, B.; Yaylaci, F.; Eyuboglu, D. Those in the Shadow of the Pandemic: Impacts of the COVID-19 Outbreak on the Mental Health of Children with Neurodevelopmental Disorders and Their Parents. Int. J. Dev. Disabil. 2021, 1–13. [Google Scholar] [CrossRef]
- Nisticò, V.; Fior, G.; Faggioli, R.; Priori, A.; Gambini, O.; Demartini, B. The Psychological Impact of COVID-19 among a Sample of Italian Adults with High-Functioning Autism Spectrum Disorder: A Follow-Up Study. Healthcare 2022, 10, 782. [Google Scholar] [CrossRef]
- Hayes, S.A.; Watson, S.L. The Impact of Parenting Stress: A Meta-Analysis of Studies Comparing the Experience of Parenting Stress in Parents of Children With and Without Autism Spectrum Disorder. J. Autism Dev. Disord. 2013, 43, 629–642. [Google Scholar] [CrossRef]
- White, S.W.; Stoppelbein, L.; Scott, H.; Spain, D. It Took a Pandemic: Perspectives on Impact, Stress, and Telehealth from Caregivers of People with Autism. Res. Dev. Disabil. 2021, 113, 103938. [Google Scholar] [CrossRef]
- Furar, E.; Wang, F.; Durocher, J.S.; Ahn, Y.A.; Memis, I.; Cavalcante, L.; Klahr, L.; Samson, A.C.; Van Herwegen, J.; Dukes, D.; et al. The Impact of COVID-19 on Individuals with ASD in the US: Parent Perspectives on Social and Support Concerns. PLoS ONE 2022, 17, e0270845. [Google Scholar] [CrossRef]
- Logrieco, M.G.; Casula, L.; Ciuffreda, G.N.; Novello, R.L.; Spinelli, M.; Lionetti, F.; Nicolì, I.; Fasolo, M.; Giovanni, V.; Stefano, V. Risk and Protective Factors of Quality of Life for Children with Autism Spectrum Disorder and Their Families during the COVID-19 Lockdown. An Italian Study. Res. Dev. Disabil. 2022, 120, 104130. [Google Scholar] [CrossRef]
- Wang, L.; Li, D.; Pan, S.; Zhai, J.; Xia, W.; Sun, C.; Zou, M. The Relationship between 2019-NCoV and Psychological Distress among Parents of Children with Autism Spectrum Disorder. Glob. Health 2021, 17, 23. [Google Scholar] [CrossRef]
- Lovibond, P.F.; Lovibond, S.H. The Structure of Negative Emotional States: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav. Res. Ther. 1995, 33, 335–343. [Google Scholar] [CrossRef]
- Brooks, S.K.; Webster, R.K.; Smith, L.E.; Woodland, L.; Wessely, S.; Greenberg, N.; Rubin, G.J. The Psychological Impact of Quarantine and How to Reduce It: Rapid Review of the Evidence. Lancet 2020, 395, 912–920. [Google Scholar] [CrossRef]
- Sparrow, S.S.; Cicchetti, D.V.; Saulnier, D.A. Vineland Adaptive Behavior Scales, 3rd ed.; Pearson: San Antonio, TX, USA, 2016. [Google Scholar]
- Colizzi, M.; Sironi, E.; Antonini, F.; Ciceri, M.L.; Bovo, C.; Zoccante, L. Psychosocial and Behavioral Impact of COVID-19 in Autism Spectrum Disorder: An Online Parent Survey. Brain Sci. 2020, 10, 341. [Google Scholar] [CrossRef]
- Mutluer, T.; Doenyas, C.; Aslan Genc, H. Behavioral Implications of the Covid-19 Process for Autism Spectrum Disorder, and Individuals’ Comprehension of and Reactions to the Pandemic Conditions. Front. Psychiatry 2020, 11, 561882. [Google Scholar] [CrossRef]
- Wagner, L.; Corona, L.L.; Weitlauf, A.S.; Marsh, K.L.; Berman, A.F.; Broderick, N.A.; Francis, S.; Hine, J.; Nicholson, A.; Stone, C.; et al. Use of the TELE-ASD-PEDS for Autism Evaluations in Response to COVID-19: Preliminary Outcomes and Clinician Acceptability. J. Autism Dev. Disord. 2021, 51, 3063–3072. [Google Scholar] [CrossRef]
- Gibbs, V.; Cai, R.Y.; Aldridge, F.; Wong, M. Autism Assessment via Telehealth during the Covid 19 Pandemic: Experiences and Perspectives of Autistic Adults, Parents/Carers and Clinicians. Res. Autism Spectr. Disord. 2021, 88, 101859. [Google Scholar] [CrossRef]
- Alfuraydan, M.; Croxall, J.; Hurt, L.; Kerr, M.; Brophy, S. Use of Telehealth for Facilitating the Diagnostic Assessment of Autism Spectrum Disorder (ASD): A Scoping Review. PLoS ONE 2020, 15, e0236415. [Google Scholar] [CrossRef]
Wave | The Third Wave | Overall | ||||||
---|---|---|---|---|---|---|---|---|
Parents | ||||||||
Group | ASD | Control | ASD | Control | ||||
Age Mean (SD) | 39.51(7.23) | 37.31(6.02) | 39.4(6.96) | 38.87(6.69) | ||||
Males (n) | 2 | 5 | 8 | 27 | ||||
Females (n) | 79 | 88 | 228 | 243 | ||||
Children | ||||||||
Group | ASD | Control | ASD | Control | ||||
Count Total | 81 | 93 | 236 | 270 | ||||
Child Gender | Boys | Girls | Boys | Girls | Boys | Girls | Boys | Girls |
Count (n) | 56 | 25 | 47 | 46 | 178 | 58 | 144 | 126 |
Age Mean (SD) | 8.91 (3.78) | 8.60 (4.29) | 7.89 (3.68) | 7.85 (4.44) | 8.37 (3.72) | 9.06 (4.30) | 8.55 (4.30) | 8.66 (4.50) |
ASD | Control | t | p | d | |
---|---|---|---|---|---|
First wave | |||||
Depression | 7.98 (9.20) | 6.07 (8.30) | 1.45 | 0.148 | 0.22 |
Anxiety | 5.00 (7.14) | 2.80 (3.80) | 2.61 | 0.010 | 0.38 |
Stress | 10.87 (8.95) | 10.09 (7.97) | 0.61 | 0.541 | 0.09 |
Second wave | |||||
Depression | 15.69 (12.61) | 7.43 (9.03) | 4.70 | <0.001 | 0.75 |
Anxiety | 10.08 (10.14) | 4.87 (7.91) | 3.57 | <0.001 | 0.57 |
Stress | 17.94 (11.19) | 11.10 (8.66) | 4.26 | <0.001 | 0.68 |
Third wave | |||||
Depression | 14.84 (11.82) | 9.13 (9.28) | 3.56 | <0.001 | 0.54 |
Stress | 16.31 (9.78) | 13.78 (8.90) | 1.78 | 0.077 | 0.27 |
Anxiety | 8.96 (8.89) | 7.08 (8.15) | 1.46 | 0.146 | 0.22 |
The First Wave | The Second Wave | The Third Wave | |||||
---|---|---|---|---|---|---|---|
ASD | Control | ASD | Control | ASD | Control | ||
Lockdown duration | % | 47.89 | 42.68 | 43.66 | 50.00 | 41.98 | 34.41 |
(95% CI) | (35.80–60.08) | (31.82–54.10) | (31.91–55.95) | (38.75–61.25) | (30.99–52.96) | (24.57–44.25) | |
Fears of the infection | % | 47.89 | 45.12 | 42.25 | 29.27 | 50.62 | 58.06 |
(95% CI) | (35.80–60.08) | (34.10–56.51) | (30.61–54.56) | (19.74–40.35) | (39.49–61.74) | (47.85–68.28) | |
Frustration and boredom | % | 42.25 | 40.24 | 30.99 | 28.05 | 37.04 | 36.56 |
(95% CI) | (30.61–54.56) | (29.56–51.66) | (20.54–43.08) | (18.68–39.06) | (26.29–47.78) | (26.59–46.53) | |
Unavailability of goods and services | % | 19.72 | 19.51 | 19.72 | 7.32 | 22.22 | 17.20 |
(95% CI) | (11.22–30.86) | (11.58–29.74) | (11.22–30.86) | (2.73–15.25) | (12.97–31.47) | (9.39–25.02) | |
Insufficient or unclear information | % | 42.25 | 54.88 | 61.97 | 74.39 | 62.96 | 54.84 |
(95% CI) | (30.61–54.56) | (43.49–65.90) | (49.67–73.24) | (63.55–83.40) | (52.22–73.71) | (44.53–65.14) | |
Work insecurity/Finances | % | 35.21 | 34.15 | 36.62 | 29.27 | 40.74 | 27.96 |
(95% CI) | (24.24–47.46) | 24.03–45.45) | (25.50–48.90) | (19.74–40.35) | (29.81–51.67) | (18.66–37.25) | |
More demanding child care | % | 78.87 | 52.44 | 57.75 | 37.80 | 74.07 | 59.14 |
(95% CI) | (67.56–87.56) | (41.11–63.59) | (45.44–69.39) | (27.32–49.19) | (64.32–83.82) | (48.96–69.32) |
ASD | Control | t | p | d | |
---|---|---|---|---|---|
First wave | |||||
Maladaptive Internalizing behavior | 9.40 (5.73) | 4.56 (4.73) | 6.19 | <0.001 | 0.92 |
Maladaptive Externalizing behavior | 5.75 (3.38) | 3.66 (3.26) | 4.20 | <0.001 | 0.63 |
Second wave | |||||
Maladaptive Internalizing behavior | 11.54 (5.63) | 4.71 (4.00) | 8.74 | <0.001 | 1.40 |
Maladaptive Externalizing behavior | 6.20 (3.72) | 2.48 (2.75) | 7.09 | <0.001 | 1.14 |
Third wave | |||||
Maladaptive Internalizing behavior | 11.00 (6.15) | 5.46 (4.49) | 6.84 | <0.001 | 1.03 |
Maladaptive Externalizing behavior | 6.89 (3.83) | 4.00 (3.71) | 5.05 | <0.001 | 0.77 |
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Polónyiová, K.; Rašková, B.; Ostatníková, D. Changes in Mental Health during Three Waves of the COVID-19 Pandemic in Slovakia: Neurotypical Children versus Children with Autism Spectrum Disorder and Their Parents. Int. J. Environ. Res. Public Health 2022, 19, 11849. https://doi.org/10.3390/ijerph191911849
Polónyiová K, Rašková B, Ostatníková D. Changes in Mental Health during Three Waves of the COVID-19 Pandemic in Slovakia: Neurotypical Children versus Children with Autism Spectrum Disorder and Their Parents. International Journal of Environmental Research and Public Health. 2022; 19(19):11849. https://doi.org/10.3390/ijerph191911849
Chicago/Turabian StylePolónyiová, Katarína, Barbara Rašková, and Daniela Ostatníková. 2022. "Changes in Mental Health during Three Waves of the COVID-19 Pandemic in Slovakia: Neurotypical Children versus Children with Autism Spectrum Disorder and Their Parents" International Journal of Environmental Research and Public Health 19, no. 19: 11849. https://doi.org/10.3390/ijerph191911849