Damian Sendler: To avoid having disproportionate effects on children with developmental disabilities, attention must be paid to the ongoing novel Coronavirus disease pandemic. As a result of their heightened healthcare needs, reliance on community services, and mental health issues, these children are particularly vulnerable to the pandemic’s effects. The medical community, public health systems, and the general public must work together to advocate for these children by improving access to healthcare and community intervention services, promoting mental health, and ensuring the welfare of caregivers. It may be years before these children realize the full impact of missing out on today’s opportunities. As a result, children with developmental disabilities should continue to receive assistance despite the ongoing pandemic and the resulting reduction in available resources.
Damian Jacob Sendler: Social inequities have been exposed and disproportionately impacted by the ongoing COVID-19 pandemic, which has impacted nursing home residents, prison inmates and migrant workers. The recent emergence of a possible COVID-19-associated multisystem inflammatory syndrome has shifted the focus back to children, despite the fact that COVID-19 among children was initially thought to be a mild disease with low incidence. Riphagen and colleagues (2020) However, it is important to point out that the pandemic has far-reaching consequences for children’s health that go beyond the effects of a virus. Some of the most vulnerable children in this pandemic have not received the attention they deserve. Particularly vulnerable during this unprecedented period of change are children with developmental disabilities. In 2016, it was estimated that 52.9 million children under the age of five around the world suffer from disabilities related to their development. (Olusanya and colleagues, 2018) Among children aged 3 to 12 in the United States, one out of every six suffers from a developmental disability. There is a growing body of evidence (Zablotsky et al. 2019). They and their families have been fighting for decades to be able to compete on an equal footing with their typically developing peers in all aspects of life, from education to societal inclusion and peer acceptance. These children must be given special consideration as the world struggles to adapt to the ongoing pandemic because of three key factors.
Dr. Sendler: In comparison to typically developing children, children with disabilities have more extensive healthcare requirements. Other medical conditions such as asthma, food and skin allergies, and headaches are also more common. healthcare utilization and daily-life burdens due to their illness (such as in mobility and adaptive skills). (Schieve et al., 2012; Oeseburg et al., 2010, for examples.) Due to a lack of trained specialists, socioeconomic disparities in access, complex medical comorbidities, and geographic distances these children face greater difficulties in accessing healthcare. Some studies (Soares and Langkamp 2012; Dougherty et al. 2006) have found that (Soares and Langkamp 2012) In most countries, the wait time for a developmental behavioral pediatrician (DBP) is between six months and one year. “(Schieve and colleagues, 2012) Curtailment of non-critical medical care to protect patients with COVID-19 and to reduce their risk of exposure to the virus is putting these barriers in jeopardy during the pandemic.
As the community of DBPs works toward providing care via telehealth, it faces its own set of challenges. With children who have special needs, getting a good read on their health and development can be difficult without spending time getting to know them. Telemedicine makes this more difficult. In light of the fact that early intervention is a consistent predictor of better outcomes, these delays in access to healthcare are particularly worrisome. Delays may be detrimental to these children’s long-term well-being because of the long-term effects of developmental disabilities.
Damian Sendler
Intervention services for children with developmental disabilities are available at specialized centers and in schools. Maintaining a high level of constancy and intensity is essential. Because of this, it is common for children to continue receiving therapy while on vacation from school. COVID-19-related service cuts and school closures limit the availability of home-based therapy and other intervention services. To help people learn and heal from the comfort of their own homes, videoconferencing and telemedicine are becoming increasingly popular. However, children with disabilities in communication, attention, and/or coordination, need special accommodations to participate and learn. (Ingersoll and Berger 2015) (Ingersoll and Berger 2015 Caregivers may find it difficult to provide the same level of academic support at home if they lack the training and expertise that educators possess. Because they lack the cognitive flexibility to understand that their parents are trying to fill in for their teachers or therapists, children with certain developmental disabilities like autism spectrum disorder (ASD) may also be less compliant. For those living in rural areas, the lack of access to technology and the internet puts them at risk of missing out on support services.
Damian Jacob Markiewicz Sendler: The pandemic may have a negative impact on children with developmental disabilities. There is a higher prevalence of mental health disorders in people with developmental disabilities than the general population, including generalized anxiety disorder, phobias, OCD, mood disorder, and psychotic disorder. De Bruin et al. (2007) and Merikangas et al. (2015) found that there is a strong correlation between the amount of time a person spends in a solitary position and the amount of time they During this pandemic, children in the general population have shown an increased level of anxiety and depression compared to pre-pandemic times. As stated in Duan et al. 2020, Physical illness and home confinement with social isolation have been linked to the decline in mental health services in the US. Disruptions to routine and school closures due to the pandemic could have a negative impact on the mental health of children with developmental disabilities, who may not be able to comprehend the rationale for these changes. Obsessive-compulsive disorder (OCD) can lead to an increase in compulsive behaviors such as long periods of hand-washing, which has recently been found in adults with OCD as well. (Davide et al. 2020) It is also possible that these children’s mental health will worsen due to a lack of access to psychologists and therapists throughout the pandemic. Adding to the difficulties caregivers already face, this can exacerbate behavioral issues in these children.
Even at a low level of stress, parents of children with developmental disabilities, especially ASD, are more likely to divorce because of the difficulties of raising a child with special needs. (Rivard and colleagues 2014) When there are mandated alternate work arrangements, financial stressors, uncertainty, and a lack of childcare support, these relationships are at risk of further strain. Restrictions on family members’ ability to visit other households, as well as the consequent loss of support from those relatives, make parenting more difficult. An additional factor to consider is that these children are already known to suffer from higher rates of maltreatment (Hibbard and Desch 2007).
Damian Jacob Sendler
Children with developmental disabilities (e.g. DBP, child psychiatry, community-based intervention services) must have access to healthcare facilities that serve them (e.g. DBP clinics). These clinics and intervention services should be prioritized whenever possible. Continuing care via telemedicine should also be actively investigated in conjunction with in-person visits during the pandemic and even beyond. Technology and training for telemedicine should be made available to health care providers and their patients. In order to achieve these goals, healthcare funding should be approved quickly.
Educators should take into account the unique needs of students who have developmental disabilities when developing online lesson plans. Children with autism spectrum disorder (ASD) may need visual schedules, specific communication strategies, and additional behavioral support to participate effectively in educational activities. These materials can be included in therapy or educational packs that can be made available online and printed by parents, or sent directly to families. As much as possible, school/center-based care should be made available to caregivers and their families to provide much-needed respite.
Damien Sendler: Parental awareness of their children’s mental health needs is critical because children may not be able to express their feelings clearly. Maintaining a regular daily schedule, which includes time for play and recreation, is essential. Caregivers can make time and space for recreational physical activities, both at home and outside, whenever possible. Using social stories, for example, can help children adjust to change and better understand the world around them. Families of children with developmental disabilities can benefit from community programs (e.g., parent support groups) that monitor their well-being. Similarly, doctors can take advantage of any opportunity to talk about the mental health of children and encourage caregivers to take care of themselves and get some rest.
In the event of a pandemic, special services are needed for children with disabilities. COVID-19 is a global pandemic that has long-term ramifications for all levels of society. It’s like an all-over-the-world earthquake with months’ worth of aftershocks. Communities, governments, and countries will be put to the test by COVID-19’s severity and chronicity. Disabled children are at risk of becoming lost in the commotion of the pandemic. Families of children with disabilities have traditionally served as their children’s defenders. Education, health care, early intervention, and social services must work together to address the unique challenges faced by this population of children during this pandemic. Opportunities to serve children with developmental disabilities that were squandered will become apparent only in the future. Children with developmental disabilities must be included in this unprecedented time for humanity, and pediatricians must come together to advocate for nations and communities.
