Background COVID-19 has affected many aspects of life across the globe. Following the outbreak of the pandemic, various countries implemented strict precautionary measures to curb the spread of the virus. It is expected that certain vulnerable populations will be most affected, such as children with special needs due to the interruption of regular intervention and routines which are pivotal in their day-to-day lives.
Objectives Our objective was to evaluate the impact of the Singapore COVID-19 Circuit Breaker (two-month lockdown) measures on children with special needs and their families.
Methods Caregivers of children who attended a tertiary child development unit completed an anonymous online survey form. There were 84 respondents who were parents of children aged 2 to 16 years (mean 6.5 years).
Results Majority of the children were in preschool/lower primary with 78.6% males and 65.5% Chinese. The most common diagnosis was Autism Spectrum Disorder (ASD; 46.4%). Almost two-thirds of caregivers reported working from home during the Circuit Breaker period. The majority indicated that their children had no difficulties coping with the restrictions in place during this period. Of those who did, the main difficulties were with wearing a mask, being restricted from going out, and having to practice social distancing. 26.2% of children had deterioration in their behavior, and a third of caregivers struggled to manage this. There was no significant difference in proportion of children experiencing a deterioration in behavior by diagnostic group [X2 (d.f.=6, N=84) =5.7, p=0.47]. Yet some (16.7%) had improvements in behavior. Sleep was minimally affected, but there was a significant increase in screen use in 81% of cases, especially in children with ASD. The majority of children received home-based learning from schools but many encountered challenges with this. About two -third of children continued to receive their early intervention or hospital-based therapy services. 54.7% of caregivers reported feeling more stressed than usual, mainly from juggling work-vs-family commitments. In spite of all the challenges, around two-thirds reported being able to spend more quality time with their child and over a half over a half of them reported having improved relationships with their child
Conclusions This survey shows that whilst many coped with the restrictive lockdown measures, there are those families who are more vulnerable, or caregivers who are less adept, and who need to be identified early for future support. Parents have the potential to be effective therapy providers in the home setting, given adequate support, but may struggle to balance work and family commitments. Telehealth has been developed but improvements in telehealth service provision and audits of its efficacy are still required.
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