14 Changes in Service Delivery Models for Children with Neurodevelopmental Disorders During the Covid-19 Pandemic

Abstract

Objective:

With the onset of the COVID-19 pandemic, many families face barriers in accessing critical services for their children. However, there is a disproportionate impact on families of children with Neurodevelopmental Disorders (NDDs), particularly those who are dependant on receiving regular services. The current study investigated how service delivery has changed for children and families with NDDs during the COVID-19 pandemic, to identify which groups are most at risk for service disruption and negative outcomes, and to provide actionable recommendations for community agencies that provide early interventions for future pandemics.

Participants and Methods:

Data was collected in the fall and winter of 2020/2021 during the Covid-19 pandemic. Families were recruited from a local service provider in British Columbia whose Early Years Support services delivery model was changed to online delivery during the pandemic. Children had a diagnosis of NDD or were on the waitlist for an assessment. Overall, 26 families participated in a semi-structured interview that asked about their experiences of receiving services for their children during the pandemic. Of these families, 20 subsequently completed online questionnaires that asked about their parenting stress levels and their children’s behaviour throughout the pandemic. Families of a range of compositions were drawn from different ethnicities (30% white, 25% South Asian, 20% Filipino, and the remaining 5% identified as Indigenous, African or East Asian). The mean age of children was 3.80 years (SD =0.72).

Results:

From the survey, we found that 58% of parents reported higher than average levels of mental health and behavioural challenges in their children during the Covid-19 pandemic. In addition, 45% of parents reported higher than average parenting stress levels. Qualitative interview data indicated that most parents reported positive experiences with receiving services during the Covid-19 pandemic and reported feeling supported even with social distancing measures. However, families also reported increased stress levels and isolation, particularly those who have children with Autism Spectrum Disorder, who rely on early funding (06 years) and early services. One of the themes that emerged from parents who were on the waitlist to receive an assessment was that wait times around assessments were very long, which contributed to parent stress levels. Parents also reported concerns around wait times to access services and difficulty of accessing online services due to internet and connection issues.

Conclusions:

The current study identified central themes of stressors and barriers experienced by families and children with NDDs in service delivery. Overall, parents reported satisfaction in changes in service delivery in most ways; however, they also reported stresses and barriers that included wait times, increased isolation, and accessing online services. Actionable steps to reduce family stress include better communication between service providers and families for wait times, and more variability in appointment times. Specific recommendations for current and future pandemics will be expanded on in the poster.