Abstract
IntroductionPrevious research has established an association between changes to the daily routine of individuals with Autism Spectrum Disorder (ASD) and increase in maladaptive behaviours. The relationship between maladaptive behaviours in autistic individuals and increase in care burden among their caregivers is also well established. However, no study has yet examined these associations in the context of the COVID-19 pandemic. The main aim of this study was to explore the impact of COVID-19 restrictions on autistic individuals and their caregivers. MethodsA questionnaire-based cross-sectional study conducted with the caregivers of 58 autistic individuals across the mental health services at Hamad Medical Corporation, Doha, Qatar. The extent of care burden was measured using the Care Burden Interview, whereas changes in behaviour in autistic individuals was assessed using the Revised Overt Aggression Scale. ResultsA total of 58 caregivers participated in the study. Out of these, 24 (41 %) reported a clinically significant increase in their care burden. Among caregivers reporting an increase in care burden, two-third were caring for individuals whose behaviour either remained unchanged or improved during social restrictions. Nine autistic people (15.5 %) were reported to have no aggression prior to the implementation of COVID-19 social restrictions compared to 13 (22.4%) individuals during COVID-19 social restrictions. Minimal, mild and moderate aggression were reported in 27 (46.6 %), 21 (36.2 %), and 1 (1.7 %) patients respectively, before COVID-19 social restrictions compared to 29 (50 %), 15 (25.9), and 1 (1.7 %) during COVID-19 restrictions. Severe aggression was not reported in any patient either before or during COVID-19 social restrictions. ConclusionThis study showed reduced levels of aggression in autistic individuals but an increase in care burden among their caregivers during the COVID-19 social restrictions highlighting the need of supporting patients and caregivers alike.
Highlights
Previous research has established an association between changes to the daily routine of individuals with Autism Spectrum Disorder (ASD) and increase in maladaptive be haviours
The current findings showed positive outcomes for autistic individuals in terms of levels of aggression during the pandemic-related social restrictions
There was a reduction seen in the proportion of autistic individuals with aggressive behaviour during the re strictions compared to when these restrictions were not in place
Summary
Previous research has established an association between changes to the daily routine of individuals with Autism Spectrum Disorder (ASD) and increase in maladaptive be haviours. Conclusion: This study showed reduced levels of aggression in autistic individuals but an increase in care burden among their caregivers during the COVID-19 social restrictions highlighting the need of supporting patients and caregivers alike. Autism Spectrum Disorder (hereafter referred to as ASD/autism/autistic) is a neurodevelopmental disorder characterised by persistent deficits in social communication and social interaction as well as restricted, repetitive, patterns of behaviours, interests or activities (Association, American Psychiatric, 2013). Deficits of this disorder commonly appear in the first few years of life and usually persist into adulthood (Al-Dewik et al, 2020). The prevalence rates of challenging behaviour in individuals with ASD and concomitant in tellectual disability (ID) are substantially higher than individuals with ID alone (Emerson et al, 2001)
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