Children's Access Research Articles

VACCINE MISINFORMATION AND HEALTH RISKS IN BRAZILIAN DAYCARES

Amidst the prevailing vaccine misinformation today, there is an urgent need for new methods to verify, inform, and promote vaccination. One potential approach involves utilizing early childhood education institutions, such as preschools since every student must present an updated vaccination card for enrollment or re-enrollment. By instructing the school staff on how to verify vaccination records or conducting vaccination campaigns within schools, there is the possibility of improving vaccination rates. The study investigated vaccination coverage among children aged one to six years in public daycare centers in a municipality in the Vale do Paraíba region of São Paulo. A cross-sectional study was conducted, involving the collection of vaccination cards from two Municipal Early Childhood Education Schools (EMEI) in the area. The research considered children between the ages of one and six who were properly enrolled in the EMEIs during the data collection period, with exclusion criteria related to the illegibility of vaccination cards. Ethical clearance for data collection was obtained from the Research Ethics Committee involving human subjects, and informed consent was obtained from the children's guardians. Data were collected manually by analyzing copies of vaccination cards, and vaccination coverage was assessed based on the minimum 95% coverage recommended by the National Immunization Program (PNI) in Brazil. More than half of the analyzed vaccination cards (56.8%) were found to have outdated vaccination schedules. Several vaccines failed to achieve the recommended 95% vaccination coverage, including the measles, mumps, and rubella (MMR) vaccine, measles, mumps, rubella, and varicella (MMRV) vaccine, hepatitis A vaccine, varicella vaccine, and polio vaccine. In contrast, vaccines with adequate coverage included the Bacille Calmette-Guérin (BCG) vaccine, pentavalent vaccine, rotavirus vaccine, pneumococcal vaccine, meningococcal vaccine, and others. The analysis also revealed a concerning decline in childhood vaccination coverage, posing a risk not only in terms of resurgent diseases but also to the country's future economic productivity. As Brazil's population ages, failure to ensure children's access to vaccination may hinder their neurological, psychomotor, and social development, negatively impacting the future workforce. In conclusion, leveraging early childhood education institutions for vaccination verification and campaigns presents a promising strategy to improve vaccination rates in the face of increasing vaccine hesitancy and misinformation.

Konten Keislaman dalam Aplikasi Edukatif sebagai Media Komunikasi Keluarga

This research aims to examine the usage of digital applications for educational purposes produced in Indonesia and containing Islamic messages in order to improve family communication. This study used a descriptive qualitative method and considered Educa Studio and Solite Kids applications as research objects. The results of this research state that these two digital applications provide benefits for intensifying communication among family members, between parents and children in particular. In addition, the Islamic content within educational games in both the Educa Studio and Solite Kids applications is a means of spreading Islamic values from an early age. In short, through these digital applications, the intensity of interaction between children and parents can prevent children's accessibility to negative media contents that are not in accordance with Islamic religious values.

AI Tutor: Solution for Chinas Disadvantaged and Under-resourced Children

This academic paper delves into the pressing issue of educational disparities in China, particularly focusing on the challenges faced by disadvantaged and under-resourced children, including both migrant and left-behind children. The paper underscores the socioeconomic and geographical complexities that exacerbate these disparities, emphasizing the need for innovative solutions. It then introduces the transformative potential of AI tutors, leveraging recent advancements in large language models (LLMs), to bridge the educational gap. The study highlights the significant impact of migration on children's access to education, with rural-to-urban migration patterns creating hurdles for migrant children to secure enrollment in urban schools. Additionally, it sheds light on the plight of left-behind children, who face emotional challenges and limited educational resources in rural settings. The paper introduces AI tutors, particularly ChatGPT-based Khanmigo, as innovative solutions that can offer personalized educational support, generate educational materials, assist teachers, and even evaluate student work. It discusses the advantages of these AI tutors, such as cost-effectiveness and accessibility, and their potential to democratize education. However, the paper also acknowledges the limitations of AI tutors, particularly in areas requiring creativity, critical thinking, and emotional intelligence. It raises concerns about exacerbating educational inequality if high-quality human educators become exclusive to the privileged, leaving disadvantaged children reliant on AI-based solutions.

Insurance coverage during transitions: Evidence from Medicaid automatic enrollment for children receiving supplemental security income.

To analyze relationships between Medicaid automatic enrollment for child Supplemental Security Income (SSI) recipients and health insurance coverage during transitions. Medical Expenditure Panel Study, 2000-2020 and National Survey for Children with Special Health Care Needs, 2001-2010. Leveraging variation in SSI-Medicaid automatic enrollment status across regions and over time, we estimate a regression model to quantify associations between automatic enrollment and insurance coverage. We validate our findings in the NS-CSHCN. Our sample includes children receiving SSI for a disability. We also analyze a subsample of children newly enrolled in SSI. Automatic enrollment is associated with a statistically significant increase in insurance coverage. Expanding automatic enrollment to all states is associated with increases in Medicaid enrollment of 3% (CI 0.9%-6.7%) among all SSI children and 7% (CI 1.1%-13.9%) among children newly enrolled in SSI. We find similar decreases in uninsurance. Analysis in the NS-CSHCN replicates these findings. Medicaid automatic enrollment policies are associated with increased insurance coverage for SSI children, particularly those transitioning into the program. Medicaid policy defaults could play an important role in reducing administrative burdens to improve children's coverage and access to care.

Speech, Sign, or Both? Factors Influencing Caregivers' Communication Method Decision Making for Deaf/Hard of Hearing Children.

Caregivers of deaf/hard of hearing infants are faced with challenging decisions regarding their child's communication method. The purpose of the current research note is to characterize the advice that caregivers receive and value as well as the factors that influence caregivers' decision making. The current study enrolled 105 caregiver-child dyads, including children between 12 and 18 months of age with bilateral, congenital hearing loss. All children were exposed to spoken language, and 63.81% of children were also exposed to sign language. Caregivers completed the "Making Decisions About Sign, Speech, and Multilingualism Survey" (Crowe et al., 2014). Caregivers most frequently received advice to use both speech and sign and highly valued advice from speech-language pathologists. When considering the use of speech, the factors that caregivers most frequently rated as very important were "My child's future academic success" (96.19%), "My child's future literary success" (95.24%), and "My child's future access to higher education" (95.19%). When considering the use of sign, the factors that caregivers most frequently rated as very important were "My child's ability to form friendships and future relationships" (82.52%), "My child's future literary success" (81.37%), and "My child's future academic success" (81.37%). Results of the current study suggest that throughout the decision-making process, caregivers' highest priority is understanding how their decisions will influence their child's future access to opportunities and relationships. Providers may consider discussing these factors early in the decision-making process to support caregivers' ability to make an informed choice regarding their child's communication method.

Changes in Children's Health Care Access and Utilization in the United States in the First 2 Years of the COVID-19 Pandemic.

To compare children's access to and utilization of health care services in the United States during the first 2 years of the pandemic to prepandemic levels. This cross-sectional study used data from the 2017 to 2021 National Survey of Children's Health. Access to care was measured by having a usual place for sick and preventive care, having a personal doctor or nurse, and unmet care needs. Utilization measures included preventive, mental health, specialist, and emergency department (ED) visits, and hospital admissions in the past 12months. Outcomes were reported by parents or other caregivers. Multivariate logistic regressions were employed adjusting for sociodemographic factors and state of residence. The study sample included 163,353 children aged 0 to 17years. Compared to 2019, there were declines in the probability of having a usual place for sick care in 2020 (-1.5 percentage-points) and a usual place for preventive care in 2021 (-2.1 percentage-points), and greater probability of unmet care needs in 2020 (+1.2 percentage-points) and 2021 (+0.8 percentage-points). The probability of having any preventive, specialist, and ED visits and hospitalizations remained lower in 2021 than 2019 (-7.5, 2.2, 5.4 and 0.9percentage-points, respectively). These differences were not explained by prepandemic trends and were observed across a range of sociodemographic subgroups. Children's health care access and utilization declined noticeably over the first 2years of the pandemic. Evaluating these outcomes in subsequent years and addressing barriers to care continue to be critical to reduce unmet needs.

Access of Children with Cerebral Palsy to Rehabilitation and Special Education Services During the COVID-19 Pandemic

Access of Children with Cerebral Palsy to Rehabilitation and Special Education Services During the COVID-19 Pandemic

Interrogating the agency and education of refugee children with disabilities in Northern Uganda: A critical capability approach

AbstractThis paper draws on empirical evidence from a 3‐year research project in Northern Uganda examining the educational experiences of refugees with disabilities. The authors present the compounded and interrelated challenges children with disabilities and their families face as they navigate their educational experiences and seek out opportunities to live well. The authors seek to make a contribution towards improving educational experiences by first highlighting compounding challenges faced by refugee children living with disabilities and their families and related policy gaps that have ramifications for refugee children's access to education in particular, and second by expanding discourse about refugee children with disabilities agency in relation to these liminal gaps and the impact the gaps have for accessing education. The authors use Powell and McGrath's (in Skills for human development: Transforming vocational education and training, Routledge, 2019; Handbook of vocational education and training, Springer, 2019) concept of critical capabilities and relationality, to expand Klocker's (in Global perspectives on rural childhood and youth: Young rural lives, Routledge, 2007) notions of thick and thin agency and to interrogate refugee children living with disabilities' agency in relation to education opportunities and rights.

Exposure to Spoken Communication During the COVID-19 Pandemic Among Children With Cochlear Implants

School closures and other COVID-19-related restrictions could decrease children's exposure to speech during important stages of development. To assess whether significant decreases in exposure to spoken communication found during the initial phase of the COVID-19 pandemic among children using cochlear implants are confirmed for a larger cohort of children and were sustained over the first years of the COVID-19 pandemic. This cohort study used datalogs collected from children with cochlear implants during clinical visits to a tertiary pediatric hospital in Toronto, Ontario, Canada, from January 1, 2018, to November 11, 2021. Children with severe to profound hearing loss using cochlear implants were studied because their devices monitored and cataloged levels and types of sounds during hourly use per day (datalogs) and because their hearing and spoken language development was particularly vulnerable to reduced sound exposure. Statistical analyses were conducted between January 2022 and August 2023. Daily hours of sound were captured by the cochlear implant datalogging system and categorized into 6 auditory scene categories, including speech and speech-in-noise. Time exposed to speech was calculated as the sum of daily hours in speech and daily hours in speech-in-noise. Residual hearing in the ear without an implant of children with unilateral cochlear implants was measured by pure tone audiometry. Mixed-model regression analyses revealed main effects with post hoc adjustment of 95% CIs using the Satterthwaite method. Datalogs (n = 2746) from 262 children (137 with simultaneous bilateral cochlear implants [74 boys (54.0%); mean (SD) age, 5.8 (3.5 years)], 38 with sequential bilateral cochlear implants [24 boys (63.2%); mean (SD) age, 9.1 (4.2) years], and 87 with unilateral cochlear implants [40 boys (46.0%); mean (SD) age, 7.9 (4.6) years]) who were preschool aged (n = 103) and school aged (n = 159) before the COVID-19 pandemic were included in analyses. There was a slight increase in use among preschool-aged bilateral cochlear implant users through the pandemic (early pandemic, 1.4 h/d [95% CI, 0.3-2.5 h/d]; late pandemic, 2.3 h/d [95% CI, 0.6-4.0 h/d]) and little change in use among school-aged bilateral cochlear implant users (early pandemic, -0.6 h/d [95% CI, -1.1 to -0.05 h/d]; late pandemic, -0.3 h/d [95% CI, -0.9 to 0.4 h/d]). However, use decreased during the late pandemic period among school-aged children with unilateral cochlear implants (-1.8 h/d [95% CI,-3.0 to -0.6 h/d]), particularly among children with good residual hearing in the ear without an implant. Prior to the pandemic, children were exposed to speech for approximately 50% of the time they used their cochlear implants (preschool-aged children: bilateral cochlear implants, 46.6% [95% CI, 46.5%-47.2%] and unilateral cochlear implants, 52.1% [95% CI, 50.7%-53.5%]; school-aged children: bilateral cochlear implants, 47.6% [95% CI, 46.8%-48.4%] and unilateral cochlear implants, 51.0% [95% CI, 49.4%-52.6%]). School-aged children in both groups experienced significantly decreased speech exposure in the early pandemic period (bilateral cochlear implants, -12.1% [-14.6% to -9.4%]; unilateral cochlear implants, -15.5% [-20.4% to -10.7%]) and late pandemic periods (bilateral cochlear implants, -5.3% [-8.0% to -2.6%]; unilateral cochlear implants, -11.2% [-15.3% to -7.1%]) compared with the prepandemic baseline. This cohort study using datalogs from children using cochlear implants suggests that a sustained reduction in children's access to spoken communication was found during more than 2 years of COVID-19 pandemic-related lockdowns and school closures.

Exploring the Relationship Between Family-related Factors and the Effectiveness of Shadow Education

This study investigates the influence of family-related factors on the effectiveness of shadow education, specifically examining the access to cultural capital, economic capital, social capital, and spiritual capital, and their impact on students' engagement. By analyzing these factors and their effects on children's participation in shadow education in Chinese households, the research provides insights for parents to identify root causes and determine strategies for improvement. The findings have significant implications for prospective parents, highlighting the critical importance of considering these factors to optimize their children's access and outcomes in shadow education. Addressing factors such as parental involvement, anxiety levels, and educational expectations is pivotal in creating a supportive environment that enhances children's educational opportunities. Furthermore, this research contributes to existing knowledge by exploring the complex dynamics between family-related factors and shadow education. Understanding family cultural, economic, social, and spiritual capital provides a deeper understanding of shadow education. In conclusion, the study emphasizes the significance of family-related factors in shaping the effectiveness of shadow education, emphasizing the role of different forms of family capital. By recognizing and addressing these factors, parents can foster an environment that maximizes educational opportunities and achievements in shadow education, empowering them to cultivate their children's educational potential.

Child dental neglect and legal protections: a compendium of briefs from policy reviews in 26 countries and a special administrative region of China.

Child neglect is a public health, human rights, and social problem, with potentially devastating and costly consequences. The aim of this study was to: (1) summarize the oral health profile of children across the globe; (2) provide a brief overview of legal instruments that can offer children protection from dental neglect; and (3) discuss the effectiveness of these legal instruments. We summarized and highlighted the caries profile and status of implementation of legislation on child dental neglect for 26 countries representing the World Health Organization regions: five countries in Africa (Nigeria, South Africa, Sudan, Tanzania, Zimbabwe), eight in the Americas (Argentina, Brazil, Canada, Chile, Mexico, Peru, Unites States of America, Uruguay), six in the Eastern Mediterranean (Egypt, Iran, Libya, Jordan, Qatar, Saudi Arabia), four in Europe (Italy, Latvia, Serbia, United Kingdom), two in South-East Asia (India and Indonesia) and one country (China) with its special administrative region (Hong Kong) in the Western Pacific. Twenty-five of the 26 countries have legal instruments to address child neglect. Only two (8.0%) of these 25 countries had specific legal instruments on child dental neglect. Although child neglect laws can be interpreted to establish a case of child dental neglect, the latter may be difficult to establish in countries where governments have not addressed barriers that limit children's access to oral healthcare. Where there are specific legal instruments to address child dental neglect, a supportive social ecosystem has also been built to facilitate children's access to oral healthcare. A supportive legal environment, however, does not seem to confer extra protection against risks for untreated dental caries. The institution of specific country-level legislation on child dental neglect may not significantly reduce the national prevalence of untreated caries in children. It, however, increases the prospect for building a social ecosystem that may reduce the risk of untreated caries at the individual level. Social ecosystems to mitigate child dental neglect can be built when there is specific legislation against child dental neglect. It may be more effective to combine public health and human rights-based approaches, inclusive of an efficient criminal justice system to deal with child dental neglect.

Immunisation coverage and its determinants among Rohingya refugee children in Malaysia.

The displacement of populations due to humanitarian emergencies has an adverse impact on the global elimination of vaccine-preventable diseases. However, the level of immunisation coverage among Rohingya refugee children remains unknown. Therefore, thisstudy investigated immunisation coverage and its determinants among Rohingya refugee children in Malaysia. A cross-sectional study was conducted from September to November 2020 among the guardians of 243 Rohingya refugee children studying under the sponsorship of the King Salman Humanitarian Aid and Relief Center, Malaysia. Among the 243 children, 90 (37%) were unimmunised, 147 (60.5%) were partially immunised and only 6 (2.5%) were fully immunised. The country of child's birth, the child's age and access to healthcare services were significantly associated with unimmunisation (all P<0.05). This study found low immunisation coverage among Rohingya refugee children in Malaysia. Given the low level of coverage, a public health intervention, such as a vaccination program, for this refugee population is necessary.

Mothers' Punishment Styles for Their Children: A Qualitative Study

The aim of this study is to examine the punishment behaviors used by mothers in the process of teaching behaviors to their children. For this purpose, data were collected from 26 mothers with at least one child between the ages of 3 and 11 using a semi-structured interview form. The collected data were analyzed by content analysis. As a result of the analysis, it was found that mothers used two different styles of punishment: Verbal/Physical Violence and Verbal/Physical Restraint. Verbal/Physical Restraint includes maternal behaviors such as restricting children's access to something they like or want, not talking to them at all or talking less, sending them to a different place and making them stay there for a while, and ignoring them audiovisually for a while. Verbal/Physical Violence includes maternal behaviors such as rebuking, threatening, beating, getting angry, raising her voice, yelling, and speaking harshly to children. The results of the study were discussed within the framework of the literature and recommendations were made.

The Tradeoff of Child Labor: Evidence from Indonesia

Using data from the Indonesia Family Life Survey (IFLS), this study examines the influence of child labor on wages and educational attainment in Indonesia. Several statistical methods, such as Propensity Score Matching (PSM), Quantile Regression, and robust Ordinary Least Squares (OLS) models, are used to analyze the relationship between child labor, income, and education while controlling for confounding variables. The findings indicate that child labor is initially associated with reduced wages, but this association becomes insignificant when other variables, such as years of education, are considered. Longer educational periods mitigate the negative effects of child labor on wages. In addition, the analysis reveals a tradeoff between child labor and educational attainment, highlighting the impact of child labor on education. Access to economic resources, however, mitigates this tradeoff, highlighting the importance of economic factors in children's decision-making. The study highlights the significance of child protection measures and effective socioeconomic policies to guarantee children's access to education and enhance their opportunities. It provides valuable insights into the effects of child labor on education and the role of economic factors in determining how children allocate their time.

Outdoor Time, Space, and Restrictions Imposed on Children's Play in Australian Early Childhood Education and Care Settings during the COVID Pandemic: A Cross-Sectional Survey from Educators' Perspective.

The study aimed to investigate the impact of COVID-19 restrictions on children's access to the outdoors in early childhood education and care (ECEC) settings. An online survey comprised of a standardised scale and questions used in previous related studies was completed by 143 early childhood educators across Australia. Participants were asked to report children's time spent outdoors, access to outdoor space, and restrictions imposed on children's play during the pandemic compared to the pre-pandemic period. The survey responses were imported into SPSS for descriptive, correlation, and ordinal regression analyses. We examined the relationship between children's outdoor time, space, restrictions imposed on children's play, and educators' characteristics, such as qualifications, professional development, and tolerance of risk or staff-child ratios during the pandemic in Australia. Most educators reported that children's outdoor time and access to outdoor space remained the same compared to before the pandemic, while imposed restrictions on children's outdoor play increased. The results of ordinal regressions indicated that educators with a higher tolerance of risk were less likely to impose additional restrictions on children's outdoor play. The findings contribute to the understanding of how educators' tolerance of risk influences children's outdoor play opportunities and provide directions for future risk-reframing interventions.

A hard pill to swallow? Parental health shocks and children's mental health.

Based on comprehensive administrative health record data from Austria, this study examines how children's mental health responds to a severe parental health shock. To account for the endogeneity of a serious parental illness, our sample is restricted to children who experience the health shock of a parent at some point in time and we exploit the timing of shocks in a dynamic DID setting. We find a positive causal effect of parental health shocks on children's mental health care utilization. Affected children have higher medical attendance for the treatment of mental illnesses, consume more psychotropic drugs, and are more likely to be hospitalized with mental and behavioral disorders. A significant increase in the utilization of antidepressants, anxiolytics, and sedatives can be observed for older children, girls and children with a white-collar family background. Our findings have important policy implications for children's access to psychotherapies and mental health care after experiencing a traumatic household event.

Caregiving across generations: Do older adults with more grandchildren get another bite at the “sandwich” generation?

Understanding the influence of grandchildren on long-term care use is a growing issue. Indeed, many countries, middle-aged adults provide unpaid care for aging family members, often their parents, at home. Although the influence of adult children's availability on their aging parents' caregiving decisions has been widely studied, the influence of grandchildren remains largely unstudied. Parental time allocated to childcare may compete with elder care, necessitating paid home care or transfer to a nursing home. Alternatively, grandparents may provide childcare, increasing incentives to keep grandparents at home. Using data from the Survey of Health, Ageing and Retirement in Europe (75,296 observations from 11 countries covering years 2004–2018), we exploit an instrumental variable strategy to study the effect of grandchildren on grandparents' long-term care decisions, specifically, use of paid home care or transfer to a nursing home. We use the generosity of maternity leave policies in time and across countries as an instrumental variable to identify the effect of the number of grandchildren. We find that the presence of grandchildren significantly increases the likelihood of having grandparents live at home: the probability of paid home care significantly increases while the probability of nursing home admission falls significantly. In conclusion, policies influencing the number of grandchildren in families have an indirect impact on long-term care use trajectories, confirming that family policies and long-term care policies are strongly imbricated and should not be considered separately.

Loneliness, Social Support, Social Trust, and Subjective Wellness in Low-Income Children: A Longitudinal Approach.

The progress and development of society in every sense is possible by raising healthy individuals. To do so, it is necessary to ensure the physical and mental development of children in a healthy way. There are many variables that affect the physical and mental development of children. These variables are affected by individual factors, social structure, social interactions and cultural values. In addition, when these factors interact with each other, their effect on behavior and well-being may increase. Undoubtedly, one of the primary factors negatively affecting a child's physical and psychological development is the adverse economic conditions and hardships experienced by his/her family and consequently, by the child. Increasing poverty hinders children's access to resources, and thus negatively affects their mental health as well as their physical development. Furthermore, positive economic conditions pave the way for an improved environment, better nutrition, higher-quality education, elevated social status, more friends, reduced feelings of loneliness, and increased social support and trust and all of these positively contribute to psychological well-being. Therefore, based on the conviction that early interventions can be protective and screening is needed to determine the proper intervention, this study aims to investigate the relationship between psychological well-being, loneliness, social support and social trust, all of which affect the psychological health of children living in economically disadvantaged families. To this end, answers to the following questions were sought. Is there a significant relationship between the loneliness, social support, social trust and psychological well-being of the children from low-income families? Do the feelings of loneliness, social support and social trust of the children from low-income families significantly predict their psychological well-being?

Immigrant Children's Access to Health Services During the Covid-19 Pandemic Process

Bu derlemede, COVID-19 pandemi sürecinde göçmen çocukların temel sağlık hizmetlerinden yararlanma durumlarının açıklanması amaçlanmıştır. Koronavirüs (Covid-19) 2020 yılının başlarında ortaya çıkarak, halk sağlığını tehdit etmiş ve bir pandemi süreci başlatmıştır. Bu süreçte birçok sağlık hizmetinde olduğu gibi rutin olarak yapılan sağlam çocuk izlemlerinde de aksaklıkların yaşandığı görülmüştür. Halk sağlını korumak amacıyla gerekli tedbirler alınsa da bu süreçten olumsuz etkilenen savunmasız gruplardan biri de göçmen çocuklar olmuştur. Göçün beraberinde getirdiği olumsuz yaşam koşulları, alınan tedbirlerin uygulanmasını güçleştirmiştir. Bununla birlikte yasal uygulamalar ve sosyoekonomik şartlarından dolayı göçmen çocukların sağlık hizmetlerine ulaşımları da kısıtlanmıştır. Bu kısıtlamaların önüne geçmek ve halk sağlığını korumak amacıyla devletlerin göçmenlere yönelik stratejiler geliştirmesi, toplumun bir parçası olarak tüm hizmetlerden eşit faydalanabilmelerini sağlayabilecek planlamaların yapılması gerekmektedir.

Caregiver perspectives on the continued impact of the COVID-19 pandemic on children with intellectual/developmental disabilities.

The COVID-19 pandemic has significantly impacted caregivers, especially those raising a child with an intellectual/developmental disability (IDD). While research has shown substantial disruption to the family, school, and occupational lives of the IDD community, little is known about the long-term impacts of COVID-19. To address this question, 249 caregivers were surveyed via an online questionnaire, between April and August of 2022 (more than 2 years into the pandemic) about potential impacts of the COVID-19 pandemic on their child's access to health- and school-based therapeutic services, caregiver mental health, and family life. The majority of caregivers reported disruptions in access to and quality of school-based therapeutic services for their child as well as a reduction in educational accommodations in the 2021-2022 academic year. Nearly half of caregivers reported feeling anxious and almost a quarter reported feeling depressed for the majority of their days. More than half of respondents reported decreased social support, and one-fifth reported employment disruptions and decreased access to food. These findings suggest that families of children with IDD are still experiencing ongoing negative impacts of the pandemic, emphasizing the critical need for continued support in the wake of the initial and more obvious disruptions caused by the COVID-19 outbreak.