impact of the COVID-19 pandemic on children and adolescents with autism spectrum disorder and their caregivers

Objective: To analyze the impact of the COVID-19 pandemic and social distancing on children and adolescents with autism spectrum disorder (ASD) and their caregivers. Methods: Observational, descriptive, and cross-sectional study conducted with parents/caregivers of children with ASD through an online questionnaire with 39 questions. Data were collected from October 2020 to January 2021, referring to the critical period of the pandemic in Ceará, from March to June 2020. Results: Of the 122 research participants (children/adolescents aged 2 to 18 years, average of 6.7 years), 87.7% interrupted multidisciplinary treatments during isolation. Most caregivers (86.8%) had more difficulties managing the children's free time. Behavioral problems became more intense for 61.5% and more frequent for 59.8% of participants. Difficulties in managing meals were reported by 39.3% of participants, and 97.1% stated that problems in managing autonomy were amplified. Behavioral regressions and worsening symptoms occurred in 81.1% of cases. Children and adolescents with pre-pandemic behavioral problems showed a significantly greater increase in the intensity (OR = 3.87, p = 0.05) and frequency (OR = 3.42, p = 0.05) of behavioral problems. In contrast, being an only child proved to be a protective factor against the negative impacts of isolation, with a significant reduction in the intensification (OR = 0.16, p < 0.05) and frequency (OR = 0.08, p < 0.01) of behavioral problems. Conclusion: The COVID-19 pandemic and social distancing negatively altered behavior, eating, and self-care patterns in children and adolescents with ASD, making this period more challenging for their caregivers.