Disrupted Behavioral Health Routines for Children during a Public Health Crisis: A Mixed-Methods Study of Digital Technology's Role in Routine Recovery

The COVID-19 pandemic caused a global disruption of daily routines. Children with behavioral disabilities were particularly impacted, losing access to critical face-to-face behavioral health services. In response, many providers and parents attempted to recover these routine services, primarily with digital technology. In April-July 2020, we conducted a mixed-methods study with parents of children with behavioral disabilities. Using a six-week survey study followed by semi-structured interviews, we identified how disrupted behavioral health routines impacted children, and how care teams recovered these services using digital technology. The recovery of children's behavioral health services was delayed, resulting in negative consequences for the children. The stoppage of services undermined care teams' coordination mechanisms, necessitating they establish digital communication channels. This digital communication supported the recovery of some services, but not most. Video conferencing was overstimulating for some children, and most recovered services required parental involvement. Our findings have substantial implications for the CSCW community regarding the design of digital technology to increase usability by (and supports for) children with disabilities, and how behavioral health practice could enable resilient behavioral health services that could withstand the impact of future disruption.