Caregiver-reported profiles of child functioning for children with developmental delays and disabilities 20 months after the onset of the COVID-19 pandemic

Background The COVID-19 pandemic raised concerns about its impact on children with developmental delays and disabilities (DDDs). Early research showed diverse trajectories, with some children experiencing worsening challenges while others demonstrated resilience. In our prior study, conducted 3 months into the pandemic, we identified a resilient group associated with higher parenting self-efficacy and easier access to schooling. As the pandemic persisted, children's functioning may have fluctuated. While adults showed varied trajectories 1 year post-pandemic, little is known about longer-term patterns in children with DDDs. Identifying these patterns nearly 2 years later, along with predictors of resilience, is essential for guiding future interventions. Objectives To identify patterns of functioning 20 months post-pandemic onset and examine associations with gender, parenting self-efficacy, and access to schooling. Methods As part of the UNICEF-WHO Global Report initiative, we conducted online caregiver surveys across Canada at T1 (June–July 2020) and T2 (November–December 2021). Latent class analysis identified profiles of functioning at T2, and multinomial logistic regression examined associations with T1 predictors. Results Among 302 respondents, we identified four profiles: Moderate Stability ( n = 107): Moderate probability of stability (53%–65%), low worsening (7%–26%), and some improvement (18%–39%). Worsening ( n = 80): No improvement and moderate worsening (23%–78%) in mental health, repetitive behaviors, and sleep. Very Stable ( n = 42): 100% probability of stability across domains. Mental Health and Sleep Improving ( n = 73): Improvement in sensory issues (48%), mental health (57%), and sleep (81%), but worsening in repetitive behavior (68%), daily living (50%), and troubling behavior (45%). Gender, parenting self-efficacy, and access to schooling at T1 significantly predicted profile membership. Girls were more likely to be in favorable profiles. Higher parenting self-efficacy increased the likelihood of belonging to stable or improving profiles. Easier school access at T1 predicted stability or improvement, while difficult access reduced improvement likelihood. Conclusion Early-pandemic factors—gender, parenting self-efficacy, and school access—significantly predicted resilience in children with DDDs. These factors may serve as intervention targets to promote long-term stability and recovery.