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1.
Pediatrics ; 146(1)2020 07.
Article in English | MEDLINE | ID: covidwho-1456130

ABSTRACT

CONTEXT: More than 4 decades of research indicate that parenting interventions are effective at preventing and treating mental, emotional, and behavioral disorders in children and adolescents. Pediatric primary care is a viable setting for delivery of these interventions. OBJECTIVE: Previous meta-analyses have shown that behavioral interventions in primary care can improve clinical outcomes, but few reviews have been focused specifically on the implementation of parenting interventions in primary care. We aimed to fill this gap. DATA SOURCES: We reviewed 6532 unique peer-reviewed articles published in PubMed, the Cumulative Index to Nursing and Allied Health Literature, and PsycInfo. STUDY SELECTION: Articles were included if at least part of the intervention was delivered in or through primary care; parenting was targeted; and child-specific mental, emotional, and behavioral health outcomes were reported. DATA EXTRACTION: Articles were reviewed in Covidence by 2 trained coders, with a third coder arbitrating discrepancies. RESULTS: In our review of 40 studies, most studies were coded as a primary. Few researchers collected implementation outcomes, particularly those at the service delivery system level. LIMITATIONS: Including only published articles could have resulted in underrepresentation of implementation-related data. CONCLUSIONS: Parenting interventions delivered and implemented with fidelity in pediatric primary care could result in positive and equitable impacts on mental, emotional, and behavioral health outcomes for both parents and their children. Future research on the implementation strategies that can support adoption and sustained delivery of parenting interventions in primary care is needed if the field is to achieve population-level impact.


Subject(s)
Neurodevelopmental Disorders/therapy , Parenting , Parents/psychology , Primary Health Care/organization & administration , Child , Humans , Neurodevelopmental Disorders/psychology
2.
Lancet Psychiatry ; 8(10): 929-936, 2021 10.
Article in English | MEDLINE | ID: covidwho-1415873

ABSTRACT

Informal (unpaid) carers are an integral part of all societies and the health and social care systems in the UK depend on them. Despite the valuable contributions and key worker status of informal carers, their lived experiences, wellbeing, and needs have been neglected during the COVID-19 pandemic. In this Health Policy, we bring together a broad range of clinicians, researchers, and people with lived experience as informal carers to share their thoughts on the impact of the COVID-19 pandemic on UK carers, many of whom have felt abandoned as services closed. We focus on the carers of children and young people and adults and older adults with mental health diagnoses, and carers of people with intellectual disability or neurodevelopmental conditions across different care settings over the lifespan. We provide policy recommendations with the aim of improving outcomes for all carers.


Subject(s)
COVID-19/psychology , Caregivers/psychology , Health Policy/legislation & jurisprudence , Health Services Needs and Demand/legislation & jurisprudence , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Caregivers/economics , Child , Child, Preschool , Female , Health Services Needs and Demand/trends , Humans , Intellectual Disability/epidemiology , Intellectual Disability/psychology , Life Change Events , Male , Mental Disorders/epidemiology , Mental Disorders/psychology , Morbidity/trends , Neurodevelopmental Disorders/epidemiology , Neurodevelopmental Disorders/psychology , SARS-CoV-2/genetics , Social Support , United Kingdom/epidemiology , Young Adult
3.
Health Psychol ; 40(7): 428-438, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1373359

ABSTRACT

OBJECTIVE: This study examined the impact of the coronavirus disease 2019 (COVID-19) pandemic in Italy by specifically looking at the psychosocial response of children/adolescents with neurodevelopmental disabilities (NDD) and their parents, and explored which factors could potentially contribute to increasing or mitigating stress-related behaviors in children/adolescents as well as their parents' stress. METHOD: An online anonymous survey was designed to investigate family demographic characteristics, COVID-19 outbreak and restriction-related variables, children/adolescents' behavioral regulation problems, parental stress, and resilience. Data were collected from 1,472 parents (83.1% mothers) of 1632 NDD children/adolescents (33.7% females). RESULTS: Compared to pre-emergency, parents reported a significant increase in their children's behavioral regulation problems: Anxious/depressed behavior, Attention problems, and Aggressive behavior (p < .001), and they reported feeling more Overwhelmed and Burdened (p < .001) as parents but less Unfulfilled, Numbness, Devastated, and Angry (p < .001). A hierarchical stepwise regression analysis revealed that both behavioral regulation problems in NDD children/adolescents and parental stress are-at least partially-buffered by resilience factors in parents (Perception of self, Planned future, Family cohesion). CONCLUSIONS: Results showed that behavioral regulation problems in children/adolescents with NDD and parental stress increased. However, parental resilience can act as a protective factor, counterbalancing parental difficulties in the care of their NDD children during the emergency. Identifying risk and protective factors impacting the psychosocial response ofchildren/adolescents with NDD and their parents is essential to implement appropriate support interventions both for parents and children/adolescents with NDD during the COVID-19 pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
COVID-19/epidemiology , Neurodevelopmental Disorders/psychology , Pandemics , Parents/psychology , Resilience, Psychological , Stress, Psychological/epidemiology , Adolescent , Adult , Child , Female , Humans , Male , Protective Factors , SARS-CoV-2
4.
Riv Psichiatr ; 56(4): 205-210, 2021.
Article in English | MEDLINE | ID: covidwho-1325471

ABSTRACT

BACKGROUND: The SARS-CoV-2 pandemic forced parents and children to modify their habits with a radical change in the family routine and consequent increase in psychological stress. Children with a neurodevelopmental disorder (NDDs) are particularly vulnerable to new and unexpected situations; moreover, the parents of these children generally show high levels of psychological stress due to the greater commitment that this condition imposes on them. The aim of this study is to evaluate the disease status of NDDs children before and during SARS-CoV-2 pandemic and to evaluate the psychological effects related to measures of social distancing on these children and their families. MATERIALS AND METHODS: Seventy-one children with NDDs, were enrolled in this study and followed up at the Child Neuropsychiatry Unit of the University Hospital Consortium Corporation Polyclinic of Bari (Italy) along with their parents. Parents were evaluated before national lockdown (baseline) and recontacted during the SARS-CoV-2 emergency almost after a year. The changes in emotional/behavioral problems of children and parenting stress before and during the SARS-CoV-2 pandemic were assessed with Child Behaviour CheckList (CBCL) and Parent Stress Index - short form (PSI). RESULTS: The analysis of the emotional and behavioral problems of children with NDDs did not show statistically significant differences between the before and during the SARS-CoV-2 pandemic period. The evaluations conducted on parents highlights an increase in parental stress during the pandemic. Significant differences (p<0.05) were found in three subscales: Parenting Distress (PD) scale, Dysfunctional Interaction Parent-Child (P-CDI) scale and Defensive responding scale (DF). CONCLUSIONS: This study highlights the increase in parental stress and a more difficult parent-child interaction with NDDs in the period of lockdown due to the pandemic; identification of these risk targets can be useful for interventions in similar situations. Therefore, it is necessary to provide caregivers information to manage and overcome challenges experienced during a pandemic and providing psychological support for caregivers of children with NDDs.


Subject(s)
COVID-19/psychology , Neurodevelopmental Disorders/psychology , Pandemics , Parents/psychology , SARS-CoV-2 , Adolescent , Caregivers/psychology , Child , Child Behavior , Child Behavior Disorders/etiology , Child Behavior Disorders/psychology , Emotions , Female , Health Services Needs and Demand , Humans , Italy/epidemiology , Male , Parent-Child Relations , Psychosocial Support Systems , Quarantine , Severity of Illness Index , Social Isolation , Stress, Psychological/etiology
5.
Sci Rep ; 11(1): 3042, 2021 02 15.
Article in English | MEDLINE | ID: covidwho-1085409

ABSTRACT

This study aimed to reveal how the COVID-19 stay-at-home period has affected the quality of life (QOL) of children with neurodevelopmental disorders and their parents and to identify possible factors that enabled them to maintain their QOL. We enrolled 136 school-aged children (intellectual quotient ≥ 50) and their parents and administered QOL questionnaires to assess the maladaptive behavior of the children; depression, anxiety, and stress of the parents; and activities of their daily lives. The relationship between their QOL and clinical features was examined. The decrease in QOL of children and parents was associated with the mother's limited job flexibility. Decreased QOL was also associated with changes in the sleep rhythms of the children. Maladaptive behaviors in children were associated with parental stress. However, maintained QOL of some families who faced these same conditions of job stress and sleep disorders was associated with less parental stress, less parental depression and anxiety, and milder maladaptive behavior in children. Both mothers with limited job flexibility and changes in the sleep rhythm of children were associated with reduced QOL of children and their parents. Low parental stress was associated with decreased maladaptive behavior in children and with maintained QOL of the family.


Subject(s)
COVID-19/epidemiology , Neurodevelopmental Disorders/epidemiology , Quality of Life , Stress, Psychological/epidemiology , Adaptation, Psychological , Adolescent , Adult , COVID-19/psychology , Child , Disabled Children/psychology , Disabled Children/statistics & numerical data , Female , Humans , Japan , Male , Neurodevelopmental Disorders/psychology , Parents/psychology , Sleep
6.
J Am Acad Child Adolesc Psychiatry ; 60(1): 2-6, 2021 01.
Article in English | MEDLINE | ID: covidwho-1065243

ABSTRACT

Families of children with neurodevelopmental disorders are especially vulnerable during the COVID-19 pandemic. Physical distancing requirements and closure of schools and services in the context of the COVID-19 pandemic are likely challenging to everyone but may be particularly impactful for families with children with neurodevelopmental disorders ([NDDs], eg, intellectual disability, attention-deficit/hyperactivity disorder [ADHD], autism spectrum disorder [ASD]). Although a small number of children may experience less stress or anxiety due to reduced social and academic expectations,1 for many children with NDDs, and particularly those with ASD, carefully developed behavioral and environmental supports, and consistent and predictable routines and expectations, are vital for their mental well-being.2 Consequently, abrupt discontinuation of these supports during quarantine and prolonged isolation creates a real risk for behavioral exacerbations in this vulnerable population.3-6 Possible consequences for family members include physical and mental strain,7 whereas for the child with an NDD, increased emotional distress and challenging behavior may create safety concerns and the need for hospitalization.4,6 Children with NDDs may be at increased risk for COVID and COVID-related complications,8 emphasizing the need for preventive and/or crisis behavioral health care availability outside of emergency and hospital settings.


Subject(s)
COVID-19/prevention & control , Neurodevelopmental Disorders/therapy , Telemedicine/methods , Adaptation, Psychological , Adolescent , COVID-19/complications , COVID-19/epidemiology , COVID-19/psychology , Caregivers/psychology , Child , Child, Preschool , Female , Humans , Male , Neurodevelopmental Disorders/complications , Neurodevelopmental Disorders/psychology , Ontario/epidemiology , Pandemics , Parents/psychology , Program Evaluation , Stress, Psychological/etiology , Stress, Psychological/therapy
7.
Acta Paediatr ; 110(4): 1281-1288, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1041842

ABSTRACT

AIM: To examine how the ongoing COVID-19 pandemic impacts child well-being and family functioning, particularly among children at risk for neurodevelopmental impairments. METHODS: Families of 73 typically developing children, 54 children born very preterm (VPT) and 73 children with congenital heart disease (CHD) from two prospective cohort studies were assessed prior to (mean age: 10.4 [SD: 1.2] years) and during (mean age: 12.8 [SD: 2.0] years) the pandemic, more specifically, in April/May 2020. Child well-being and family functioning were assessed with validated, parent-reported questionnaires and tested with linear mixed models. Group comparison of child distress and parental concerns related to medical implications of COVID-19 and homeschooling, assessed with 5-point Likert scales, was done with Mann-Whitney U tests. RESULTS: Children's psychological well-being and family functioning (both, p < 0.001) decreased significantly during the pandemic, irrespective of group. Children with CHD were reported to be more concerned about becoming infected with SARS-CoV-2 than were others. Child distress due to homeschooling and parents' concerns about children's academic achievements were significantly higher in VPT and CHD children than in typically developing peers (all p < 0.001). CONCLUSION: The COVID-19 pandemic substantially impacts the whole family and leads to additional distress in families with children at risk for neurodevelopmental impairments. These families should receive individualised counselling and assistance from healthcare providers and schools during the pandemic.


Subject(s)
COVID-19 , Heart Defects, Congenital/complications , Infant, Premature, Diseases/etiology , Neurodevelopmental Disorders/etiology , Adolescent , Attitude to Health , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Case-Control Studies , Child , Child Health , Cross-Sectional Studies , Family Relations/psychology , Female , Health Surveys , Heart Defects, Congenital/psychology , Humans , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases/diagnosis , Infant, Premature, Diseases/psychology , Longitudinal Studies , Male , Mental Health , Neurodevelopmental Disorders/diagnosis , Neurodevelopmental Disorders/epidemiology , Neurodevelopmental Disorders/psychology , Neuropsychological Tests , Pandemics , Physical Distancing , Prospective Studies , Quality of Life , Risk Factors , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Stress, Psychological/psychology , Switzerland/epidemiology
8.
Res Dev Disabil ; 109: 103840, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-989160

ABSTRACT

Research on the psychological impact of the COVID-19 pandemic highlighted negative effects on the general population and particularly on parents. However, little is known about families of children with Neurodevelopmental Disorder (NDD). The present study investigated parental stress, coparenting, and child adjustment in Italian families with children with NDD (N = 82) and typical developing children (TD, N = 82) during lockdown, using an online survey. Results of quantitative analyses showed a significant increase in parental stress and child externalizing behaviors, but not of coparenting. Parental stress is predicted by externalizing behaviors, and coparenting acted as a moderator in the relationship between the change in the amount of time spent with the children before and during lockdown and parental stress. In children with NDD, the decrease in therapeutic/rehabilitation support predicted higher externalizing behaviors. Qualitative analysis showed that beyond the difficulties and worries arising during lockdown, most of the parents appreciated the opportunity of spending more time with their children and strengthening the parent-child relationship. In conclusion, our results point out the importance of ensuring continuity of care for children with NDD (e.g. telehealth) during home confinement and of providing psychological support for parents.


Subject(s)
COVID-19 , Communicable Disease Control/methods , Neurodevelopmental Disorders , Parents/psychology , Problem Behavior/psychology , Stress, Psychological , Adaptation, Psychological , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Child , Child Behavior , Female , Humans , Italy/epidemiology , Male , Needs Assessment , Neurodevelopmental Disorders/epidemiology , Neurodevelopmental Disorders/psychology , Psychosocial Support Systems , SARS-CoV-2 , Stress, Psychological/etiology , Stress, Psychological/prevention & control , Surveys and Questionnaires , Telemedicine/methods
10.
Disabil Rehabil ; 43(1): 27-32, 2021 01.
Article in English | MEDLINE | ID: covidwho-917577

ABSTRACT

BACKGROUND: The present study investigated the impact of the COVID-19-related rehabilitation services lockdown on the mental health of caregivers of children with neurodevelopmental disabilities. METHODS: Between 26 March and 11 May 2020, 84 caregivers filled out ad-hoc and standardized questionnaires through an online survey in order to measure their psychological response to the emergency and lockdown as well as their levels of parenting stress, anxiety and depression. RESULTS: Worries about COVID-19 contagion and concerns for the child left without rehabilitation programs were the greatest sources of mental health burden for caregivers. Nonetheless, only the concerns for the child were significantly associated with caregivers' reports of stress, depressive and anxious symptoms. DISCUSSION: These findings highlight the burden faced by caregivers of children with neurodevelopmental disabilities during the COVID-19 emergency in Italy. These families should be considered as a high-risk population that requires dedicated healthcare attention, such as promoting continuity of care by investing in tele-rehabilitation programs. Implications for rehabilitation Caregivers of children with disability reported symptoms of anxiety and depression during COVID-19 emergency. Major concerns regarded COVID-19 contagion risk and child development during rehabilitation lockdown. Caregivers' psychological symptoms were associated with concerns for child development during the lockdown. Parents of children with disability may face relevant stress during and after COVID-19 psychological burden. During COVID-19 recovery, policy-makers and clinicians should dedicate specific care actions for families of children with disability.


Subject(s)
COVID-19/psychology , Caregivers/psychology , Mental Health/statistics & numerical data , Neurodevelopmental Disorders/psychology , Parents/psychology , Telerehabilitation/methods , Adult , Anxiety/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Child , Child, Preschool , Communicable Disease Control , Delivery of Health Care , Female , Health Services Needs and Demand , Humans , Italy , Male , Neurodevelopmental Disorders/rehabilitation , Pandemics/prevention & control , SARS-CoV-2 , Social Isolation/psychology , Social Support , Stress, Psychological , Surveys and Questionnaires
11.
Child Adolesc Ment Health ; 25(4): 265-266, 2020 11.
Article in English | MEDLINE | ID: covidwho-852235

ABSTRACT

The COVID-19 pandemic lockdown response has had a disproportionate and damaging effect on the lives, mental health and well-being of young people globally. They have been neglected in policy-making and their needs have been subjugated to those of adults which contravenes the UN Convention on the Rights of the Child. Here, I argue that the needs and rights of young people must come first to protect their health, mental health and futures. If we do not do this, we will let down a generation of children who will bear the brunt of the fallout of the economic burden of the global COVID-19 crisis.


Subject(s)
Coronavirus Infections , Mental Health , Pandemics , Pneumonia, Viral , Quarantine/psychology , Schools/organization & administration , Students/psychology , Adolescent , COVID-19 , Child , Humans , Learning , Neurodevelopmental Disorders/psychology
12.
Clin Neuropsychol ; 34(7-8): 1380-1394, 2020.
Article in English | MEDLINE | ID: covidwho-733443

ABSTRACT

Objective: To describe the challenges related to COVID-19 affecting pediatric neuropsychologists practicing in inpatient brain injury rehabilitation settings, and offer solutions focused on face-to-face care and telehealth.Methods: A group of pediatric neuropsychologists from 12 pediatric rehabilitation units in North America and 2 in South America have met regularly since COVID-19 stay-at-home orders were initiated in many parts of the world. This group discussed challenges to clinical care and collaboratively problem-solvedsolutions.Results: Three primary challenges to usual care were identified, these include difficulty providing 1) neurobehavioral and cognitive assessments; 2) psychoeducation for caregivers and rapport building; and 3) return to academic instruction and home. Solutions during the pandemic for the first two areas focus on the varying service provision models that include 1) face-to-face care with personal protective equipment (PPE) and social distancing and 2) provision of care via remote methods, with a focus on telehealth. During the pandemic,neuropsychologists generally combine components of both the face-to-face and remote care models. Solutions to the final challenge focus on issues specific to returning to academic instruction and home after an inpatient stay.Conclusions: By considering components of in-person and telehealth models of patient care during the pandemic, neuropsychologists successfully serve patients within the rehabilitation setting, as well as the patient's family who may be limited in their ability to be physically present due to childcare, illness, work-related demands, or hospital restrictions.


Subject(s)
Betacoronavirus , Coronavirus Infections/therapy , Neurodevelopmental Disorders/rehabilitation , Neuropsychology/trends , Pandemics , Pneumonia, Viral/therapy , Telemedicine/trends , COVID-19 , Child , Coronavirus Infections/epidemiology , Female , Humans , Inpatients/psychology , Male , Neurodevelopmental Disorders/epidemiology , Neurodevelopmental Disorders/psychology , Neuropsychological Tests , Neuropsychology/methods , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Telemedicine/methods
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