Participation of school-aged children with ASD during the pandemic: the unique impact of parents' participation

ABSTRACT

Introduction: Participation of children with autism spectrum disorder (ASD) is influenced by child, family, and environmental factors. However, little is known about the impact of parents' own participation on their child's participation, especially during COVID-19. We estimated to what extent complexity of child condition, income, mother's actual participation, and environmental barriers/supports, explains participation (frequency, involvement, and desire for change) of school-aged children with ASD in home and community. Patients and Methods: Mothers (n = 130) of children with ASD aged 6-13 years (mean = 9.09, SD = 1.89) completed an online survey including the Participation and Environment Measurement for Children and Youth (measuring child participation, environmental barriers/supports), the Health Promoting Activities Scale (assessing mother's participation), a checklist of child's functional issues, and a socio-demographic questionnaire. Multiple linear regressions were conducted and R2 change was calculated to determine the unique contribution of each factor. Results: On average, parents desired change in 71% of activities in both settings. Involvement and desire for change at home had the highest variance explained (20.9% and 17.4% respectively), and mother participation was more pronounced for explaining involvement levels (β = 0.34, ΔR2 = 10.4%). Income consistently explained child's frequency (ΔR2 = 41.4%) and involvement (ΔR2 = 8.7%) in community;other factors had negligible contributions. COVID-19' s impact was negatively associated with the child's participation frequency in community (r = -0.51, p <0.01), whereas at home, this association was positive (r = 0.188, p <0.05). Conclusion: Mother's own participation positively impacts the involvement of children with ASD at home. This can re-direct clinicians' attention towards improving parental participation. The environment had limited impact on child participation in the community, due in part to the pandemic.