Mental health implications of COVID-19 on children with disabilities.

The world suddenly underwent a major and abrupt change with the advent of COVID-19, a virus outbreak which was termed as a pandemic by the World Health Organization in March 2020 (WHO, 2020). With physical health risks of COVID-19 being rightfully promoted, the current work serves as a platform to discuss its mental health implications on children with disabilities. The impact of COIVD-19 is evident with schools and colleges shifting classes online and work from home becoming a way of life throughout the globe. Commonly termed as social distancing or social isolation, has led to a lack of daily routine and structure. Maintaining a routine induces a sense of discipline as well as safety in children, which is important for their psychological and emotional development. Making adjustments to routines, like, experiencing closure of schools and day care centers, social distancing and/or confinement to home can prove to be a real struggle for children with physical and mental disabilities (Bartlett et al., 2020).

With schools being suspended nationwide in 189 countries since April 2020 (UNICEF, 2020), the entire education system has shifted online. While online classes are proving to be favorable for most students, little is talked about its psychological impact for children with disabilities. Children with pre-existing mental and physical disability are at utmost risk given the current situation. Most online platforms are not compatible with assistive technology used for teaching children with visual impairments or those who are hard-of-hearing (Hills, 2020). Challenges of online learning coupled with a lack of recreational activities that can be done at home can prove to be frustrating for children with such physical disabilities. Furthermore, developing social skills and social interaction has been one of the hardest issues for children with Autism Spectrum Disorder (ASD). The current situation of social distancing and having no access to outdoor activities deteriorates their development. A lack of routine and the attached uncertainty can make children with Autism Spectrum Disorder (ASD) feel more anxious, grumpy, restless, and develop unpleasant feelings.

Tandon (2020), in their work has rightly pointed out the relation between COVID-19 and psychiatry, and vice versa. Experiencing negative emotions, changes in moods, and changes in the sleeping and eating patterns of children put them at a greater risk of experiencing relapse of mental illness as well as exacerbating existing mental health issues. With medical care being prioritized for those affected by the pandemic along with closure of mental health clinics serves as a source of stress, anxiety, and fear. For instance, in India, 7.8 million children between 0–19 years of age have a physical or mental disability, and one fourth of them do not attend any educational institute (UNESCO, 2019). This becomes a cause of concern as there is already a lack of physical infrastructure, inclusive education, and assistive technologies in countries like India. Coupled with this, being confined to home during the pandemic leads to an elevated level of frustration and helplessness in such children. On the other hand, United States has seven million children between 3–21 years of age who have been receiving special education classes at school (National Center for Education Statistics, 2020). Shifting classes online leads to a dearth of providing special education assistance to children as parents cannot replace special education teachers and there exists a lack of assistive technologies. This impacts development of children with Specific Learning Disabilities (SLD), Down Syndrome, and the like. Lives of children with physical and mental disabilities need to be globally recognized and prioritized in the planning involved for this pandemic along with formation of a global leadership.

Levels of stress and anxiety have been elevated than usual. There is an extended responsibility for parents as they are playing multiple roles amidst the current situation. Stress experienced by parents can negatively affect their children. One of the greatest responsibilities of parents with young children is to explain them the current situation as transparently as possible, as effective communication about sensitive information has long-term effects of psychological wellbeing for a child (Dalton et al., 2020). Fear along with insufficient knowledge about the pandemic also leads to a lack of understanding leading to incorrect decision making (Tandon, 2020). Thus, caregivers should aim to spend quality time with their children. A system of online clinics and volunteer based psychological interventions should be set up as immediate priority to mitigate effects of COVID-19 on children with mental health issues (Holmes et al., 2020). Conducting international research on mental health consequences on children with physical and mental disability is of utmost importance to seek long-term solutions to combat this issue. As an immediate remedy, guidelines by UNICEF providing resources on children with disability during COVID-19 can be effectively followed (UNICEF, 2020).

In conclusion, everyday lives for individuals across the globe have been severely affected due to COVID-19. Amidst this, it becomes important to keep children with physical and mental disability not only physically safe, but also look after their psychological and emotional wellbeing. In particular, social distancing and its effects are extremely novel and difficult to understand for children, especially those experiencing developmental and intellectual delays. This affects their wellbeing and places them at a higher risk for clinically significant mental health issues. COVID-19 has disrupted lives across the globe and is more likely to disproportionately affect those children with pre-existing vulnerabilities. Effective measures should be taken to seek immediate as well as long-term solutions to battle this issue.

Financial disclosure

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Declaration of Competing Interest

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