Supporting Children With Neurodevelopmental Disorders During the COVID-19 Pandemic.

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.