A longitudinal study of the mental health of autistic children and adolescents and their parents during COVID-19: Part 2, qualitative findings.
A longitudinal study of the mental health of autistic children and adolescents and their parents during COVID-19: Part 2, qualitative findings.
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DOI：
10.1177/13623613221086997
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发表时间：
2023-01
期刊：
影响因子：
5.2
通讯作者：
Toseeb, Umar
中科院分区：
文献类型：
--
作者：
Asbury, Kathryn;Toseeb, Umar
关键词：
在这项英国研究的第一部分中，在2020年3月至10月的四个时间点，自闭症儿童和年轻人的父母报告的抑郁和焦虑症状水平高于有其他特殊教育需求和残疾的儿童和年轻人。在这项研究中，我们利用来自478名自闭症学生和有其他特殊教育需要和残疾的学生的父母/照顾者的定性数据，进行纵向定性内容分析，检查这些年轻人及其父母/照顾者在COVID-19大流行的前6个月内心理健康的稳定性和变化。在所有时间点，焦虑和心理困扰都是主要类别，我们注意到，与定量研究结果一致，自闭症学生的焦虑随着时间的推移保持稳定，但对于那些有其他特殊教育需求和残疾的学生来说，焦虑有所减少。第三个主要类别是幸福感，我们看到有证据表明，消除需求，特别是上学的需求，是少数学生，特别是自闭症学生及其父母/照顾者幸福感的驱动力。总体而言，我们观察到两组父母之间的心理健康体验没有差异，这也反映了定量研究结果。我们知道，自闭症儿童和青少年以及他们的照顾者患精神疾病的风险增加。我们询问了COVID-19的前6个月是否加剧了这种风险，以及对自闭症学生及其照顾者的影响是否与那些有其他特殊教育需求和困难的学生不同。在一篇链接的论文中，我们发现自闭症学生的照顾者报告说，他们的孩子比有其他特殊教育需要和困难的孩子的父母有更高水平的抑郁和焦虑症状（Toseeb &阿斯伯里，2022）。对于有其他特殊教育需要和困难的学生，他们的父母报告的焦虑症状随着时间的推移而缓解，而自闭症学生的焦虑症状一直很高。自闭症学生的照顾者和有其他特殊教育需要和困难的学生之间的心理健康和幸福感没有差异。在这里，我们使用了父母对自己和孩子在COVID-19前6个月的心理健康的书面描述，以更深入地探索这些相关的发现。我们发现了所有人都有焦虑和痛苦的强有力证据，但最突出的是自闭症儿童和年轻人。我们的研究结果，担心和痛苦随着时间的推移下降的其他特殊教育需要和困难的学生，但不是自闭症学生，得到了支持，我们观察到照顾者之间的一些差异。我们还在整个样本中发现了幸福的证据，以及一些（主要是自闭症）学生从需求减少（例如上学）中受益的例子。这对我们理解自闭症学生的学校经历有影响。研究结果表明，在COVID-19的前6个月，自闭症儿童和青少年的心理健康可能受到不成比例的影响，从健康和教育的角度仔细考虑最佳支持至关重要。
In Part 1 of this UK-based study, across four timepoints between March and October 2020, autistic children and young people showed higher levels of parent-reported depression and anxiety symptoms than those with other special educational needs and disabilities. In this study, we draw on qualitative data from 478 parents/carers of autistic pupils and those with other special educational needs and disabilities to conduct a longitudinal qualitative content analysis examining stability and change in the mental health of these young people, and their parents/carers, during the first 6 months of the COVID-19 pandemic. Worry and psychological distress were dominant categories at all timepoints and we noted that, in line with quantitative findings, worry in autistic pupils stayed stable over time but decreased for those with other special educational needs and disabilities. The third dominant category was wellbeing and we saw evidence that removing demands, especially the demand to attend school, was a driver of wellbeing for a significant minority of pupils, particularly autistic pupils, and their parents/carers. Overall, we observed no differences in mental health experiences between the two groups of parents, also mirroring quantitative findings. We know that autistic children and young people, and their caregivers, are at increased risk of mental ill health. We asked whether the first 6 months of COVID-19 exacerbated that risk, and whether the implications were different for autistic pupils and their caregivers, than for those with other special educational needs and difficulties. In a linked paper, we found that caregivers of autistic pupils reported higher levels of depression and anxiety symptoms in their children than parents of children with other special educational needs and difficulties (Toseeb & Asbury, 2022). For pupils with other special educational needs and difficulties, their parent-reported anxiety symptoms eased over time while remaining high throughout for autistic pupils. There were no differences in mental health and wellbeing between caregivers of autistic pupils and those with other special educational needs and difficulties. Here, we used parents’ written descriptions of their own and their child’s mental health during the first 6 months of COVID-19 to explore these linked findings in greater depth. We identified strong evidence of worry and distress for all, but most prominently autistic children and young people. Our finding that worry and distress declined over time for pupils with other special educational needs and difficulties, but not for autistic pupils, was supported and we observed a few differences between caregivers. We also found evidence of wellbeing throughout the sample, and examples of some (mainly autistic) pupils benefitting from a reduction in demands (e.g. going to school). This has implications for our understanding of the school experience for autistic pupils. Findings suggest that the mental health of autistic children and young people may have been disproportionately affected during the first 6 months of COVID-19 and that careful consideration of optimal support, from both health and education perspectives, is vital.
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