Changes in Child Health Care, Health, and Caregiver Mental Health During the COVID-19 Pandemic in Children with Autism and Special Health Care Needs

PurposeThe COVID-19 pandemic and subsequent mitigation efforts impacted communities in many ways and placed immense strain on the health care system, impacting access to services. The purpose of this study was to examine changes in prevalence of child health care, child health, and caregiver and household health within children with autism and children with special health care needs (CSHCN) pre-pandemic to early pandemic years.MethodsWe examined data from the National Survey of Children's Health to examine changes in child health care, child health, and caregiver and household health for autistic children and CSHCN from 2018 to 2021.ResultsAbout one-third of children with autism and CSHCN missed preventive checkups due to the COVID-19 pandemic and half had virtual care in 2021. Parents of children with autism had less help with care coordination in 2020 compared to previous years. In CSHCN prevalence of anxiety increased from 2018/2019 to 2021, with a concurrent increase in need for mental health care, this was not seen in children with autism. Finally, difficulty paying medical bills and for food was less common in 2020 and 2021 (compared to 2018/2019).ConclusionsThe COVID-19 pandemic changed the healthcare landscape for everyone, including children with autism and CSHCN as highlighted in this study. Understanding the disruptions and how they impacted populations differently can be helpful in informing plans long-term emergency preparedness. This planning should involve disability inclusive policies, to ensure the most vulnerable groups retain health care access as needed. The COVID-19 pandemic impacted physical health, mental health, and access to health care for children with special health care needs. The specific impact of the pandemic on autistic children and their families is not thoroughly documented. What this study adds: Children with autism experienced disruptions to health care during the COVID-19 pandemic. As a group with great health care and service needs, disruptions could be overly impactful to health trajectories, strengthening the need for continuous, accessible care.