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      Conducting CBT for Anxiety in Children with Autism Spectrum Disorder During COVID-19 Pandemic

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          Abstract

          This commentary describes the transition to remote delivery of cognitive-behavioral therapy (CBT) for anxiety in children with autism spectrum disorder (ASD) who participates in a clinical trial during the COVID-19 pandemic. The effects of COVID-19 on children’s anxiety and on the family functioning are discussed. Modifications to CBT necessitated by telehealth delivery were aimed at maximizing engagement of children and their parents while maintaining treatment fidelity and adhering to the research protocol. Treatment targets were updated to address new sources of anxiety and CBT exposure exercises were modified to accommodate the new reality of quarantine restrictions. If the COVID-19 pandemic continues to affect treatment delivery it may require a widespread utilization of telehealth for treating anxiety in children with ASD.

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          The online version of this article (10.1007/s10803-020-04845-1) contains supplementary material, which is available to authorized users.

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          Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality

          Jörg Fegert, Benedetto Vitiello, Paul L. Plener … (2020)
          Background The coronavirus disease 2019 (COVID-19) is profoundly affecting life around the globe. Isolation, contact restrictions and economic shutdown impose a complete change to the psychosocial environment in affected countries. These measures have the potential to threaten the mental health of children and adolescents significantly. Even though the current crisis can bring with it opportunities for personal growth and family cohesion, disadvantages may outweigh these benefits. Anxiety, lack of peer contact and reduced opportunities for stress regulation are main concerns. Another main threat is an increased risk for parental mental illness, domestic violence and child maltreatment. Especially for children and adolescents with special needs or disadvantages, such as disabilities, trauma experiences, already existing mental health problems, migrant background and low socioeconomic status, this may be a particularly challenging time. To maintain regular and emergency child and adolescent psychiatric treatment during the pandemic is a major challenge but is necessary for limiting long-term consequences for the mental health of children and adolescents. Urgent research questions comprise understanding the mental health effects of social distancing and economic pressure, identifying risk and resilience factors, and preventing long-term consequences, including—but not restricted to—child maltreatment. The efficacy of telepsychiatry is another highly relevant issue is to evaluate the efficacy of telehealth and perfect its applications to child and adolescent psychiatry. Conclusion There are numerous mental health threats associated with the current pandemic and subsequent restrictions. Child and adolescent psychiatrists must ensure continuity of care during all phases of the pandemic. COVID-19-associated mental health risks will disproportionately hit children and adolescents who are already disadvantaged and marginalized. Research is needed to assess the implications of policies enacted to contain the pandemic on mental health of children and adolescents, and to estimate the risk/benefit ratio of measures such as home schooling, in order to be better prepared for future developments.
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            Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis

            Meng-Chuan Lai, Caroline Kassee, Richard M. A. Besney … (2019)
            Co-occurring mental health or psychiatric conditions are common in autism, impairing quality of life. Reported prevalences of co-occurring mental health or psychiatric conditions in people with autism range widely. Improved prevalence estimates and identification of moderators are needed to enhance recognition and care, and to guide future research.
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              Internet-Related Behaviors and Psychological Distress Among Schoolchildren During COVID-19 School Suspension

              I-Hua Chen, Chao-Ying Chen, Amir Pakpour … (2020)
              The novel coronavirus disease 2019 (COVID-19) infection has rapidly grown worldwide,1 and many governments have implemented policies to control the infection rate. For example, school suspension, self-quarantine, requirement of citizens to stay at home,2 travel and border controls, and discouragement of outdoor activities3 have been used. Although these actions emphasizing the importance of “spatial distancing” are based on the perspective of public health, they may result in health problems other than COVID-19 infection, such as psychological distress and fear.4 Therefore, the present authors examined the potential predictors for psychological distress among schoolchildren during COVID-19 school suspension.
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                Author and article information

                Contributors
                Denis G. Sukhodolsky:
                ORCID: http://orcid.org/0000-0002-5401-792X
                denis.sukhodolsky@yale.edu
                Journal
                Journal ID (nlm-ta): J Autism Dev Disord
                Journal ID (iso-abbrev): J Autism Dev Disord
                Title: Journal of Autism and Developmental Disorders
                Publisher: Springer US (New York )
                ISSN (Print): 0162-3257
                ISSN (Electronic): 1573-3432
                Publication date (Electronic): 1 January 2021
                Pages: 1-9
                Affiliations
                [1 ]GRID grid.47100.32, ISNI 0000000419368710, Child Study Center, , Yale University School of Medicine, ; 230 S. Frontage Road, New Haven, CT 06520 USA
                [2 ]GRID grid.266419.e, ISNI 0000 0001 0352 9100, Department of Psychology, , University of Hartford, ; West Hartford, USA
                [3 ]GRID grid.19006.3e, ISNI 0000 0000 9632 6718, Department of Education, , University of California Los Angeles, ; Los Angeles, USA
                [4 ]GRID grid.19006.3e, ISNI 0000 0000 9632 6718, Department of Psychiatry, , University of California Los Angeles, ; Los Angeles, USA
                Author information
                http://orcid.org/0000-0002-5401-792X
                Article
                Publisher ID: 4845
                DOI: 10.1007/s10803-020-04845-1
                PMC ID: 7775616
                PubMed ID: 33385281
                SO-VID: 1c759743-4c35-4308-94c9-d6f20731a31c
                Copyright © © The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature 2021
                License:

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Date accepted : 12 December 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100009633, Eunice Kennedy Shriver National Institute of Child Health and Human Development;
                Award ID: R01HD083881
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/100000025, National Institute of Mental Health;
                Award ID: T32 MH18268
                Award Recipient :
                Categories
                Subject: Commentary

                ScienceOpen disciplines: Neurology
                Keywords: autism spectrum disorder,anxiety,cognitive-behavior therapy,covid-19 pandemic,telehealth
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: autism spectrum disorder, anxiety, cognitive-behavior therapy, covid-19 pandemic, telehealth

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