Published online Jul 19, 2021. doi: 10.5498/wjp.v11.i7.388
Peer-review started: February 7, 2021
First decision: March 16, 2021
Revised: March 26, 2021
Accepted: June 3, 2021
Article in press: June 3, 2021
Published online: July 19, 2021
Although staying at home prevents the spread of coronavirus disease 2019 (COVID-19), this poses a number of challenges, especially for children with special needs such as autism spectrum disorders (ASD) and their parents. The parents of children with ASD participate in special education practices that involve physical activity in order to cope with the behavioral, cognitive and mental problems of their children. However, during COVID-19 pandemic, this process was disrupted, and the mental health of the parents was affected.
Although there were many studies on the effects of the COVID-19 pandemic in the literature search, it was observed that there was very limited information on mental health effects on the parents of children with ASD, and there was no systematic review on this topic.
In this systematic review, it is aimed to determine the mental health status of the parents of children with ASD in the COVID-19 pandemic.
Articles in English, which could be accessed in full text without any limitation of publication year and country, were included in the study. The systematic review was conducted according to the PICOS strategy (Participants: The parents of children with ASD; Interventions: Effects of COVID-19 pandemic on mental health; Comparators: The parents of children without ASD; Main outcomes: Anxiety, stress, difficulty in coping, loneliness, inadequacy of support systems, social isolation, change in routines and financial difficulties; Additional outcomes: Exercise at home, practicing yoga and meditation, reading newspapers, receiving support from a therapist, cooking meals, talking to their loved ones on online platforms during the pandemic. These results have been reported in studies and included and presented in this systematic review. Study design: Quantitative/qualitative studies). The search results were reached by browsing the Web of Science, PubMed (including MEDLINE), Cochrane, Scopus, Science direct and Google Scholar databases using the keywords COVID-19 AND (“autism” OR “autistic” OR “autism spectrum disorder”) AND parent AND (“mental health” OR “anxiety” OR “stress”). The list of the references of the included studies was reviewed to access additional studies.
The systematic review was conducted according to the PICOS strategy, and a total of 12 studies were included in a quantitative and qualitative design. The studies have revealed that parents are negatively affected by the COVID-19 pandemic. It was reported that the parents of children with ASD had increased anxiety and stress during the pandemic, children became aggressive as their routines changed, and the parents had difficulty coping with this process. During the pandemic, the parents met with their friends via online platforms, practiced yoga and meditation, the spouses provided rest breaks to each other and received support from therapists.
The COVID-19 pandemic negatively affected the mental health of children with ASD and their parents. It may be recommended to plan more interventions that will positively affect the mental health of parents and support them.
Given the uncertainty of how long the COVID-19 pandemic will last, it is important to conduct a large number of descriptive and interventional studies on the mental health of parents with children who have ASD. In this systematic review, it was revealed that the number of studies on this topic is quite limited. It is thought that this systematic review will form the basis for future studies.