A Pediatrician’s Guide to Working with Children on the Autism Spectrum in Coronavirus Disease 2019 and Beyond: Retrospect and Prospect

The COVID-19 pandemic is an unprecedented event with devastating effects on children and families, highlighting and broadening disparities in the care of children with developmental disabilities, while simultaneously catalyzing innovation. Children are vulnerable to the impacts of COVID-19, resulting in increased stress, anxiety, isolation, and health challenges, further amplified in autistic children and children with other neurodevelopmental disabilities. These children are uniquely vulnerable due to communication impairments, comorbid medical disorders, reduced adaptability, and reliance on therapeutic interventions. Abrupt reduction in services and access to care during the pandemic compromised physical and mental health and led to missed intervention opportunities at critical times. It is important to examine the effects that the pandemic triggered, address deficiencies, and recognize new opportunities to improve systems of care to prepare for unforeseen futures. Key points • The COVID-19 pandemic is an unprecedented event with observable consequences and devastating effects on autistic children and families, highlighting and broadening disparities in the care. • Abrupt reduction in services and access to care during the pandemic compromised physical and mental health and led to missed intervention opportunities at critical times. • However, many autistic children and providers demonstrated resilience in adapting to these challenges.     Introduction The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented event with observable consequences and devastating effects on children and families. This global occurrence highlighted and broadened gaps and disparities in the care of children with developmental disabilities, while simultaneously catalyzing innovation. Initially not seen as direct victims of the disease, children are inherently vulnerable to the impacts of COVID-19, resulting in increased stress, anxiety, isolation, and health challenges. The impact is further amplified in autistic children and children with other neurodevelopmental considerations. These children are uniquely vulnerable due to communication impairments, comorbid medical disorders, poor adaptability, and reliance on therapeutic interventions. Abrupt reduction in services and access to care during the pandemic led to compromised physical and mental health and missed opportunities for intervention at critical times, which may have profound consequences further down the road [ ]. There are, however, bright spots in this story, because many autistic children demonstrated resilience in their abilities to adapt to these challenges. It is important to examine the effects that the pandemic triggered, address deficiencies, and recognize new opportunities to improve systems of care to prepare for unforeseen futures. This review outlines the impacts of the first year and a half of the pandemic on autistic children and provides tools for professionals, recognizing the ever-evolving nature of the situation ( Fig. 1 ).