Behavioural response of parents and children with autism and developmental disorders in times of uncertainty: a Malaysian experience.

Introduction: Children and families with neurodevelopmental conditions have more difficulty coping with changes compared to peers. This study investigated the emotional/behavioural responses of children with autism spectrum disorder (ASD) and developmental disorders, and their families during the early stages of COVID-19 lockdown and identified the predictive factors. Methods: Data from 265 children, 4-17 years, with ASD, other developmental disorders and typically developing children that include parent-rated questionnaires of emotion/behaviour, behaviour change, and parents' level of stress were collected. We compared the mean scores of both clinical groups with typical developing children using Cohen's d and determined the factors predictive of emotional/behavioural difficulties using logistic regression. Results: Children with ASD experienced the most emotional/behavioural difficulties and behaviour deterioration during the early phase of COVID-19 lockdown. Parents from all groups reported comparable stress levels. Children with a diagnosis of ASD had a 3-fold increase in odds of emotional/behavioural difficulties (OR= 3.11; 95% 1.60-6.03, p < 0.001). A weaker association was observed with older age (13-17 years) (OR = 2.28; 95% CI 0.96-5.38, p = 0.056). Correlation analysis showed that parents' stress levels were positively associated with children's emotion/behaviour scores and behaviour deterioration. Conclusions: Family-centred approaches are a priority to recognise vulnerable families and provide support during times of crisis.