Association Between Emotional–behavioral Problems of Children with ASD and Parental Perceived Stress During COVID-19 First-wave Lockdown

Background: The first-wave stay-at-home mandate (lockdown) during coronavirus disease 2019 (COVID-19) pandemic disrupted routines across various aspects of life. Children with autism spectrum disorder (ASD) were at high risk of experiencing emotional–behavioral problems due to lockdown. We aimed to assess emotional–behavioral changes in children with ASD during the first wave of COVID-19 lockdown and its association with perceived stress in the parents. Methods: This cross-sectional study involved contacting parents of children with ASD over the telephone. We assessed 101 parents’ perceived stress using the Perceived Stress Scale, coping ability with the Brief Resilient Coping Scale, and changes in emotional or behavioral problems with the Strengths and Difficulties Scale (parental report). The latter was evaluated considering two-time frames: six months before the lockdown and one month during the lockdown. The association between perceived stress scores, changes in emotional–behavioral problems, child gender, and family type was tested using the Wilcoxon signed-rank test. Results: Emotional problems in children with ASD significantly increased during the lockdown compared to the pre-lockdown period ( z = −1.983, P = .047). Most parents showed medium to high resilient type of coping as measured on brief resilient coping scale. However, parents’ perceived stress was not significantly related to these increased emotional problems, but however linked with type of family and religious involvement. Conclusions: Children with ASD exhibited significantly increased emotional problems during the first wave of the COVID-19 lockdown compared to the pre-COVID-19 period, which did not correlate with parents’ stress levels.