598 - Parental Concerns About Child Development During the Initial Stay-at-Home Order of the COVID-19 Pandemic

Poster Number: 598
Publication Number: 598.309

Audrey G. Brewer, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Nina L. Alfieri, Ann & Robert H. Lurie Children's Hospital of Chicago, Oak Park, IL, United States; Emily Golbeck, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Anne Bendelow, Ann & Robert H. Lurie Children's Hospital of Chicago, CHICAGO, IL, United States; Michelle L. Macy, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Tracie L. Smith, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Jenifer Cartland, Ann & Robert H Lurie Children's of Chicago, Chicago, IL, United States; Sarah Babula, Kellogg School of Management, Northwestern University, chicago, IL, United States; Matthew M. Davis, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States

Background: Earlier developmental therapeutic services help improve long-term outcomes among children with development delays and disabilities. The COVID-19 pandemic resulting in stay-at-home orders across the country resulting in disruptions in access to health care for many children.

Objective: To examine caregivers’ perceptions of their children’s progress toward developmental milestones by comparing children who had cancelled or delayed medical appointments, parental job loss, and other social indicators of health in metropolitan Chicago during stay-at-home orders, from March 21-May 7, 2020.

Design/Methods: Investigators at Ann & Robert H. Lurie Children’s Hospital of Chicago fielded a web-based survey to understand the impact of the early weeks of the COVID-19 pandemic on children’s health care experiences by caregivers’ report. The outcome of interest was caregiver report of whether their child was falling behind on developmental milestones by comparing the following groups of children by caregiver-reported cancelled or delayed appointments after March 21, 2020: (1) Missed Therapeutic: physical, occupational, or speech therapy appointment, and (2) Other missed medical appointments other than physical, occupational, or speech therapy. Bivariate analysis was used to characterize the study population by key sociodemographic and health service characteristics. Logistic regression examined associations of the outcome of interest with cancelled or delayed appointment type across key patient sociodemographic characteristics.

Results: Overall, 229 (7.5%) caregivers reported their child falling behind on developmental milestones (Table 1). Children in the Missed Therapeutic group had a higher odds of parents’ perception of falling behind on milestones (adjusted odds ratio (aOR) 10.3, 95% confidence interval (CI) 7.60-14.0) compared with children in the Other Missed group (Table 2). Caregivers who experienced job loss (aOR 1.59, CI 1.11-2.28) or reduced hours or pay (aOR 1.90, CI 1.28-2.82) were more likely to report children falling behind on developmental milestones than their peers.Conclusion(s): When children have disruptions in physical, occupational, and speech therapy services as seen during the COVID-19 pandemic, this may lead to greater likelihood of falling behind in developmental milestones. Pediatricians, developmental specialists, and policy makers should ensure equitable care is provided to vulnerable pediatric populations as we continue to face challenges with the pandemic.
Table 1. Sociodemographic Characteristics of Children Perceived as Falling Behind versus Not Falling Behind on Developmental Milestones, During the First Wave of the COVID-19 Pandemic
Table 2. Likelihood of Perceived Falling Behind on Development Among Children in Metropolitan Chicago During the Stay-at-Home Period of COVID-19