601 - Therapies Curtailed by the COVID-19 Pandemic

Poster Number: 601
Publication Number: 601.309

Jamie P. Sklar, Cohen Children's Medical Center, Lake Success, NY, United States; Eli Rapoport, New York University Grossman School of Medicine, New York, NY, United States; Ruth Milanaik, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, United States

Background: During the COVID-19 pandemic(COVID) >1 million children in NYC and Long Island switched to virtual school. The Individuals with Disabilities Education Act gives children with disabilities rights to free, appropriate public education and related services. COVID disrupted typical practice and forced adaptations for school/therapies.

Objective: To characterize changes to therapy services received by children with developmental or behavioral conditions(CDBC) in the NY COVID epicenter, such as transitions to virtual therapy(VT).

Design/Methods: An original electronic survey was completed by 312 caregivers of CDBC, which asked if CDBC received applied behavioral analysis(ABA), speech therapy(ST), occupational therapy(OT), physical therapy(PT) and/or special instruction(SI) pre-COVID (before 3/2020) and/or during COVID (3/2020-8/2020). The percent of CDBC receiving each service that then stopped receiving it during COVID was calculated.
For CDBC that received a service both pre- and during COVID, prevalence figures were calculated for switch to VT, service disruption (stop/restart) and decreased satisfaction. The percent of CDBC initially improving pre-COVID but not during COVID was calculated for each therapy. X2 tests were used to investigate associations between VT and caregivers gained ability to observe therapy and report VT as a preferred therapy location.

Results: All service types experienced decreases in CDBC who received services(Table 2). Decreases for ABA were 40%, ST 14%, OT 24%, PT 30% and SI 33%.

77-84% of CDBC that received ABA, ST, OT, PT, or SI both pre- and during COVID switched to VT. 40-60% had service disruption. 21-35% had decreased satisfaction for each service. Of the CDBC who were improving pre-COVID, 17-31% stopped improving.
A switch to VT for ST or OT resulted in a 39% and 65% increased likelihood of caregiver observation compared to those who did not switch, respectively(Table 3). 18.9% of CDBC in ST and 13% in OT had caregivers who preferred VT; there was no association between caregiver preference for VT and switch to VT.Conclusion(s): COVID overall negatively impacted the distribution of therapy across services. Despite the majority of CDBC converting to VT, out of CDBC who had therapies pre- and during COVID, many caregivers noted discontinued improvement and decreased satisfaction. Yet, VT did provide opportunity for caregiver involvement and some may prefer it. During the pandemic, a large portion of children were not provided required services to which they have a right; therapists must transition to provide quality services to meet needs of CDBC, which may include VT.
Table 1. Demographics
Table 2: Change in Therapies for Children Who Received Services both Pre-COVID and During COVID