The Impact of COVID-19 Lockdown on Parents and Young People With Autism Spectrum Disorder (ASD)

ABSTRACT

The spread of COVID-19 resulted in restrictive lockdowns. For families supporting young people with autism spectrum disorder (ASD), the service system was stripped away. The aim of this study was to explore the impact of this challenging situation on a group of Australian carers and parents of children and young people with ASD, with an intention to inform policy and practice based on the lived experiences of these families. A survey of parents of children and young people with ASD in Australia returned 117 responses, of which 86 responded to open-ended questions about COVID-19 lockdowns. Twelve parents responded to the invitation to be interviewed. Interview and survey data were analysed thematically. Five themes emerged: accessing support services, receiving support services online, changes in behaviour, higher levels of conflict, and impact on health and relationships. The experience of lockdowns under COVID-19 undermined informal and formal support systems, and had a particularly strong negative impact on the experiences of children with ASD and their families. These findings also provide support for understanding the social model of disability as a mainstay in the lives of children with disabilities and their carers.

IMPLICATIONS

• The social model of disability was dismantled for children and young people and their carers during the COVID crisis. This unacceptable attack on the human rights of disabled people (people with a disability) needs future planning to ensure that it does not occur again.

• Future crises require more nuanced policy and practice responses that do not close off all child and family supports to children with ASD and their carers.

KEYWORDS:

• Autism
• ASD
• Autism Spectrum Disorder
• Asperger’s Syndrome
• COVID-19
• Lockdown
• Coping
• Lived Experience
• Child
• Parent
• Carer
• Wellbeing
• Family Support
• Support Services
• Social Model
• Disability
• Behavioural Change
• Conflict
• Interpersonal Relationships
• Online Delivery
• Isolation
• Anxiety
• Depression
• Fear

The understanding and identification of autism spectrum disorder (ASD) has been growing over the past decade. It is now recognised as a developmental condition identified in early childhood, usually before the age of three. Autism spectrum disorder symptoms are characterised by repetitive and restricted behaviours, as well as challenges in social interaction and communication (American Psychiatric Association, 2013). Currently, ASD also includes Asperger’s syndrome, childhood disintegrative disorder, and pervasive developmental disorders not otherwise specified (PDD-NOS). Maskey et al. (2013) revealed that 50% of children with ASD exhibit four or five co-occurring conditions (e.g., sleep and eating problems). Additionally, the sensory hypersensitivities in children and young people with ASD can lead to anxiety (Kern et al., 2007) and disturbed behaviours such as tantrums and aggression (Leekam et al., 2007). These problems experienced by individuals with ASD not only affect their daily functioning but also can place substantial stress on their families outside of crises such as COVID-19 (Martınez-Montilla et al., 2017).

The description above provides a recognisable description of ASD. However, it represents a diagnosis rather than an understanding of the context in which neurodiverse individuals understand themselves and the barriers that they and their families experience in a social and cultural milieu that may not be adapted to their lives (Levitt, 2017). The social model of disability, which differentiates impairment from disability/disabling environments (Oliver, 1996), continues to be developed including through social work practice that explores the interplay between individual impairment and disabling social contexts. Highlighted in the social work context is the focus on self-determination and holistic analysis (Australian Association of Social Workers, 2016, p. 6), qualities noted in the scoping review by Bigby et al. (2017) in their overview of disability research in Australia. This is particularly pertinent in relation to neurodiverse young people where there are significant questions raised about whether the terminology of “autism”, “autist” or “young people with ASD” represents stigmatising language that needs to be addressed (Woods, 2017). While noting the potential for this change, in this article the disability organisations and the carers who were surveyed in this research used the terminology of ASD or autism and hence the authors have used this language. Cognisant of the importance of the social model of disability, this article focuses on the ways in which the basic supports that adapt a potentially disabling environment have been disrupted through the lockdowns associated with COVID-19 and the impacts that carers reported.

Recent studies of the impact of COVID-19 point to issues in relation to young people with ASD, as well as with their carers (parents and siblings). Overall, the impact of the COVID-19 lockdowns on children and young people with ASD has been reported as largely negative (Colizzi et al., 2020; Eshraghi et al., 2020; Stenhoff et al., 2020), highlighting the specific issues that they face. These issues included significant disruptions to school and therapy; worsening of ASD symptoms; and increased family distress (White et al., 2021). It has been observed that young people with ASD generally have a need for regularised routines and certainty in the structures of their day and that these were disrupted by COVID-19 lockdowns with serious adverse consequences for children and young people and their families (Asbury et al., 2021; Colizzi et al., 2020; Eshraghi et al., 2020; Jacques et al., 2022). Furthermore, the shift to “home schooling” was generally perceived as negative (Eshraghi et al., 2020; Stenhoff et al., 2020), noting that going to school had multiple functions, including the development of communication and social skills and specific evidence-based programs (Stenhoff et al., 2020). These features are not easily replaced in the homeschool context. While some students with an affinity for electronics responded well in the home environment to both schooling and telehealth (Eshraghi et al., 2020; Ferguson et al., 2021), others were much more challenged by the technology and access to learning that was lost, particularly for children in rural areas (Stenhoff et al., 2020).

The loss of professional and social support greatly impacted young people with ASD (Jacques et al., 2022). An increase in behavioural and emotional difficulties for children was reported (Alhuzimi, 2021; Colizzi et al., 2020; Eshraghi et al., 2020). This included reports of substantially higher rates of depression, anxiety, and stress than had otherwise been reported in the general population (Lim et al., 2021). It appeared that the greater the severity of ASD in the young person and the higher the number of services in place prior to COVID-19, the greater the impact on the behaviour and development of the young person when these services were withdrawn (Colizzi et al., 2020; Manning et al., 2021). The study by Colizzi et al. (2020) reported that behavioural problems grew more severe for about one third of children in their study, and that those children with behavioural problems prior to COVID-19 were twice as likely to experience more intense and frequent behaviour problems during COVID-19 lockdowns.

Parents who were the carers of children and young people with ASD also reported being significantly impacted by COVID-19 lockdowns (Friesen et al., 2022). A comparison of Chinese parents of children with typical development (N = 4962) and Chinese parents of children with ASD (N = 1764) showed significantly higher levels of depression and anxiety in the latter parental group. They also showed lower levels of resilience and positive coping strategies (Wang et al., 2021). These findings are similar to a Saudi Arabian study of 150 parents of children with ASD (Alhuzimi, 2021). Again, based on standardised tests, the study reported a significant impact on parental stress and wellbeing. It found that the age (younger) and gender (boys) of the child with ASD and the severity of their symptoms impacted negatively on the parents’ emotional wellbeing and stress levels (Alhuzimi, 2021). Parents appeared to be particularly stressed in relation to isolation, fear, illness, financial problems, finding essential goods and services, and notably addressing their children’s fears for their own health and safety and that of their family (Friesen et al., 2022). The withdrawal of professional and informal supports held particular impacts in relation to respite care. This was an area in which there was reported to be a high need for these supports, but also a fear of strangers providing respite during the COVID-19 lockdowns (Manning et al., 2021).

The studies reporting upon the impact of COVID-19 lockdowns on children and young people and their parents are primarily quantitative studies. There is frequent mention of behavioural difficulties, but little identification of reported conflict in the family. Our research is based on qualitative data with the aim of eliciting more information regarding the experiences of caregivers (parents) with children and young people with ASD. It explored the following question: What were the challenges and opportunities identified by parents of children and young people with ASD during the COVID-19 lockdowns?

Method

Research Design

The research question was explored within a wider project using mixed methods (Johnson & Onwuegbuzie, 2004). The wider project, “Sources and solutions of conflict: families living with a child/young person with autism”, involved both a survey and interviews with carers of young people with ASD. In the survey, two open questions were asked about the family’s response to lockdown during COVID-19. These questions were Has the level of support in your family changed due to COVID-19? and Has the level of conflict in your family changed because of COVID-19? At the end of the survey, participants were also invited to an interview where they could discuss their experiences in greater depth.

Participants and Procedure

The survey was sent out using Qualtrics software and supported via a project reference group comprised of representatives from disability organisations and the “University Research Unit anonymised”. Using this method, it was not possible to ascertain the return rate for the questionnaire. However, a posthoc estimate using an ABS (2018) estimate of the number of Australians with autism combined with data concerning the likely distribution of numbers across families (Ozonoff et al., 2011) suggested there could be approximately 185,090 such families across Australia. Ethics clearance was provided through the Human Research Ethics Committee (HREC Reference Number: 2021-13583-15778-4) at the University of Melbourne.

The process was designed to gather information on the perspectives of carers about their family life, particularly in relation to conflict and support. This included experiences during COVID-19. The online survey delivered 158 returns, of which 117 provided full demographic data, which were then available for analysis (Table 1). Only some (N = 86) survey participants responded to the open-ended, qualitative questions about COVID-19. In relation to the interviews, the interviewer contacted the 12 volunteers who provided their contact details at the end of the online survey. They were provided a consent form and a plain language statement outlining the project, the issues of confidentiality, and service contact information. The interviews, which ranged from 45 to 90 min, were audio recorded and transcribed.

Table 1 Demographic Characteristics of Parents and Carers

Participant characteristics		N=117 Parents
Age		M=42.82 (SD=9.13)
Gender	Female	112 (95.7%)
	Male	5 (4.3%)
Country of birth	Australia	93 (79.5%)
	Other	24 (20.5%)
Primary language spoken at home	English	114 (97.4%)
	Other	3 (2.6%)
Indigenous identity (Aboriginal or Torres-Strait Islander)		1 (0.9%)
Disability status	None	84 (71.8%)
	Autism (including Asperger’s)	9 (7.7%)
	Physical (e.g., cerebral palsy)	1 (0.9%)
	Neurological (e.g., epilepsy)	2 (1.7%)
	Psychiatric	5 (4.2%)
	Prefer not to say	16 (13.7%)

Data Analysis

Work was undertaken by the team to examine the preliminary data from the open-ended questions in the survey and the interview data. A deductive approach to data was taken, drawing from the experiences of the project reference group and the literature (Thomas & Harden, 2008). Different researchers analysed the two data sources, although they worked closely when using the framework for thematic analysis developed by Thomas and Harden (2008). This framework coded the many primary themes from the data, prior to synthesising the data to produce secondary themes. The thematic analysis between the interviews and survey questions indicated a major overlap in themes. In the findings, the different sources were differentiated, but the themes were aligned between the two data sources and were, therefore, reported together.

Findings

Of the 117 potential respondents to the survey, 86 responded to questions relating to COVID-19, and 12 participated in a semistructured interview. The demographic data for the whole sample is included to provide a picture of the cohort surveyed.

The demographic data pointed to the role that women played in responding to the survey and potentially the unevenness in the caring roles within the family. Interestingly, the number of respondents born outside Australia (20%) is lower than the current Australian population data of 30% born overseas (ABS, 2021), but, nevertheless, it was a cohort substantially represented in the sample. The findings of the project are outlined in response to the research questions. Five central themes emerged: accessing support services, receiving support services and schooling via online modes, observing changes in behaviour, experiencing levels of conflict in the home, and impacting the health and relationships of carers and their family.

Accessing Support Services

Participants highlighted that the COVID-19 pandemic had an effect on the accessibility of support services. A large number of participants cited losing access to both formal supports (funding, therapy, school) and informal supports (friends and family). Overwhelmingly, the difficulty in accessing support services had a perceived negative impact on families. Fifty-four participants from the survey and 10 of those interviewed cited losing access to some or all support services. The inability of formal support services to continue operating face-to-face was perceived as a devastating loss for many participants.

It’s been hell. All supports just disappeared. —S17 (S = Survey response)

It is so hard during COVID. Not being able to see the speech pathologist/kinder teachers in person for lockdown 1.0 and now everyone he knows has to wear a mask. Child is very confused and distressed by all of this. —S92

Numerous carers criticised the response of the National Disability Insurance Scheme (NDIS) and expressed their despair at the lack of funding provided to support families during the pandemic.

They [the NDIS] took it all off us … he had these massive interruptions throughout the year … and he regressed significantly and then they use that regression against him … you can’t use someone’s disability against them to withhold funding for their disability. —IV3 (IV = Interview response)

We haven't had as much therapies in place as were anticipated, so then there's the looming pressure of how do I make sure we don't lose half our NDIS plan? —IV6

Participants from both data sets cited losing access to the informal supports of family, friends, and social activities due to COVID-19 restriction measures. Carers highlighted the detrimental impact of not being able to ask or rely on friends and family for assistance.

There was just a lot fewer people to talk to and you know maybe just let off steam to a bit. No people at work either. You know the casual conversation “how are the kids going this week?” You don’t tend to have those sorts of casual conversations in a meeting via Teams that you do when you’re sitting at your desk … I found that a lot harder. —IV7

With the lockdown, my son doesn’t do video calls or phone calls, so it’s really hard to keep in contact with family. And grandma doesn’t do even mobile phones, let alone computers, she doesn’t do that kind of stuff either. So the lockdown has been particularly hard. —IV4

Receiving Support Services and Schooling Through Online Modes

Participants described a significant shift in how they received formal support services due to the constraints of the COVID-19 pandemic. Allied health therapies, social work, medical consultations, and schooling were commonly delivered through online modes. The transition to telehealth and online home learning was perceived negatively by most participants. Many carers reported that the COVID-19 pandemic led to receiving support services via telehealth or “online” services. Most participants found this unsuccessful for their child.

We found it was quite challenging and we could see a difference when he does the face-to-face versus the telehealth … But I feel like progress slowed down because he had to do telehealth. —IV10

All therapy services have gone to telehealth. No provisions available for children who can't work via computer. —S25

Yes, the therapies that my son used to have face-to-face (speech therapy, occupational therapy) became telehealth sessions due to COVID-19. My son has been able to continue these supports, but there are limitations to what he can do via telehealth. For example, with speech therapy he was able to have his sessions at school and it provided him an opportunity to practise his communication skills with his teacher and peers. He cannot do this via telehealth. —S124

Twenty-three of 25 participants who described a shift in education to homeschooling through online modes of learning cited that this led to negative consequences. Carers found that this type of online delivery was not suitable for the physical, cognitive, and social needs of the child.

With school she wouldn't get on the computer; she didn't want to be part of the school group zoom sessions … What we did is she had her camera turned off and her voice turned off. And then I just typed in the comments box for her. She didn't like the idea of everyone at school looking at her … I could tell that she was just overloaded with the sensory stuff. —IV2

It’s severely impacted him (son), absolutely. He hasn’t done any school, nothing … He didn’t feel comfortable. He would just end up in a panic. —IV5

There were two participants who found the transition to online services helpful. Primarily, participants expressed that the flexible nature and convenience of telehealth enabled them to receive greater access to services at times that suited them.

Support has increased due to use of telehealth. Fitting in around 13 zoom sessions per week. More time to access telehealth with remote learning at home. —S141

Observing Changes in Behaviour

Many participants observed changes to their children’s physical behaviour and mental health due to the constraints and changes imposed by the COVID-19 pandemic. The confinement of all family members at home and changes to the child’s routine were cited by participants as regular causes of distress. Participants also found their children became increasingly tentative to engage in social interaction, growing suspicious and fearful of catching COVID-19.

The confinement of all members of the family was viewed by carers as a significant cause of distress. Carers also reported that changes to the child’s routine led to heightened anxiety and adverse behaviour.

There has been an escalation in difficult behaviour in the home, due to increased anxiety regarding the health issues, changes in daily activity and routines, loss of social contact. Hard spending more time all together in the home. —S118

Unfortunately, the unpredictable nature of COVID-19 resulted in chaos to his schedule, which is awful for people with autism. He has had wild anxiety … He has new behaviours of concern which he has never had before. He has begun binge eating and self-harming, has been angry and emotionally volatile. —S30

Further, nearly half of the interview participants cited that their children developed social anxiety due to the fear of catching COVID-19.

Even when people were able to go outside, he (son) wouldn’t go outside, because [COVID-19] was out there. So, between March and now, he’s been outside, I think, three times. —IV5

Experiencing Higher Levels of Child-related Conflict in the Home

Fifty-one of the survey participants expressed that they experienced elevated levels of conflict in their family because of the COVID-19 pandemic. Primarily, carers cited the shift to telehealth and online learning and the changes to children’s behaviour and mental health as key contributors (outlined earlier). Carers also attributed their own personal struggles to increased conflict in the home. Again, a small number of participants stated that they experienced less conflict within their home during this period.

Yes. Both our sons’ education has effectively stopped. The mental health of them both has deteriorated, with one trying suicide three times already. The violence of our younger son has dramatically increased. We have gone through so much crockery, seen too much blood, and my husband, who has terminal cancer, was punched multiple times. —S102

The second lockdown, he couldn't handle it. Every day was a struggle with school. I got chairs thrown at me. I got stabbed with pencils. Flat refusal to do school work. —IV3

He did get very angry during the second lockdown and was sort of doing a lot of the fists and a lot of banging and he said he couldn’t, like he felt like his brain was telling him he couldn't do it. You're too stupid, that type of thing. —IV1

There were a small number of participants who found their child was more relaxed in the home environment, reducing the demands on the family and conflict experienced.

Conflict in our house has improved. Our son has been a lot more relaxed. —S13

Impacting the Health and Relationships of Carers and Their Family

Many participants acknowledged that the COVID-19 pandemic had affected their own health and personal relationships. Parents who had to take on multiple roles within the home, without respite, were particularly stressed. Strain on relationships, particularly between the primary carer (usually mothers) and their partner was regularly cited. Despite most participants having a negative experience, some spoke of the positives of coparenting and sibling bonding that eventuated because of the COVID-19 pandemic.

Participants commonly experienced anxiety and burnout from taking on all caring and educating responsibilities for their child. Mental health concerns were exacerbated by having the children at home all day, without the respite afforded to them by support services, school, and social activities.

It’s up to me to do everything. I am autistic too and I’m completely burnt out at the end of the day. —S98

I’ve found my coping mechanisms have failed, as an educated and “usually” level-headed person. I wouldn’t have predicted the amount of anxiety I’ve been feeling. I yell 100 times more since starting the restrictions. I’m exhausted from being stressed at home. —S17

Three kids and husband all working from home in close confines while in lockdown. Not able to have time apart from one another. Very stressful!!! Especially for me trying to keep the peace between everybody and caring for everyone. —S141

Carers suggested that their increased responsibilities and the home circumstances that developed from COVID-19 led to additional strain on their relationship with their partner and children.

Yes, it has put a huge amount of strain on my relationship with my husband. I feel like I am trying to be therapist/carer constantly as well as full time employee all working from home. The caring at the moment is nonstop and I don't feel I get a break. —S92

However, a small number of participants in both the survey and interview data acknowledged that having their partner at home during the day allowed for more effective coparenting. Further, a few carers in the interview data cited that some relationships between siblings were able to grow and develop with the additional time spent together.

During that COVID lockdown period, because they were forced to spend time together, they actually I think developed … That bond actually did develop more because they were forced to spend more time together. —IV10

Discussion

The parents of children and young people with ASD reported through this study that they were a group of people who were heavily impacted by lockdowns and the presence of COVID-19 in the community. While there were a small group of families who reported positively on opportunities provided by COVID-19, overwhelmingly the experiences were challenging and largely negative. A similar, though more nuanced response, has been reported in other highly sensitive areas such as domestic and family violence (DFV). For example, there was an increase in the onset and severity of DFV (Boxall et al., 2020). However, practitioners in the service system and some of those with lived experience reported that the changes to the service system, including the ability to access courts and police virtually, provided some positive opportunities (Pfitzner et al., 2020). The disability sector experience for the families in our sample reported fewer of these positives as the system closed down around them.

Our qualitative study mirrored many of the findings from quantitative studies from outside of Australia about COVID-19 and its impact on families with a child or young person with ASD (Jacques et al., 2022; Lim et al., 2021; & White et al., 2021). However, our study also has provided powerful and important qualitative insights into the experiences that lie behind the statistics. The specific needs of children and young people with ASD created vulnerabilities when regular routines were disrupted (Eshraghi et al., 2020) and the shift to an overreliance on technology created sensory overload for some children (Stenhoff et al., 2020).

Of particular note was the disintegration of the service system that supported the children and their families. In many families, all formal, face-to-face services were withdrawn or severely curtailed during COVID-19. Most of these services were not provided or were unable to be satisfactorily accessed virtually. As reported elsewhere, children’s behaviours and emotional problems unsurprisingly became more severe (Colizzi et al., 2020; Lim et al., 2021). The withdrawal of the informal service system was equally concerning (Eshraghi et al., 2020). The children’s grandparents often were unable to manage the technology that might have otherwise supported important social contact, there were difficulties explaining the lack of social contact, and children frequently were not comfortable with the change to accessing informal friendship and family networks online. Children’s social anxieties, to which they may have already been vulnerable (Manning et al., 2021), became more acute with the lack of social contact.

The shift to homeschooling mostly was reported as unsuccessful for both children and parents alike. While only short quotes are provided in the text, the overwhelming tenor of the responses from parents was that children were profoundly disadvantaged by this change. As reported by Stenhoff et al. (2020), school has multiple functions, including social contact, tailored programs for their development and the development of social skills, alongside the attention to their academic progress. Parents consistently reported that their children were “going backwards” as homeschooling could not address the wide range of activities and stimulation provided by schools.

The pressures on parents were profound. The isolation created by COVID-19 and the withdrawal of personal and professional support were reported as distressing and stressful. As reported elsewhere (Alhuzimi, 2021; Friesen et al., 2022; Wang et al., 2021), the mental health of parents was affected, with reports of anxiety, depression, and burnout. The pressures of living in a confined space with few external supports created a relentless “pressure cooker” environment, which placed strain on all relationships. Many parents reported increased conflict within the family, both between siblings and between parents. There was little explicit reporting of DFV, but rather of heightened conflict.

While reporting on the overwhelming negative impacts of living with lockdowns as a result of COVID-19, there were a minority of carers who reported positive benefits. In our data, there were reports of siblings looking out for each other, the child with ASD being more relaxed, some positive reports of increased coparenting, and the lack of formal schooling suiting a few of the families. These opportunities for some children with ASD and their families should not be overlooked.

It was noteworthy that at the time of the survey and interviews, lockdowns were in place though there were relatively few reported cases of COVID-19 in Australia. Therefore, the data referred primarily to the impact of lockdowns with their severe restrictions and their impact on families with a child or young person with ASD. Nevertheless, the majority of parents in this survey reported that the children in their care held fears about the virus and many developed anxiety about leaving the home.

There are both policy and practice implications that arise from the carers’ reports about managing children and young people with ASD through COVID-19 lockdowns. The social work concerns for social justice, which demand that the social context in which individual problems occur is strengthened, point to the need for policy initiatives that address the erosion of the service system at a time of crisis (AASW, 2020). The social model of disability importantly centres the focus of reform on creating a facilitating rather than a disabling context (Levitt, 2017; AASW, 2016). The reinvigoration of the social model of disability that Levitt (2017) and Woods (2017) discussed includes neurodiverse children and young people, and could equally be applied to, and updated to include, responses during a crisis such as COVID-19. The withdrawal of the formal service system from these children and their families is a major issue that has had widespread ramifications. It stripped most resources from children, young people, and their families, creating a disabling environment, in which most children and parents were negatively impacted.

In other areas, such as child protection with highly vulnerable children, visits were curtailed, but, in some circumstances, continued (Katz et al., 2021). Similarly, childcare centres and schools remained open for essential workers. In a crisis, the service system does not need to entirely disappear for those for whom access to the internet is difficult, and where children’s development is undermined by a lack of appropriate services (both health and educative). As the lockdowns for COVID-19 continued, there were some reported easing of restrictions on children with ASD (Department of Education, Skills & Employment, 2020). This move was entirely appropriate given the level of adversity children and young people with ASD and their families were experiencing.

Limitations

It was not possible to ensure that the samples for the survey and interviews were representative. Therefore, care has been taken to not overgeneralise findings from the data presented. The research did not survey or interview young people directly about their experiences, and the research did not provide proportionate representation of Aboriginal and Torres Strait Islander people in the sample. These are areas for further research. It might be that these findings, concerning as they are, underestimate the full impact of COVID-19 lockdowns because those parents who responded were potentially representing a group with the personal and family resources available to enable them to respond to a survey in addition to dealing with day-to-day family demands.

Conclusion

A crisis is often seen as a point of change that can create both challenges and opportunities. COVID-19 undoubtedly is a crisis that reverberated throughout Australian and international communities, but one which has not impacted evenly across the community. The fractures and inequalities in society were highlighted and the lack of social justice for vulnerable children and their families were writ large. The carers of children and young people with ASD were particularly and adversely impacted by the restrictions associated with COVID-19 lockdowns. Their voices point to the value of those with lived experience contributing to the research, policy, and practice agenda. The service system at the time was found wanting, creating a highly disabling context. Future preparation for responding to crises may reap some benefits from this research about what “not to do” as well as what needs to be done, drawn from the experiences of parents living through the Australian lockdowns prompted by the COVID-19 pandemic.

Acknowledgements

We would like to acknowledge all parents who responded to the survey and interviews. We would like to thank the reference group for their time, guidance, and advice. We would also like to acknowledge Gemma Dodevska, who supported the initial project management and field work for the research.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The Project was funded by the Melbourne Disability Institute, University of Melbourne.