Impact of the COVID-19 pandemic on therapy service delivery and functioning for school-aged children with disabilities in the United States

BACKGROUND: The COVID-19 pandemic caused wide-scale disruptions to therapy services for children with disabilities in the United States. OBJECTIVE/HYPOTHESIS: We evaluated changes in therapy service delivery during the first four months of the pandemic, examined the impact of these changes on children's functioning, and analyzed factors predicting the loss of in-person services and receipt of teletherapy services. METHODS: We undertook an anonymous cross-sectional online survey of parents/caregivers of children with a disability aged 5–17 years. Changes in therapy service delivery and children's functioning were descriptively summarized. Logistic regressions examined individual and contextual predictors of loss of therapy services or receipt of teletherapy services. RESULTS: 402 parents of children aged 5–17 years old with one or more disabilities participated; 42% of children lost access to all therapy services, and 34% of children received at least one therapy service via telehealth. Children receiving a greater number of services pre-COVID and having access to more technological devices pre-COVID were significantly more likely to receive teletherapy. Over 40% of parents attributed declines in their child's motor, behavior, social, and communication skills to changes in therapy services; this impact was greater for children with multiple diagnoses. CONCLUSIONS: Findings underscore the negative impact of therapy service disruptions on children with disabilities.