356 Psychological ill-effects and resilience of providers of children with developmental disabilities during the COVID-19 pandemic

Background Providers of children with developmental disabilities (DD) had to rapidly innovate to translate face to face care to a virtual platform in order to continue to support the needs of their patients during the coronavirus 2019 pandemic. Objectives We aimed to explore the extent of psychological ill-effects, if any, and explore resilience in providers of children with DD. Methods This was a voluntary cross-sectional study involving an anonymous questionnaire, administered via a secure online platform, between 13 May and 1 July 2020, coinciding with the Circuit Breaker (similar to a lockdown) period in Singapore. Participants included healthcare providers serving children with DD in various capacities at public and private healthcare settings in the country. Common diagnoses of DD included autism spectrum disorder and global developmental delay. The Depression, Anxiety, and Stress Scales (DASS-21) and Connor-Davidson Resilience Scale 25-item were administered. Descriptive statistics were conducted. Results Ninety-five responses were received. Mean age of respondents was 37.4 years (SD 9.45), with 96.8% of them being female. A quarter (24.5%) were medical professionals (doctor, nurse, psychologists), a third (33.0%) were therapists (physiotherapists, speech therapists and occupational therapists), a third were school-based providers (teachers in mainstream or special-education schools, learning support educators), and the rest (8.5%) were working in administrative aspects of dealing with children with DD (case manager, social workers, administrative staff). A quarter (25.5%) worked in a hospital, 20.2% worked in a school setting, 37.2% at a therapy centre (e.g early intervention centres), while 17.0% worked in social community agencies. On the DASS (table 1), more than half (56.8%) of the respondents had a positive screen for stress, of which half of these (53.7%) had levels which were in the ‘extremely severe’ range. Almost half (42.1%) of providers had anxiety, of which 45.0% of these were ‘extremely severe’. Depression rate was lower, with a positive screen present in 13.7% in this group of providers, and half of these were in the ‘mild’ range. Chi-square analysis showed that providers in school-based institutions were more likely than providers in non-school-based institutions to have a positive screen for depression on the DASS-21 (36.8% vs 8.0%, p=0.004). Mean resilience scores on the CD-RISC 25 was 62.7 (range 36.0 to 88.0), lower compared to the published normative data for this scale. Conclusions Providers of children with DD face significant psychological ill-effects during this pandemic, as well as lower resilience compared to the general population. Targeted institutional support for these providers and interventions to improve their resilience are both crucial to enhance the mental well-being of these providers. This will in turn facilitate continued provision of care for children with DD despite the pandemic.