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  • Population Study Article
  • Published:

Life satisfaction for adolescents with developmental and behavioral disabilities during the COVID-19 pandemic

Pediatric Research volume 95, pages 827–834 (2024)Cite this article

Abstract

Background

This study aimed to identify contextual factors associated with life satisfaction during the COVID-19 pandemic for adolescents with mental, emotional, behavioral, and developmental (MEBD) disabilities.

Methods

Data were collected from a sample of 1084 adolescents aged 11–21 years from April 2020 to August 2021. This cross-sectional study used a sequential machine learning workflow, consisting of random forest regression and evolutionary tree regression, to identify subgroups of adolescents in the Environmental influences on Child Health Outcomes (ECHO) consortium who demonstrated enhanced vulnerability to lower life satisfaction as described by intersecting risk factors, protective factors, and MEBD disabilities.

Results

Adolescents with a history of depression, anxiety, autism, and attention-deficit/hyperactivity disorder were particularly susceptible to decreased life satisfaction in response to unique combinations of stressors experienced during the COVID-19 pandemic. These stressors included decreased social connectedness, decreased family engagement, stress related to medical care access, pandemic-related traumatic stress, and single-caregiver households.

Conclusion

Findings from this study highlight the importance of interventions aimed specifically at increasing adolescent social connectedness, family engagement, and access to medical support for adolescents with MEBD disabilities, particularly in the face of stressors, such as a global pandemic.

Impact

  • Through a machine learning process, we identified contextualized risks associated with life satisfaction among adolescents with neurodevelopmental disabilities during the COVID-19 pandemic.

  • The COVID-19 pandemic resulted in large-scale social disruptions for children and families. Such disruptions were associated with worse mental health outcomes in the general pediatric population, but few studies have examined specific subgroups who may be at heightened risk. We endeavored to close that gap in knowledge.

  • This study highlights the importance of social connectedness, family engagement, and access to medical support as contributing factors to life satisfaction during the COVID-19 pandemic for adolescents with neurodevelopmental disabilities.

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Fig. 1: Evolutionary regression Tree 1 solution pruned to only include branches that include MEBD conditions.
Fig. 2: Evolutionary regression Tree 2 solution pruned to only include branches that include MEBD conditions.

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Data availability

De-identified data from the ECHO Program are available through NICHD’s Data and Specimen Hub (DASH) (https://dash.nichd.nih.gov). DASH is a centralized resource that allows researchers to access data from various studies via a controlled-access mechanism. Researchers can now request access to these data by creating a DASH account and submitting a Data Request Form. The NICHD DASH Data Access Committee will review the request and provide a response in approximately two to three weeks. Once granted access, researchers will be able to use the data for three years. See the DASH Tutorial for more detailed information on the process (https://dash.nichd.nih.gov/resource/tutorial).

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Acknowledgements

We wish to thank our ECHO colleagues; the medical, nursing, and program staff; and the children and families participating in the ECHO cohorts.

Funding

Research reported in this publication was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of the Director, National Institutes of Health, under Award Numbers U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center), U24OD023319 with co-funding from the Office of Behavioral and Social Sciences Research (PRO Core), UH3OD023332 (Trasande), UH3OD023313 (Deoni), UH3OD023282 (Gern), UH3OD023389 (Leve, Neiderhiser, Ganiban), UH3OD023286 (Oken), UH3OD023348 (O’Shea), UH3OD023290 (Herbstman, Perera), UH3OD023249 (Stanford). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Phillip Sherlock, Maxwell Mansolf, Courtney K. Blackwell, David Cella, Richard Gershon & Jin-Shei Lai

  2. New York University, New York, NY, USA

    Clancy Blair & Elizabeth B. Miller

  3. Bill & Melinda Gates Foundation, Seattle, WA, USA

    Sean Deoni

  4. University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Rebecca C. Fry & T. Michael O’Shea

  5. George Washington University, Washington, DC, USA

    Jody Ganiban

  6. Columbia University, New York, NY, USA

    Julie B. Herbstman & Amy E. Margolis

  7. University of Oregon, Eugene, OR, USA

    Leslie D. Leve

  8. University of California San Francisco, San Francisco, CA, USA

    Kaja Z. LeWinn

  9. Pennsylvania State University, University Park, PA, USA

    Jenae M. Neiderhiser &  Gatzke-Kopp

  10. Harvard University, Cambridge, MA, USA

    Emily Oken

  11. University of Utah, Salt Lake City, UT, USA

    Joseph B. Stanford & J. Stanford

  12. University of Minnesota, Minneapolis, MN, USA

    Philip D. Zelazo

  13. Duke Clinical Research Institute, Durham, NC, USA

    P. B. Smith & K. L. Newby

  14. Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA

    L. P. Jacobson

  15. Research Triangle Institute, Durham, NC, USA

    D. J. Catellier

  16. Northwestern University, Evanston, IL, USA

    R. Gershon & D. Cella

  17. New York School of Medicine, New York, NY, USA

    L. Trasande

  18. University of North Carolina, Chapel Hill, NC, USA

    M. Swingler

  19. Baystate Children’s Hospital, Springfield, MA, USA

    R. Vaidya

  20. Beaumont Health Medical Center, Royal Oak, MI, USA

    R. Obeid

  21. Boston Children’s Hospital, Boston, MA, USA

    C. Rollins

  22. East Carolina University Brody School of Medicine, Greenville, NC, USA

    K. Bear

  23. Helen DeVos Children’s Hospital, Grand Rapids, MI, USA

    S. Pastyrnak

  24. Michigan State University College of Human Medicine, East Lansing, MI, USA

    M. Lenski

  25. University of Chicago, Chicago, IL, USA

    M. Msall

  26. University of Massachusetts Medical School, Worcester, MA, USA

    J. Frazier

  27. Wake Forest Baptist Health (Atrium Health), Winston Salem, NC, USA

    L. Washburn

  28. Yale School of Medicine, New Haven, CT, USA

    A. Montgomery

  29. University of Wisconsin, Madison, WI, USA

    J. Gern

  30. Columbia University Medical Center, New York, NY, USA

    R. Miller

Authors
  1. Phillip Sherlock
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  3. Courtney K. Blackwell
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  4. Clancy Blair
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  5. David Cella
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  6. Sean Deoni
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  7. Rebecca C. Fry
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  8. Jody Ganiban
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  9. Richard Gershon
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  10. Julie B. Herbstman
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  11. Jin-Shei Lai
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  12. Leslie D. Leve
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  13. Kaja Z. LeWinn
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  14. Amy E. Margolis
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  15. Elizabeth B. Miller
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  16. Jenae M. Neiderhiser
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  17. Emily Oken
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  18. T. Michael O’Shea
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  19. Joseph B. Stanford
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  20. Philip D. Zelazo
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Consortia

on behalf of program collaborators for Environmental influences on Child Health Outcomes

  • ECHO Components

    • P. B. Smith
    • , K. L. Newby
    • , L. P. Jacobson
    • , D. J. Catellier
    • , R. Gershon
    •  & D. Cella

  • ECHO Awardees and Cohorts

    • L. Trasande
    • ,  Gatzke-Kopp
    • , M. Swingler
    • , R. Vaidya
    • , R. Obeid
    • , C. Rollins
    • , K. Bear
    • , S. Pastyrnak
    • , M. Lenski
    • , M. Msall
    • , J. Frazier
    • , L. Washburn
    • , A. Montgomery
    • , J. Stanford
    • , J. Gern
    •  & R. Miller

Contributions

P.S. and M.M.: substantial contributions to conception and design, analysis and interpretation of data, drafting the article or revising it critically for important intellectual content, final approval of the version to be published. C.K.B.: substantial contributions to conception and design, drafting the article or revising it critically for important intellectual content, final approval of the version to be published. C.B., Deoni, Fry, Ganiban, Herbstman, Leve, LeWinn, Margolis, Miller, Neiderhiser, Oken, O’Shea, and Stanford: acquisition of data and drafting the article or revising it critically for important intellectual content, final approval of the version to be published. D.C., R.G., J.-S.L. and P.D.Z.: drafting the article or revising it critically for important intellectual content, final approval of the version to be published. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Phillip Sherlock.

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Competing interests

The authors declare no competing interests.

Consent for publication

Written informed consent or parent’s/guardian’s permission was obtained along with child assent as appropriate, for ECHO-wide Cohort Data Collection Protocol participation and for participation in specific cohorts.

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Sherlock, P., Mansolf, M., Blackwell, C.K. et al. Life satisfaction for adolescents with developmental and behavioral disabilities during the COVID-19 pandemic. Pediatr Res 95, 827–834 (2024). https://doi.org/10.1038/s41390-023-02852-3

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