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Anxiety, concerns and COVID-19: Cross-country perspectives from families and individuals with neurodevelopmental conditions

Sideropoulos, Vassilis; Van Herwegen, Jo; Meuleman, Ben; Alessandri, Michael; Alnemary, Faisal M; Rad, Jamal Amani; Lavenex, Pamela A Banta; Bolshakov, Nikita; Bölte, Sven; Buffle, Paulina; Cai, Ru Y; Campos, Ruth; Chirita-Emandi, Adela; Costa, Andreia P; Costanzo, Floriana; Des Portes, Vincent; Dukes, Daniel; Faivre, Laurence; Famelart, Nawelle; Fisher, Marisa H; Gamaiunova, Liudmilla; Giannadou, Aikaterini; Gupta, Rashmi; Hardan, Antonio Y; Houdayer-Robert, Françoise; Hrncirova, Lenka; Iaochite, Roberto Tadeu; Jariabkova, Katarina; Klein-Tasman, Bonita P; Lavenex, Pierre; Malik, Supriya; Mari, Francesca; Martinez-Castilla, Pastora; Menghini, Deny; Nuske, Heather J; Palikara, Olympia; Papon, Anouk; Pegg, Robin S; Pouretemad, Hamidreza; Poustka, Luise; Prosetzky, Ingolf; Renieri, Alessandra; Rhodes, Sinead M; Riby, Deborah M; Rossi, Massimiliano; Sadeghi, Saeid; Su, Xueyen; Tai, Claire; Tran, Michel; Tynan, Fionnuala; Uljarević, Mirko; Van Hecke, Amy V; Veiga, Guida; Verloes, Alain; Vi...

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Vassilis Sideropoulos

Jo Van Herwegen

Ben Meuleman

Michael Alessandri

Faisal M Alnemary

Jamal Amani Rad

Pamela A Banta Lavenex

Nikita Bolshakov

Sven Bölte

Paulina Buffle

Ru Y Cai

Ruth Campos

Adela Chirita-Emandi

Andreia P Costa

Floriana Costanzo

Vincent Des Portes

Daniel Dukes

Laurence Faivre

Nawelle Famelart

Marisa H Fisher

Liudmilla Gamaiunova

Aikaterini Giannadou

Rashmi Gupta

Antonio Y Hardan

Françoise Houdayer-Robert

Lenka Hrncirova

Roberto Tadeu Iaochite

Katarina Jariabkova

Bonita P Klein-Tasman

Pierre Lavenex

Supriya Malik

Francesca Mari

Pastora Martinez-Castilla

Deny Menghini

Heather J Nuske

Olympia Palikara

Anouk Papon

Robin S Pegg

Hamidreza Pouretemad

Luise Poustka

Ingolf Prosetzky

Alessandra Renieri

Sinead M Rhodes

Massimiliano Rossi

Saeid Sadeghi

Xueyen Su

Claire Tai

Michel Tran

Fionnuala Tynan

Mirko Uljarević

Amy V Van Hecke

Guida Veiga

Alain Verloes

Stefano Vicari

Sonja G Werneck-Rohrer

Eric Zander

Andrea C Samson


The COVID-19 pandemic had a major impact on the mental health and well-being of children with neurodevelopmental conditions (NDCs) and of their families worldwide. However, there is insufficient evidence to understand how different factors (e.g., individual, family, country, children) have impacted on anxiety levels of families and their children with NDCs developed over time.

We used data from a global survey assessing the experience of 8043 families and their children with NDCs (mean of age (m) = 13.18 years, 37% female) and their typically developing siblings (m = 12.9 years, 45% female) in combination with data from the European Centre for Disease Prevention and Control, the University of Oxford, and the Central Intelligence Agency (CIA) World Factbook, to create a multilevel data set. Using stepwise multilevel modelling, we generated child-, family- and country-related factors that may have contributed to the anxiety levels of children with NDCs, their siblings if they had any, and their parents. All data were reported by parents.

Our results suggest that parental anxiety was best explained by family-related factors such as concerns about COVID-19 and illness. Children’s anxiety was best explained by child-related factors such as children’s concerns about loss of routine, family conflict, and safety in general, as well as concerns about COVID-19. In addition, anxiety levels were linked to the presence of pre-existing anxiety conditions for both children with NDCs and their parents.

The present study shows that across the globe there was a raise in anxiety levels for both parents and their children with NDCs because of COVID-19 and that country-level factors had little or no impact on explaining differences in this increase, once family and child factors were considered. Our findings also highlight that certain groups of children with NDCs were at higher risk for anxiety than others and had specific concerns. Together, these results show that anxiety of families and their children with NDCs during the COVID-19 pandemic were predicted by very specific concerns and worries which inform the development of future toolkits and policy. Future studies should investigate how country factors can play a protective role during future crises.


Sideropoulos, V., Van Herwegen, J., Meuleman, B., Alessandri, M., Alnemary, F. M., Rad, J. A., …Samson, A. C. (2023). Anxiety, concerns and COVID-19: Cross-country perspectives from families and individuals with neurodevelopmental conditions. Journal of Global Health, 13, Article 04081.

Journal Article Type Article
Acceptance Date Jul 1, 2023
Online Publication Date Jul 28, 2023
Publication Date 2023
Deposit Date Sep 6, 2023
Publicly Available Date Sep 6, 2023
Journal Journal of Global Health
Print ISSN 2047-2978
Electronic ISSN 2047-2986
Publisher International Society of Global Health
Peer Reviewed Peer Reviewed
Volume 13
Article Number 04081
Keywords Public Health, Environmental and Occupational Health; Health Policy
Public URL


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