COVID-19 takes toll on health of children and youth with disabilities: U of T researchers

The health of children and youth with disabilities – already poorer than that of their peers – was hit hard by the pandemic, researchers at the University of Toronto have found.

Kelly Arbour-Nicitopoulos, an associate professor in the Faculty of Kinesiology & Physical Education (KPE), and her team found that 17 per cent of children and 24 per cent of youth with disabilities experienced a decline in their health during the acute period of COVID-19 in the spring of 2020. That included feelings of social isolation and anxiety, and greater joint and muscle pain.

The researchers also found that 60 per cent of children and youth with disabilities drastically reduced their physical activity from pre-pandemic levels – a trend further exacerbated by sociocultural and neighbourhood inequities.

“Girls and older children and youth with disabilities, as well as those who received less parental support for physical activity experienced even greater declines,” says Arbour-Nicitopoulos, who is also director of KPE’s ADAPT Lab for accessible and inclusive physical activity.

“Families living in neigbourhoods lacking available and accessible physical activity options such as playgrounds and in-person programming struggled to maintain their physical activity.”

Additionally, many parents experienced limited access to the community resources they previously relied on before COVID-19 struck.

“Programs that once offered one-to-one, in-person support, trained staff and specialized equipment for children and youth with disabilities to participate in physical activity were forced to shut their doors in 2020 and 2021,” says Arbour-Nicitopoulos. “In many cases, these doors remain to be opened to optimally support children and youth with disabilities.”

Arbour-Nicitopoulos points to the State of the Sport report released by the Canadian Tire Jumpstart Charities in March 2021, which shows that “three in 10 sport organizations are temporarily or indefinitely closed, one third of sport organizations are bankrupt or approaching bankruptcy, and almost one in five organizations believe they will need to permanently close within six months of bankruptcy.” 

While the report focused on youth sport clubs in Canada – not just those for kids with disabilities – the findings are indicative of the challenges faced by them, too.

“These challenges are compounded by a number of factors,” says Arbour-Nicitopoulos. “Disability groups are often not high priority for facility bookings because adapted programs typically generate less revenue and the cost of facility bookings has increased, which places a huge financial burden for not-for-profit organizations that used to be one of the main providers of physical activity programs for persons with disabilities.”

Additionally, COVID protocols and concerns of virus transmission have contributed to a shortage of volunteers, who are central for running adapted physical activity and sport programs.

Arbour-Nicitopolous says greater action is required from ministers and non-governmental organizations responsible for sport and recreation, as well as sport and recreation organizations to ensure programs and policies provide children and youth with disabilities with opportunities to fully participate in their communities.

“For example, sport clubs can invest in quality programming and capacity-building through enhanced training of coaches, instructors and volunteers to work with children and youth with disabilities, and the (re)construction of indoor and outdoor infrastructure that is accessible and welcoming to all children and youth.”

Arbour-Nicitopoulos and her team have been helping to inform the design of inclusive playgrounds and developed a resource that can be used by families of children and youth experiencing disability to advocate for change in their neighbourhoods and ensure they are provided with the same opportunities and resources as other community members. 

“It’s important that the setting in which sport and physical activity takes place has infrastructure and policies that are accessible and welcoming to all children and youth,” she says. “This includes the physical features of facilities, parks and playgrounds, and neighbourhoods where programming is offered. 

“Programmers and administrators should consider not only whether children and youth with disabilities and their families can access the activity space, but also the accessibility of the surrounding environment such as the availability of accessible parking, wide and barrier-free entry points, ramps and uniform surfaces, and the appropriateness of equipment for children and youth experiencing disability.” 

COVID-19 recovery efforts must also prioritize the well-being of parents of children and youth with disabilities, says Arbour-Nicitopoulos. 

Many sport and physical activity programs have started to implement a one-child-per-parent policy to avoid the community spread of COVID-19. However, if a parent has multiple children, this policy may not make it possible for their child to participate.

If capacity allows, Arbour-Nicitopoulos suggests offering programming for children and youth with disabilities and their siblings. “Programs that are offered to children and youth with disabilities must be created with an intentional focus on the physical, social and environmental supports for program members and their families.”