Impact of COVID-19 Pandemic on Developmental Service Delivery in Children With a History of Neonatal Seizures

Abstract

Background and Objective Children with a history of acute provoked neonatal seizures are at high risk for disability, often requiring developmental services. The COVID-19 pandemic has led to widespread changes in how healthcare is delivered. Our objective was to determine the magnitude of service interruption of services among children born between 10/2014-12/2017 and enrolled in the Neonatal Seizure Registry (NSR) , a nine-center collaborative of pediatric centers in the US. Design /Methods Prospective cohort study of children with acute provoked seizures with onset 44 weeks gestation and evaluated at age 3-6 years. Parents of children enrolled in the NSR completed a survey about their child’s access to developmental services between June 2020 and April 2021. Results Among 144 children enrolled, 72 children (50%) were receiving developmental services at the time of assessment. Children receiving services were more likely to be male, born preterm, and have seizure etiology of infection or ischemic stroke. Of these children, 64 (89%) experienced a disruption in developmental services due to the pandemic, with the majority of families (n=47, 73%) reporting that in-person services were no longer available. Conclusion Half of children with acute provoked neonatal seizures were receiving developmental services at ages 3-6 years. The COVID-19 pandemic has led to widespread changes in delivery of developmental services. Disruptions in services have the potential to impact long term outcomes for children who rely on specialized care programs to optimize mobility and learning.

Neonatal seizures: stepping outside the comfort zone

“…34) A recent study emphasized that the COVID19 pandemic has led to a wide spread disruption in the delivery of developmental services to children with a history of neonatal seizures. 35) Of note, seizure onset and type are crucial to identifying the underlying etiology and hence tailoring early distinct therapeutic interventions aimed at reducing the detrimental effects of seizures on synaptic plasticity in the growing brain. HIE accounts for approximately twothirds of acute symptomatic seizures occurring on the first day of life, whereas genetic disorders occur around the seventh day of life.…”

“…In addition, 2 neonates exposed to prenatal infection developed ventriculomegaly, neurological dysfunction, and seizures [ 34 ]. A recent study emphasized that the COVID-19 pandemic has led to a widespread disruption in the delivery of developmental services to children with a history of neonatal seizures [ 35 ].…”

Perceptions of Service Recipients on the Roles of Community Health Nurses in Children's Primary Care During the COVID-19 Outbreak in Northeastern Thailand

“…When children were hospitalized, there was a risk of infection; moreover, home quarantine led to decreased physical activity and increased obesity. Children with disabilities could not receive ongoing physical therapy, causing the development of musculoskeletal disorders (Peyton et al, 2022;Zehra & Gulendam, 2021). Caregivers obtained training information online; although they had skills to promote muscle strength, behavioral skill promotion was reduced (Allison & Levac, 2022).…”