Supporting the Health and Well-Being of Children with Intellectual and Developmental Disability During the COVID-19 Pandemic

Underserved populations are at dramatically higher risk of becoming infected with Severe Acute Respiratory Syndrome, Coronavirus-2 (SARS-CoV-2) and death from COVID-19. Children with IDD are vulnerable to the negative impact of school closure. School districts provide critical services beyond the education, including nutritional, social, therapy (physical, occupational, and speech-language) and healthcare services. Risks are heightened for children with IDD, as they are often unable to wear masks, practice social distancing and/or implement effective hand hygiene. Access to rapid and reliable SARS-CoV-2 testing is essential for children with IDD and school staff in order to safely return to school. Members of the research team developed an innovative, scalable, low-cost method for SARS-CoV-2 testing using saliva samples. Investigators at the Washington University Intellectual and Developmental Disabilities Research Center (IDDRC@WUSTL), in collaboration with the University of Missouri-Kansas City Institute of Human Development and the Kennedy Krieger Institute in Maryland (which includes an IDDRC, the Maryland Center for Developmental Disabilities, and the Kennedy Krieger School Programs), were ideally positioned to determine the best implementation strategies to maximize use of a saliva-based SARS-CoV-2 diagnostic test for vulnerable children and school staff in a school setting. The IDDRC@WUSTL has a long-standing relationship with the Special School District (SSD) of St. Louis County, whose mission is to serve children with IDD, and the national network of the Association of University Centers on Disabilities (AUCD). First, the study determined the most effective messaging and implementation strategies to maximize weekly SARS-CoV-2 testing in a school setting. In this adaptive clinical trial, 52,000 diagnostic tests were administered to students and school staff at SSD, whose student population is 48% Black. Second, the study measured national attitudes among parents/guardians of children with IDD and school staff regarding the impact of COVID-19 and the importance of SARS-CoV-2 testing. At the successful completion of this project, this study improved the acceptance, adoption, and process for SARS-CoV-2 diagnostic testing in a school-based setting to enable delivery of critical educational activities for children with IDD in an underserved community. By identifying the most effective methods for SARS-CoV-2 testing in a vulnerable population of children with IDD, the study established a blueprint for wider adoption of COVID-19 mitigation efforts, such as vaccination.