Determinants of Positive Evolution of Symptoms in Children with Autism Spectrum Disorders (ASD) during the COVID-19 Lockdown in the Democratic Republic of Congo. (DRC).

Lockdown imposed by the COVID 19 pandemic increased the time families spent together at home. A negative impact of the lock-down on children with autism has been reported. Few studies described the positive impact of parents' presence on the severity of their children's autism symptoms during lockdown. To describe the positive impact of the COVID-19 lockdown on the evolution of Children' Symptoms with autism and parents' emotional status and to determine which variables had a positive or negative impact on the severity of autism features in Kinshasa. From April 15 to July 15, 2020, we analyzed the evolution of core symptoms of 68 children with autism and correlated these findings with the presence of a parent at home during lockdown. We performed multivariate logistic regression to assess the factors associated to autism symptoms improvement after adjustment by sex, age at ASD diagnosis, education, parent occupation, child's occupancy time, presence of parent's depression, and presence of comorbidities and core symptoms in children. Parents reported ASD symptom improvement in 42.6% of children. Factors positively associate with ASD symptoms improvement were presence of a parent for more than 8 h per day, improvement of social communication and autonomy. In contrast, severe to moderate depression in parents and presence of main comorbidities in children were associated with more severe autistic symptoms in their children. The presence of a parent at home, improved child communication and autonomy improved autism symptoms. On the other hand, parental depression and comorbidities in children with ASD aggravated the symptoms during lockdown in Kinshasa/DRC. These findings emphasize the importance of the physical presence of parents as well as the length of time they spend with their children with ASD. In addition, they show that depressive feelings in parents and comorbidities in ASD have a negative impact in the severity of their symptoms during lockdown.