Mental health & maltreatment risk of children with special educational needs during COVID-19

Winnie W.Y. Tso, Ko Ling Chan (Corresponding Author), Tatia M.C. Lee, Nirmala Rao, S. L. Lee, Fan Jiang, Sophelia H.S. Chan, Wilfred H.S. Wong, Rosa S. Wong, Keith T.S. Tung, Jason C. Yam, Anthony P.Y. Liu, Gilbert T. Chua, Jaime S. Rosa Duque, Almen L.N. Lam, K. M. Yip, L. K. Leung, Yuliang Wang, Jin Sun, Guanghai WangGodfrey C.F. Chan, Ian C.K. Wong, Patrick Ip (Corresponding Author)

Research output: Journal article publicationJournal articleAcademic researchpeer-review

10 Citations (Scopus)


Background: Children with special educational needs (SEN) are more vulnerable during the COVID-19 pandemic with risk of poor mental wellbeing and child maltreatment. Objective: To examine the impact of COVID-19 on the mental health of children with SEN and their maltreatment risk. Participants and setting: 417 children with SEN studying at special schools and 25,427 children with typical development (TD) studying at mainstream schools completed an online survey in April 2020 in Hong Kong during school closures due to COVID-19. Method: Emotional/behavioural difficulties, quality of life and parental stress of children with SEN were compared with typically developed children using mixed effect model. Linear regression analyses were performed to explore factors associated with child emotional/behavioural difficulties and parental stress during the pandemic. Chi-square test was performed to detect the differences in maltreatment risk before and during COVID-19. Results: Children with SEN had significantly poorer overall quality of life (68.05 vs 80.65, p < 0.01). 23.5% of children had at least one episode of severe physical assault and 1.9% experienced very severe physical assault during COVID-19. Rates of physical assault increased significantly (59.8% vs. 71.2% p < 0.001) while children with mental disorders had increased risk of severe physical assault comparing to those without mental disorders (RR = 1.58, ꭓ2 = 5.19 p = 0.023). Conclusion: Children with SEN had poorer mental health than typically developed children during the COVID-19 pandemic. Maltreatment risk for children with SEN is higher in comparison to pre-COVID-19 era. Surveillance of child maltreatment, continuity of medical and rehabilitation care to support children with SEN are essential during a disease pandemic.

Original languageEnglish
Article number105457
Number of pages9
JournalChild Abuse and Neglect
Publication statusPublished - 1 Aug 2022


  • Child maltreatment
  • COVID-19
  • Mental health
  • Special educational needs

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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