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COVID-19 and intellectual disability/autism spectrum disorder with high and very high support needs: issues of physical and mental vulnerability

Elisabetta F. Buonaguro (Section of Psychiatry, Department of Neuroscience, University School of Medicine “Federico II”, Naples, Italy)
Marco O. Bertelli (CREA (Research and Clinical Centre), San Sebastiano Foundation, Misericordia di Firenze, Florence, Italy)

Advances in Mental Health and Intellectual Disabilities

ISSN: 2044-1282

Article publication date: 31 December 2020

Issue publication date: 16 February 2021




The COVID-19 outbreak has profoundly plagued the world, and current health efforts are focused on providing prevention and ensuring access to intensive services for people with the most severe symptomatology. Many reports have already described substantial psychological distress in the general population. Nevertheless, disasters tend to affect vulnerable subjects disproportionately, and individuals with intellectual disabilities/autism spectrum disorder with high and very high support needs (PwID/ASD-HSN) seem to be counted among the hardest hit populations. The present paper aims to provide a comprehensive discussion and evaluation of COVID-19 related issues specific to PwID/ASD-HSN.


Commentary on available literature and analysis of new preliminary data on PwID/ASD-HSN’s physical and psychic vulnerability factors. This knowledge is fundamental to provide families and caregivers special advice to counteract the risks associated with the current pandemic.


PwID/ASD-HSN represent one of the most vulnerable population to the COVID-19 outbreak and the associated factors of mental distress for several reasons, including multimorbidity, low levels of health literacy, difficulties to understand and communicate, reliance on other people for care, low compliance with complex hygiene rules, the strong need of routine/sameness and low adaptive skills.


In the present work, the authors analyze the specific factors of physical and mental vulnerability in PwID/ASD-HSN, corroborating the dissertation with a discussion on the first data published worldwide and with preliminary data collected on the Italian territory for what concerns prevalence rates of COVID-19 and complications in persons with PwID/ASD-HSN and signs and symptoms of psychic distress during the mass quarantine period.



The authors acknowledge SIDiN (Italian Society for Neurodevelopmental Disorders) for the license and support given in the realization of the study covered in the present paper. Thanks to all caregivers/family members and health-care workers who contributed to the same study.


Buonaguro, E.F. and Bertelli, M.O. (2021), "COVID-19 and intellectual disability/autism spectrum disorder with high and very high support needs: issues of physical and mental vulnerability", Advances in Mental Health and Intellectual Disabilities, Vol. 15 No. 1, pp. 8-19.



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