Exploring the relationship between COVID-19 and autistic adults' community participation: Findings from a two-timepoint longitudinal study

Background: The COVID-19 pandemic has resulted in a continuum of changes in communities that have impacted the lives and health of millions of autistic people. Method: To identify community participation changes during COVID-19, we conducted a twotimepoint (2018 and 2022) longitudinal quantitative study involving 116 autistic adults in Pennsylvania to investigate the impact of the pandemic on their community participation. Community participation was measured by the Temple University Community Participation Measure, and the impact of the pandemic was measured by a series of factors related to the COVID-19 pandemic (e.g., healthcare access, transportation, safety, etc.). Results: Results of paired sample t-tests did not show changes in participants' total days of participation over the last 30 days, the total number of activities, or percentages of all activities participants considered important and participated in (i.e., breadth ratio) between the timepoints. However, the percentage of activities that were important to participants and in which they reported engaging as much as they wanted to (i.e., sufficiency ratio) reduced significantly. When examining participation outcomes and COVID-19 impact, we found that multiple participation outcomes (i.e., number of activities, breadth ratio, and sufficiency ratio) were negatively associated with the COVID-19 impact. Conclusion: Results suggest that the COVID-19 impacts on autistic adults are variable, with those reporting a more significant impact also reporting a significantly lower level of participation. These findings emphasize the importance of individualized planning to support autistic adults to maintain or regain participation in their preferred activities during the pandemic and beyond.