{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:08:55Z","timestamp":1786975735450,"version":"build-2736575974"},"reference-count":34,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n The COVID-19 pandemic and associated lockdowns resulted in changes to the way children learned, developed, and accessed health care.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate changes in rates and rate trends of new neurodevelopmental diagnoses for children in Ontario, Canada, before, during, and after the COVID-19 pandemic.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This population-based retrospective cohort study used administrative data from ICES to assess new neurodevelopmental diagnoses from March 14, 2015, to December 31, 2024, among 291\u202f896 children aged 6 years or younger in Ontario.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n The COVID-19 pandemic period, defined as March 14, 2020, to November 30, 2022, and the postpandemic period, defined as December 1, 2022, to December 31, 2024.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Monthly rate of new neurodevelopmental diagnoses per 1000 child-months, defined as the total number of children with a neurodevelopmental diagnosis divided by the total number of child-months. Interrupted time series analysis using data before, during, and after the pandemic was performed to evaluate changes in rate levels or slopes between study periods.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 291\u202f896 children received a neurodevelopmental diagnosis during the study period. Of 1\u202f481\u202f844 children at risk, 130\u202f418 received a diagnosis in the prepandemic period (mean [SD] age, 2.5 [1.6] years; 79\u202f573 boys [61.0%]); of 1\u202f115\u202f791 children at risk, 86\u202f383 received a diagnosis during the pandemic period (mean [SD] age, 2.4 [1.6] years; 52\u202f943 boys [61.3%]); and of 1\u202f014\u202f792 children at risk, 75\u202f095 received a diagnosis in the postpandemic period (mean [SD] age, 2.7 [1.6] years; 45\u202f030 boys [60.0%]). In the prepandemic period, rates of neurodevelopmental diagnoses increased monthly (slope\u2009=\u20090.04; 95% CI, 0.03-0.05;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). In the first month of the pandemic, rates of neurodevelopmental diagnoses decreased by 0.91 per 1000 child-months (95% CI, \u22121.56 to \u22120.25 per 1000 child-months;\n P<\/jats:italic>\n \u2009=\u2009.01) compared with the expected rate in the absence of the pandemic. Rates recovered and remained stable, with no statistically significant differences in slopes between the prepandemic period and either during or after the pandemic.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This population-based cohort study showed no significant differences in rates of new neurodevelopmental diagnoses among children aged 6 years or younger from prepandemic rates in the pandemic and postpandemic periods. The rapid deployment of virtual care may have helped maintain health care access, facilitating diagnoses during the pandemic and postpandemic periods.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.5683","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T15:00:36Z","timestamp":1775660436000},"page":"e265683","source":"Crossref","is-referenced-by-count":2,"title":["Neurodevelopmental Diagnoses Before, During, and After the COVID-19 Pandemic"],"prefix":"10.1001","volume":"9","author":[{"given":"Sloane J.","family":"Freeman","sequence":"first","affiliation":[{"name":"Women and Children\u2019s Health Program, St Michael\u2019s Hospital, Unity Health Toronto, Toronto, Ontario, Canada"},{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, Unity Health Toronto, Toronto, Ontario, Canada"},{"name":"Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosane","family":"Nisenbaum","sequence":"additional","affiliation":[{"name":"Strategic Partnerships in Health Excellence, Research, and Engagement, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, Unity Health Toronto, Toronto, Ontario, Canada"},{"name":"Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Sgro","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Health Program, St Michael\u2019s Hospital, Unity Health Toronto, Toronto, Ontario, Canada"},{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, Unity Health Toronto, Toronto, Ontario, Canada"},{"name":"Faculty of Medicine, University of Toronto, Toronto, Ontario, 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