{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T03:06:08Z","timestamp":1779419168544,"version":"3.53.1"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"vor","delay-in-days":129,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["UIP 178856"],"award-info":[{"award-number":["UIP 178856"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID\u201019 pandemic profoundly altered daily life and interrupted key milestones during the transition to adulthood for youth with special healthcare needs (YSHCN). In this patient\u2010oriented study, we investigated the impact of the COVID\u201019 pandemic on Canadian YSHCN during their transition to adulthood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used a sequential, exploratory mixed methods design. In Phase 1 (Interpretive Description), we conducted semi\u2010structured interviews with 21 YSHCN or their caregiver proxies. Rapid qualitative analysis identified key themes that informed Phase 2, a cross\u2010sectional online survey completed by 516 YSHCN or their proxies. Survey results were summarized using descriptive statistics, and heterogeneity in experiences was examined using chi\u2010square and multivariable logistic regression analyses. Mixed methods findings were integrated using joint displays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>YSHCN described positive and negative experiences across the domains of healthcare, autonomy, relationships, vocation and lifestyle. Virtual modalities enhanced accessibility for some but deepened exclusion for others, particularly youth requiring hands\u2010on or specialized support. Participants described strengthened family connections and accelerated pathways to autonomy as positive experiences, whereas disrupted access to healthcare, delayed milestones and increased social isolation were common negative experiences. In the survey, family support and positive coping strategies emerged as protective influences, whereas lack of in\u2010person services, distressing news and social distancing were identified as key negative factors. Youth with mental or developmental healthcare needs were more likely to experience positive impacts of virtual services, whereas younger youth and those with mental healthcare needs were more likely to be negatively impacted by the lack of in\u2010person services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The pandemic had mixed impacts on YSHCN, highlighting the need for flexible health, education and community services that accommodate diverse needs. Findings underscore the importance of building inclusive, resilient systems and policies that preserve accessibility gains and meaningfully engage youth and caregivers in post\u2010pandemic recovery and future crisis planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cch.70294","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T04:01:01Z","timestamp":1778472061000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Growing Up Through a Pandemic: A Mixed\u2010Methods Study of How the COVID\u201019 Pandemic Shaped the Transition to Adulthood for Youth With Special Healthcare Needs and Their Families"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1822-4048","authenticated-orcid":false,"given":"Lin","family":"Li","sequence":"first","affiliation":[{"name":"Lawrence Bloomberg Faculty of Nursing University of Toronto  Toronto Ontario 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of Adolescent Medicine The Hospital for Sick Children (SickKids)  Toronto Ontario Canada"},{"name":"Department of Paediatrics University of Toronto  Toronto Ontario Canada"},{"name":"SickKids Research Institute  Toronto Ontario Canada"},{"name":"Institute for Clinical Evaluative Sciences (ICES)  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Robeson","sequence":"additional","affiliation":[{"name":"Children's Healthcare Canada  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1246-3910","authenticated-orcid":false,"given":"Jessica","family":"Geboers","sequence":"additional","affiliation":[{"name":"CanChild Centre for Childhood\u2010onset Disability Research McMaster University  Hamilton Ontario 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