Figure 1

Factors affecting QOL during the COVID-19 stay-at-home period. Children with worsening sleep patterns and mothers with usual working patterns were two factors of a reduced family QOL. In spite of these factors, some families were able to maintain a healthy quality of life with reduced parenting stress, less parental depression and anxiety, and milder internalizing and externalizing symptoms in the children with NDDs. Conversely, increased parenting stress, a severe depressive state and anxiety in parents, and severe internalizing and externalizing symptoms in children deteriorated the QOL of children with NDDs and their parents. Internalizing and externalizing symptoms in children were associated with parental stress, a depressive state, and anxiety in parents.