COVID-19 Screening in Schools for Children with IDD

September 7, 2021

Since November 2020, investigators at Washington University in St. Louis School of Medicine have studied whether weekly saliva-based screening testing of staff and students and mitigation strategies may help keep children with disabilities safe at school. This work is a joint partnership between the Washington University Intellectual and Developmental Disabilities Research Center (WUIDDRC), the Kennedy Krieger Institute in Maryland, the University of Missouri-Kansas City Institute of Human Development, in collaboration with the Special School District of St. Louis County (SSD) in Missouri, with funding from the National Institutes of Health.

During the peak of the pandemic in fall 2020, parents were resistant to return their children with intellectual and developmental disabilities (IDD) to school for in-person learning, even though these children often receive many academic and related services (e.g., speech-language, occupational and physical therapies, and counseling services) through the school system. Their expected inability to reliably wear masks and practice other mitigation strategies, as well as having a significant vulnerability to COVID-19 infection, was thought to put the IDD population at greater risk along with their teachers. Although schools for typically developing children have been shown to be relatively safe during the COVID-19 pandemic, less is known about transmission in schools serving children with IDD.

To investigate the safety in these schools, our study group at Washington University in St. Louis, in collaboration with the Special School District of St. Louis County (SSD), implemented voluntary weekly screening tests for staff and students using saliva-based tests. Results of the first six months of this testing (November 2020 through May 2021) in six schools in St. Louis County that specialize in the education of children with IDD was recently published in the Journal of Neurodevelopmental Disorders. As the first study of COVID-19 screening in schools devoted to children with IDD, the researchers found school serving children with IDD implementing mitigation strategies to be at least as safe, if not safer, than the community.

Out of the 7,289 tests performed, 21 of 416 participants tested positive during the study period (19 staff and 2 students). The average weekly positivity rate was 0.29% which was less than community-based asymptomatic screening protocols. Out of 103 individuals who were quarantined for in-school exposures, the researchers found only two cases that were possibly attributed to in-school transmission, both among staff. In addition, SSD administrators found that students did better than expected with masking, reporting that about 70% of students complied well to mask wearing. Reduced room capacity and phased re-opening were also found helpful mitigation strategies to keep transmission low. Recent emergence of the SARS-CoV-2 delta variant, however, warrants cautious interpretation of these results and highlights the need for ongoing studies of mitigation strategy effectiveness for this evolving pathogen.

In June 2021, the researchers expanded this weekly COVID-19 screening study for staff and students to the Kennedy Krieger Institute schools in Baltimore, Maryland, which similarly serve K-12 students with IDD throughout the Maryland and DC area.