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Background During the COVID-19 pandemic, children with autism spectrum disorders (ASD) and neurotypical siblings of children with ASD and their parents and caregivers have been required to change their daily schedule. In this study, we focused on siblings of children with ASD to reveal their adjustment to their daily life. In addition, we examined their caregivers’ stress. Methods An online Qualtrics survey was given to caregivers of children with ASD on February, 2021 at Thomas Jefferson University in the United States. First, we assessed the severity of children with ASD. In addition, we examined how their neurotypical siblings adjusted to their daily life using the validated Strength and Difficulties Questionnaire (SDQ). Moreover, we analyzed caregivers’ stress and their socioeconomic status. Results Fifteen caregivers responded to the survey. 42% of children with ASD had behavioral issues beforehand, 80% of which showed worse behaviors during this pandemic. Siblings of children with ASD showed higher scores of difficulties in adapting to new routines during COVID-19. Some caregivers lost their jobs and caregivers of those with behavioral issues reported stress levels that were 4.4 points higher on the scale. Conclusions Siblings of children with ASD and their caregivers are facing difficulties in their daily life during this pandemic. Appropriate support systems for children with ASD, their siblings, and their parents and caregivers may help them with their better adjustment. Key messages Siblings of children with ASD show difficulties in adjusting, and their caregivers feel more stress during COVID-19 pandemic.

1382Adjustment for the Siblings of Children with Autism Spectrum Disorder during COVID-19