Background: A growing body of evidence attests to the disproportionate impact of COVID-19 on persons with intellectual and developmental disabilities (IDD) during the pandemic. This study asked caregivers about their perceptions of how COVID-19 impacted them and the people they support. Method: An online survey was conducted in 12 countries during August-September 2020 and sought information on demographics, support practices, information and training, experiences of COVID-19, social distancing, and wellbeing, as measured by the DASS12. This study reports on 3,754 family members, direct support professionals, and managers who participated in the survey. Results: Caregivers observed increases in depression/anxiety, stereotyped behaviours, aggression towards others and weight gain in the person(s) they supported. They also reported difficulties supporting the person(s) to access healthcare. Families reported reducing or ceasing employment and absorbed additional costs when supporting their family member. Direct support professionals experienced changes in staff shifts, staff absences, increased workload and hiring of casual staff. Caregivers' wellbeing revealed high levels of stress, depression, and less so anxiety. The strongest predictor of wellbeing among families was observation of changes in mood in the person(s) they supported, while for direct support professionals, the strongest predictors of wellbeing were reorganisation of staff shifts and increases in new direct support staff. Discussion: Findings support the contention of this population experiencing a disproportionate burden during the COVID-19 pandemic, reflecting historical inequities in access to healthcare and other human rights violations which are now protected under the United Nations Convention on the Rights of Persons with Disabilities.

ANFFAS Trentino Onlus DAD© project group Trento Trentino 38121 Italy

Business Information Systems O'Rahilly Building University College Cork Cork Ireland

Canadian Institute for Inclusion and Citizenship University of British Columbia 2080 West Mall Vancouver BC Canada V6T 1Z2 Canada

Centre for Disability Studies Sydney Medical School Faculty of Medicine and Health University of Sydney Sydney Camperdown NSW 2050 Australia

Department of Education University of West Bohemia Plzeň 3 301 00 Czech Republic

Department of Psychology University of Almeria La Canada de San Urbano Almeria 04120 Spain

Department of Social Sciences Ersta Sköndal Bräcke University Sköndal Sweden

Department of Social Work Norwegian University of Science and Technology Trondheim Norway

Department of Social Work The Chinese University of Hong Kong Shatin New Territories Hong Kong China

Department of Special Education Charles University Praha 1 116 39 Czech Republic

Human Services Research Institute 2336 Massachusetts Ave Cambridge MA MA 02140 USA

Inclusive Education at Faculty of Health Education and Society University of Northampton Northampton UK

Living with Disability Research Centre School of Allied Health Human Services and Sport La Trobe University Bundoora Vic 3086 Australia

School of Health and Welfare Halmstad University Halmstad Sweden

School of Humanities and Social Sciences Department of Social Work and Sociology University of Zambia Great East Road Campus P O Box 32379 Lusaka 10101 Zambia

School of Nursing and Midwifery Queen's University Belfast BT9 7BL UK

School of Psychology Maynooth University Maynooth Ireland

Tizard Centre Univesity of Kent Canterbury Kent CT2 7NZ UK

UCD Centre for Disability Studies University College Dublin Belfield Dublin 4 Ireland

UCD School of Nursing Midwifery and Health Systems University College Dublin Belfield Dublin 4 Ireland

UCD School of Psychology University College Dublin Belfield Dublin Ireland

University of Humanistic Studies Kromme Nieuwegracht 29 Utrecht 3512 HD The Netherlands

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