As
a practicing early intervention occupational therapist in a child and adult
mental health clinic(CAMHS) clinic and personally as father to a toddler son
born a few months before the Covid-19 pandemic and the subsequent lockdown, I
have had interesting conversations with parents regarding the effects of the
above on their children and if there were any associations between the
pandemic(and lockdown) with the presenting difficulties their children were
facing.
These
discussions have ranged from parents wanting to know whether the pandemic (and
subsequent lockdown) was the cause of the difficulties their children were facing
or whether the severity of the difficulties would have been minimal if the
pandemic did not occur. Some parents have made enquiries on whether there are
ongoing effects of the Covid-19 pandemic their children might be facing or
whether the effects would be long term.
On
a personal level as father to a toddler son who could safely be assumed to be one of the many “Covid babies”
who was born a few months before the pandemic and spent much of their infancy
in home confinement due to the lockdown, I have occasionally found myself in
thought whether although my son who is typical developing, would he have been
more socio emotionally developed if he had spent his first year of life
differently(minus the pandemic and lockdown).
Such
questions are what motivated me to dig deeper into literature/research
pertaining to the long-term effects of the Covid-19 pandemic and mental health
consequences in children.Below are my top five findings relating to the above.
Research
shows that The Covid-19 pandemic Influenced children's social development
differently across all ages, but the effects were larger in perceived closeness
rather than social behavior.
During
the pandemic children’s face to face interactions with others in social
settings were limited which affected social relationships. This deprived children’s
opportunities to interact with peers.
In
clinical settings children's social behavior in everyday context is assessed by
Strengths and Difficulties Questionnaire (SDQ) which includes components of
peer problems and prosocial behavior.
SDQ
has enabled researchers to investigate the impact of Covid-19 pandemic on
children's social relationships through online surveys e.g., a UK study
reported increased children's socioemotional problems during the pandemic
compared to pre-covid. This is due to the strict national lockdown in England;
whereas in Japan which had less intense lockdown research showed increased
prosocial behaviors in children during the same period.
Other
studies have used the IOS Measure (measure to assess the level of overlap in
boundaries between oneself to another) to measure children's perceived
closeness/proximity to others. It is possible to assume that school closures
significantly affected the way children perceived closeness to others.
Using
the IOS measures, elementary school children's perceived proximity to parents
significantly decreased during and after school closure, while to others such
as peers it increased.
In
infants and preschoolers social quarantine would not have affected this age
group of children's social relationships with others since parents are the
dominant others during these periods of interaction. But for Elementary
schoolers whose dominance of association with parents has weakened while with
peers it has strengthened, research has shown that the pandemic(lockdown)
significantly influenced the way children perceived closeness to others.
Studies
have also shown that there were no significant changes in infants and
preschoolers perceived closeness to both parents and others unlike in school
age children. Social quarantine less impacted these age group of children
social relationships because for younger children unless there were
circumstances that significantly altered the ways of parent-child relationships
(e.g., parent-child permanent separation), perceived proximity remained strong
even with lockdown related home confinement.
Younger
children's perception would be that perceived proximity required the same (parent/child
interactions), unless unusual circumstances where family co-existence was
challenged.
In
middle school where peer relationships are intimately formed, the quarantine
psychologically distanced children from others, thereby this age group of
children's perceived proximity to others negatively influenced their social
development and wellbeing.
Quarantine
was not related to children's social behavior for all age groups in most
research because although school closure influenced children's social
relationships, it was not severe enough to change children's behavior towards
others.
Parents
may have also felt strong stress under lockdown which led to negative children’s
social behaviors. Parents' mental health problems could have affected
children's mental health during the pandemic.
Other
studies have also shown that Covid related variables which include home school experience,
child perceived family stress and instability, screen time use, missing friends
and worry about virus infection were associated with children's emotional,
physical, and cognitive and worry reactions. With family stress and instability
having the strongest effect.
Older
children were more negatively impacted i.e., reported higher levels of
reactions with home schooling and social isolation under Covid-19.
Apart
from academic learning, schools are also areas for development, socialization/connecting
with friends/peers and emotional support from teachers. School closures due to
Covid-19 led to academic learning loss and multiple health risk behaviors.
Studies
show that social isolation during the pandemic caused loneliness, negative
effects on mental health and other health related behaviors in children and
adolescents e.g., elevated depression and anxiety. Also, loneliness and mental
health problems in adolescents were majorly due to social media use and lack of
physical contact with friends.
Family
consequences of the pandemic included changes in the division of labor and
daily routines in families, family disruptions affecting family routines,
rituals and rules, changes in rituals including religious or cultural celebrations.
These disruptions led to increased household tensions and increased
interparental conflicts.
Family
stress and instability are more strongly linked with emotional reactions in
older children.For
older children, support from friends is more important and that meant that they
were more severely affected by the changes than younger children.
Other
research while focusing on children tried to shift focus from psychopathology
and mental health difficulties to normal range of reactions with Fewer reported
emotional reactions but more physical and cognitive reactions in children i.e.,
coped better emotionally but poorly in sleep and concentration.
Research
also indicates that increased Screen time/social media use, but not online
gaming led to loneliness and symptoms of anxiety and depression in older
children and adolescents. Home schooling gave children more control over their
day but required an important level of discipline and motivation to succeed.
Missing friends was also linked to higher levels of emotional reactions because
children need emotional support from friends and absence of usual contact at
school heightened emotional reactions.
Worrying
about the virus infection led to more emotional and worrying reactions. This
worry was linked to a wider range of emotional reactions in children.
Some
research has also demonstrated the positive attributes to the pandemic which
include lockdown measures reducing many daily
stressors for some children and families, children’s wellbeing might have
improved under covid-19 because of increased parental attention and support
than usual, and families spent more time together. Another reported positive
attribute was that children got a break from school related worries and
pressures.
In
summary it is a fact that characteristics of quarantine differed across
countries (e.g., strict lockdown or activity restrictions in the form of self-restraint
rather than a lockdown) so results of one study in a particular region/country
may not be generalized to children in different situations elsewhere.
It is
however my hope that my literature review can help provide some clarity to
parents regarding the topic which most of us would rather wish to forget
(covid- 19 pandemic and the impact it had /continues to have on our children).
Which of the above findings can you relate with and why?
References:
Hiromichi
et al, (2022) COVID‑19 school and kindergarten closure relate to
children’s social relationships: a longitudinal study in Japan; Scientific Reports
12:814
https://doi.org/10.1038/s41598-022-04944-2
Larsen
et al, (2021) The impact of school closure and social isolation on
children in vulnerable families during COVID‑19: a focus on children’s
reactions
European
Child & Adolescent Psychiatry (2022) 31:1231–1241
https://doi.org/10.1007/s00787-021-01758-x
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