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The Hidden Effects of the COVID-19 Pandemic on Children
by Viren D’Sa, MD, director of developmental behavioral pediatrics at Rhode Island Hospital and its Hasbro Children’s Hospital, and associate professor of pediatrics at The Warren Alpert Medical School of Brown University
The COVID-19 pandemic has taken an undue toll on everyone from all walks of life and across generations. While we’ve heard a lot about the direct medical and health-related effects of the virus on both previously healthy and those considered medically fragile, the hidden effects of the pandemic are slowly emerging as we return to some semblance of normal life. This is particularly true in pediatrics, where children have been generally spared the most severe medical effects of the SARS-CoV-2 virus but have suffered through the direct and indirect effects of changes brought about by the pandemic.
School-age children are presenting with difficulties that range from inattention to delays in their learning that have come to light or have widened over the course of the past two years.
When the pandemic started, there was a necessary but sudden pivot from in-person interactions at schools, daycares, social settings, and healthcare clinics to remote/distant instruction and interaction. This changed the mode of delivery of academic instruction as well as healthcare and therapeutic services such as well-child visits, Early Intervention services, and additional programs. Healthcare facilities, clinics, schools, and other childcare entities made efforts to provide services through remote learning modes such as telehealth and distance learning. Over the course of the past two years, and now more recently as we come out of the worst of the pandemic, the previously hidden impact is more apparent.
As schools return to in-person learning this academic year, school-age children are presenting with difficulties that range from inattention to delays in their learning that have come to light or have widened over the course of the past two years. The inattention and distractibility (attention deficit hyperactivity disorder or ADHD-like symptoms) appears to be most apparent in those children who might have tested positive for the virus but is also noted in children who are having a harder time returning to conventional academic demands. Whether this is possibly related to the “brain fog” due to COVID that many have described, or a predisposition to ADHD that has come to light during this time, remains to be seen and studied.
Similarly, learning gaps have been hard to adequately bridge during this time and schools continue to have a challenge on their hands addressing and mitigating learning delays in the pace of academic progress as children have returned to schools. State-administered standardized test scores in Rhode Island and other states reflect this trend with scores in reading and math, for example, either staying unchanged or declining.
In addition to their learning and academic needs, children thrive on social interactions that are integral to their healthy social and emotional development. The pandemic has caused a shift in the natural pattern of interaction by children and their families for reasons that were required to minimize the spread of a virus and infection of which we knew little and that was taking a disproportionate toll on the lives of the medically fragile and vulnerable. Financial and food insecurity, experienced by many during the pandemic provided added stress on families. All this contributed to an escalation in the frequency and severity of mental health disorders, reaching a crisis point in several parts of the country, including here in Rhode Island.
It is never too late to get connected to therapeutic resources tailored to the developmental and behavioral needs of the growing child.
While school-age children have dealt with the difficulties discussed above, we have also heard of the experiences of families with young children who have delayed their much-needed screening and evaluations for developmental and behavioral difficulties, such as speech and language delays, delays in social-emotional development including autism spectrum disorder, and other behavioral disorders. Typically, children would be assessed by their pediatricians and referred to agencies such as Early Intervention and their well-qualified therapists. For families that have any concerns or doubts about their child’s developmental progress, we urge them to have a conversation with their pediatrician or primary care practitioner. It is never too late to get connected to therapeutic resources tailored to the developmental and behavioral needs of the growing child.
The team of specialists in developmental behavioral pediatrics at the Children’s Neurodevelopment Center (CNDC) at Hasbro Children’s Hospital is committed to working with children, their families, and their schools in addressing these concerns and working towards effective management plans.
Clinical assessments could include evaluations by a developmental behavioral pediatrician, clinical psychologist, social worker, or family service coordinator through the Lifespan Three Cedar program. In addition, clinicians at the CNDC work closely with colleagues in speech and language pathology, occupational therapy, and physical therapy to provide comprehensive services in those areas when necessary.
Informing our approaches to clinical care and exploring the yet-to-be-determined short, intermediate, and long-term outcomes of COVID, we also have on-going research conducted through the Advanced Baby Imaging Lab, studying the impact of COVID on the developing brain throughout childhood and into early adulthood.