Tuesday, January 18, 2022

More Behavioral Issues Reported in Children When School Is Virtual

The behavior of children forced to switch learning formats during the pandemic was worse when their learning was remote, according to surveys of their parents. The findings were published in JAMA Pediatrics.

“The COVID-19 pandemic has interrupted the education of more than 1 billion children worldwide, with many experiencing shifts between remote, hybrid, and in-person learning,” wrote Emily C. Hanno, Ph.D., of Harvard University and colleagues. To assess the impact of these changes on youth’s behavior, the researchers asked 405 parents of children (average age 7.5 years) who were participating in the broader Early Learning Study at Harvard to complete four online surveys between January 4, 2021, and May 23, 2021.

For each survey, parents were asked to indicate their child’s current learning format (for example, in person, remote, or hybrid). They also were asked to report on their child’s behavioral health using the following three measures:

  • General behavioral health: Parents were asked to rate their child’s behavior in the past month on a five-point scale, ranging from “much worse than usual” to “much better than usual.”
  • Emergence of maladaptive behaviors: Parents were asked to indicate if they had witnessed maladaptive behaviors, such as more aggression and/or tantrums, in the past month.
  • Frequency of dysregulated behaviors: Parents were asked how often they had seen 11 dysregulated behaviors, such as difficulty switching activities or limited attention, in their child in the past month.

Of 405 parents included in the analysis, 348 (85.9%) reported on 356 children’s behaviors in at least one of the four surveys. Nearly 60% of the children switched learning formats at least once during the nearly five-month period. “Parents reported that when learning remotely, their child exhibited worse general behavior, more maladaptive behavioral changes, and more dysregulated behaviors than when learning in person,” the authors wrote. Children experiencing hybrid learning exhibited better general behavior than when remote, but worse behavior than when in person, they added.

“[O]ur analyses … did not account for all time-varying factors that might explain children’s learning format and parents’ perception of their well-being at any given time,” Hanno and colleagues wrote. “Therefore, [the] results should not be interpreted to mean that remote learning caused worse behavioral health; rather, the results illustrate that parents perceived their children’s behaviors as having shifted systematically through the COVID-19 pandemic’s educational interruptions.”

Also appearing in JAMA Pediatrics is a review of 36 studies from 11 countries revealing that school closures and social lockdown during the first COVID-19 wave were associated with adverse mental health symptoms (such as distress and anxiety) and health behaviors (such as higher screen time and lower physical activity) among children and adolescents.

“The toll of school closures and social isolation on children’s mental health cannot be overstated and will require both immediate- and long-term investigation and action to fully assess and address the impact,” wrote Danielle G. Dooley, M.D., M.Phil., of Children’s National Hospital and colleagues in an accompanying editorial.

For related information, see the Psychiatric News article “Building Resilience in Our Children for the Aftereffects of COVID-19.”

(Image: iStock/onebluelight)

Webinar on No Surprises Act Addresses What Law Means to You

Register to join the AMA webinar “Implementing the No Surprises Act” on Thursday, January 20, at 1 p.m. ET. The law, now in effect, protects patients from the financial impact of surprise medical billing. Learn what you need to do immediately to comply with the law. Experts will also address enforcement challenges and the interaction between state and federal surprise billing requirements. The moderator is Bobby Mukkamala, M.D., chair of the AMA Board of Trustees.


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