Three months is a long time for children to be out of the classroom, devoid of interaction with their ‘agemates’. IB World Magazine investigates the possible damaging long-term mental health effects of this.
As schools emerge from months of lockdown due to COVID-19 (Coronavirus) and attempt to establish a ‘new normal’, social distancing is being advised to continue by the World Health Organization (WHO) and is being enforced by local authorities all over the world with no end date in sight. In less daunting precautions, many schools that have reopened are encouraging social distancing by reducing class size groups, introducing small social bubbles and eliminating the use of shared toys and stationery in the classroom.
But, as we navigate our way through a post-lockdown world, mental health experts are questioning how detrimental quarantine was and what the negative impact of prolonged social distancing could be. When considering the long-term fallout of the outbreak, many experts are most concerned about the impact it will have on children.
Depression and anxiety
Approximately one in five children in the Chinese cities of Wuhan and Huangshi reported symptoms of depression and anxiety in the month following school closures, according to a study in JAMA Pediatrics. Additional research is needed to see if these symptoms remit or persist long-term.
Another study found that children and adolescents are, “likely to experience high rates of depression and anxiety long after current lockdown and social isolation ends”, according to the University of Bath, in the UK. As a result, it predicts that there could be a spike in demand for mental health services in the years to come, and the impact of loneliness on mental health could last for at least nine years.
Helen Dodd, professor of child psychology at the University of Reading, in the UK, says: “Some children and young people may need support to cope with COVID-19 related grief, trauma and anxiety. The type of mental health concerns will likely vary depending on the age of the child or adolescent. For example, young children are more likely to have difficulties around separation, and adolescents may have more difficulties with social anxiety or low mood”.
She says: “There is evidence that it’s the duration of loneliness, as opposed to the intensity, which seems to have the biggest impact on depression rates in young people. This means that returning to some degree of normality as soon as possible is, of course, important. However, how this process is managed matters when it comes to shaping young people’s feelings and experiences about this period”.
For teachers and policymakers preparing for a phased restart of schools, Dr Maria Loades, clinical psychologist from the Department of Psychology at the University of Bath, who led the work, suggests the research could have important implications for how this process is managed too.
The importance of play
Focusing on primary age children, Dr Loades suggests that schools should prioritize the importance of play to help children reconnect with friends and adjust following an intense period of isolation.
Professor Dodd, who is also one of the mental health experts for the #playfirst campaign—an initiative led by @playfirstuk asking for play to be prioritized by government after lockdown—agrees.
“Only when children are emotionally well can they learn effectively”, she says. “This may mean that formal lessons and academic progress take a back seat for now but in the long term, children’s academic progress will be better if their social and emotional needs are met”.
Professor Dodd adds: “Social distancing is very difficult for children, and could be detrimental to their emotional well-being if it is strictly enforced in a non-compassionate way. Children will benefit from playing with their peers even if it is at a distance (for example, kicking a ball between each other) but ideally play should not be restricted in this way. Small social bubbles of children who are allowed to play together without social distancing would seem to be a good solution to this”.
The role of parents
Parents have had many concerns throughout the lockdown period, as New York City psychologist Dr Andrew Schwehm has found. These include how children will progress to the next grade, or start a new school, as there are worries regarding whether children are getting the adequate amount of knowledge through home-schooling, and how they will adapt back to ‘normal life’.
But it’s important to remember that parents’ concerns and anxieties will influence how children behave, advises Dr Schwehm. “Children are extremely perceptive and can pick up on what’s going on with their parents. They will start to take their cues from their parents and feel that they need to be more cautious”.
“Parents may be concerned that the quarantine and social distancing will negatively affect interaction and social skills, but children are incredibly resilient”, he adds. “They will bounce back really quickly. The ones who have difficulty bouncing back, might be the children who may have had difficulties later down the line so in some ways this pandemic has expedited something that would have happened later, allowing earlier intervention”.
“Parents may be concerned that the quarantine and social distancing will negatively affect interaction and social skills, but children are incredibly resilient”,
Now is a time, more than ever, to communicate with children. Parents can be instrumental in reducing their child’s distress and increasing their resilience in the face of the current crisis.
“Be patient, listen to your child and try to understand what they are going through”, says Dr Schwehm. “Encourage them to talk to you about the difficulties that they are experiencing. The more you are able to hear what they are going through, the easier it is for you to normalize that for them and help explain why this is happening, why things are changing, and to help them move forward as things change back”.
Dr Olga Jablonka, a licensed clinical child psychologist practicing in New York City, adds: “Parents can help their children cope with COVID-19 by having conversations to understand their child’s responses to the pandemic, validating their emotions, and teaching them to regulate their emotions. Parents can also encourage safe social connections, limit access to media and re-establish a routine to create a sense of normalcy, safety, and predictability. Lastly, it is critical that parents take care of their own emotions and model healthy coping”.
“Play with peers is unique and essential to children’s development and it has been restricted for a long period. So, schools and parents should support and encourage children and young people to re-engage with their peers as soon as possible”,
Prevent avoidance, suggests Professor Dodd, because the longer a child can avoid something they find anxiety-provoking, the greater that anxiety will become.
“If a child is anxious about separating from parents, start having some separation as soon as it is feasible, even if it is only for short periods at first”, says Professor Dodd.