Coronavirus (COVID-19): children, young people and families - evidence summary - December 2020

1. General children, young people and parent/carer COVID-19 evidence and research

Listen and Act – 15 Stories – Engaging with the views and experience of families with younger children during the COVID-19 pandemic
Source: Children's Parliament
Date: November 2020

• Children's Parliament was commissioned by the Scottish Government to engage with children aged 3-7 and their parents/carers to seek their views and experiences during the COVID-19 pandemic. This work was designed to gain insight into the lived experience from a broad range of families including those from vulnerable groups. A total of 15 families were involved in this qualitative research which used artwork and online interviews and which took place in September 2020. Key findings are summarised below:
• The reopening of early learning centres (ELC) and schools was identified by all families as the most positive thing to happen since the start of the pandemic. Parents and children are largely happy with the procedures in place to mitigate Covid transmission risks, although there were varying levels of school/ELC communications.
• Parents' biggest concern is further nursery or school closures which they felt would take them and their children back to a period of isolation – from friends, family and learning.
• The closure of parks and play areas in the early months of lockdown, along with closing down organised play and sporting activities, had a profound impact on children. Parents welcomed the increased emphasis on outdoor learning and play since ELCs and schools reopened:
  
  "But we don't have a garden, and the parks were shut for the first while, but we could play in a field. The police were patrolling anyone who stopped to play, and there was a lot of anxiety about the police talking to people. Friends of mine got stopped by them for playing football with their five-year-old, and for sitting on a picnic blanket. Also going out in a public space was quite stressful. Especially where we live, it's so densely populated. People were getting quite angry with children in public." (Marion's story)

• The financial impact of the pandemic was a common theme. The cost of food, the effects of unemployment, lost income and the cost of return to school were all been identified by parents as issues.
• The impact on children's behaviour was also raised, with parents seeking a professional-parent partnership in understanding children's behaviours free of judgement.
• Other key issues raised were the social isolation experienced by lone parents and difficulties experienced by co-parents (i.e. where a child lives in two homes).
• There was a feeling from some families that (statutory) services took too long to adapt and respond during lockdown, whilst community (often third sector) services were quicker to support families in need. The importance of having key workers that parents trust and they know to be authentic in their care and respect was also emphasised.

A website with all 15 stories has been created which displays some of the children's artwork and parent's stories.

How are you doing? A report on the findings from the How are you doing? Survey
Source: Children's Parliament
Date: November 2020

This is the fourth and final report on the How are you doing? online survey series for 8-14 year olds in Scotland. This report compares results from surveys conducted in April (4000 responses), May (3698 responses) and June (2810 responses) to results from the most recent survey in September/October (1969 responses. Whilst it is helpful to make such comparisons, as all the surveys were open to anyone aged 8-14, there will inevitably be variation in the respondents (sample) of each survey which make drawing robust conclusions about change over time problematic. Additionally, as this was an open survey, findings cannot be treated as representative of young people in Scotland. Key findings were:

Signs of recovery

• Emotional wellbeing - Post-lockdown children surveyed were more likely to agree that they generally felt cheerful and in a good mood (64%); the largest increase in positive responses came from the 12 to 14 year olds.
• Loneliness - There were significant improvements when it comes to children reporting that they often feel lonely (from 26% to 20%). This was particularly so for the group of children who had reported highest levels of loneliness during lockdown i.e. girls aged 12 to 14 (from 34% to 20%).
• Friendships - Respondents reported positively about their friends and responses indicate a strengthening of peer relationships in the post-lockdown period which has seen children return to school. Post-lockdown, children pointed to friends as the most likely thing to help them to feel better.
• Family relationships - The vast majority of children who responded enjoyed being with their family (93%) and reported that their family gets along well together. A larger proportion of respondents post-lockdown strongly agreed with this statement.
• Meaningful activities - Post-lockdown children reported that they had more fun things to do in their day, they felt less bored and they were more likely to say that when they do something, they try their hardest.
• Physical health - A majority and consistent percentage of children surveyed indicated – in lockdown and post lockdown – that they thought they made healthy choices, with a shift post-lockdown toward a strongly agree response. Boys of all ages and older girls aged 12 to 14, reported that having returned to school they thought they got enough exercise (but this was not the case for younger girls – see below).

Areas of concern

• Online safety - The move to digital platforms for learning and peer relationships has been accompanied by an increase in the number of respondents reporting that they are less likely to feel safe online (this echoes findings from other research referenced in previous briefings). The biggest increase was seen in girls aged 8-11 (8% reported feeling unsafe online in the most recent survey).
• Family income - Nearly 1 in 3 children (29%) continued to report that their parents or carers worry about having enough money. As time has gone on, younger children reported this concern in increased numbers.
• Anxiety and worry – Overall, rates of worry across a range of topics including school work and 'the future' remained constant and, in the case of child and family health, money problems and exams, increased post- lockdown. Girls aged 12 to 14 consistently reported the highest levels of agreement that 'there are lots of things they worry about in their life', whilst children aged 8 to 11 were more likely to report worrying about multiple areas than in previous surveys.
• Resilience in younger age groups – Despite overall improvements in mood, in terms of children feeling that even if they are having a difficult time they feel they will be okay, there was a decline in positive responses post- lockdown for all children but particularly for older girls and 8 to 11 year olds.
• Access to health information/services - When responding to the statement 'If I have a question about my health I know who to speak to', children were less likely to agree than in previous survey – this was particularly so for 8 to 11 year olds.
• Participation - The survey reported a reduction of 10 percentage points on children responding positively to the statement post lockdown 'I feel like my rights are respected by others'.

Lockdown Lowdown: A survey of young people in Scotland about their 'new normal' lives as lockdown restrictions change
Source: Scottish Youth Parliament/YouthLink/ Young Scot
Date: 7 December 2020

This online survey follows on from the initial Lockdown Lowdown survey which was carried out in April. It ran between 28th September and 2nd November 2020 and received 6,043 responses from young people aged 11-25 across Scotland. As this was an open survey, findings cannot be treated as representative of young people in Scotland. Most survey respondents were aged under 18 and around six in ten were female. Key findings included:

Impact of coronavirus on education

• Around three quarters (76%) of young people in education (including FE/HE) had returned to in-person learning. Of those who had returned, around three quarters were happy with the arrangements for their educational course, over two thirds (67%) agreed that they were happy to be back, and almost two thirds (63%) agreed that their educational establishment had re-opened in a safe way.
• When respondents were asked if they would like anything altered about the current arrangements, the most common suggestions were to enforce or increase safety measures, a preference for in-person and blended learning, and suggestions for altering the structure of the school week. Respondents also mentioned that students were not receiving adequate support.

Impact of coronavirus on relationships

• The majority of respondents agreed that they currently have a good relationship with their family (83%) and friends (84%).
• Impact of coronavirus on their relationships discussed in open questions were around the inability to see friends and family, difficulties with keeping in contact and the negative impact of reduced socialising on mental health.

Impact of coronavirus on employment

• The majority of respondents who were in employment had experienced a change in their employment due to COVID-19. For those in part time employment, the most common impacts were reduced hours (41%); being furloughed (38%) and a change to working conditions (26%). For those in full time employment, the most common impacts were a change in working conditions (54%); being furloughed (38%); and a reduction in hours (22%).
• Substantial percentages of respondents had concerns around their employments. Those in full time employment were slightly more positive, with 60% saying they felt good about their current employment situation, and 43% that they felt good about their future employment prospects. Among those in part time employment, 53% felt good about their current employment situation, and 34% felt good about their future employment prospects.
• When asked if they had any further thoughts on the impact of coronavirus on their relationships, the most common concerns were around future job prospects, employment levels in the UK and competition with adults for jobs. There were also concerns regarding the link between the impact in education and future employment prospects.

Impact of coronavirus on health

• Six in ten respondents felt good about their physical health and wellbeing, but only four in ten felt good about their mental health and wellbeing.
• In terms of concerns around the health impact of COVID-19, 45% were concerned about catching coronavirus, 71% were concerned about a second wave of coronavirus and 64% of respondents were concerned about transmitting coronavirus to others.

Access to information and understanding of restrictions

• When asked about their knowledge of the current coronavirus restrictions, the most common response was 'I know what the rules are in general, but I'm not sure on all the details' (54%). Only 3% stated that they did not know what the current rules were.
• The topics that young people felt most confident in accessing information about were information and updates or advice about the current coronavirus restrictions. The topic that young people felt least confident accessing information about was financial support.
• When asked if there were any topics that respondents would like more information about, the most common requests were information and support for mental health and wellbeing, clear reliable and accessible statistics about the virus itself and information on schools, education and exams.

Lockdown Lowdown: The Voice of Seldom Heard Groups During COVID-19 Pandemic Report
Source: Scottish Youth Parliament/YouthLink/ Young Scot
Date: 7 December 2020

This report presents findings from focus groups with targeted groups of young people that were carried out alongside the Lockdown Lowdown wave 2 survey in October and November 2020. The groups were as follows:

• Young people from Black, Asian, and Minority Ethnic (BME) communities
• Young people with disabilities and additional support needs
• Care experienced young people
• Young people with experience of the criminal justice system
• Young carers

Findings from the cross-cutting themes across all groups are presented below. Findings relating to particular groups are presented in the relevant section of this briefing.

Theme 1 - School, learning and employment

• Most young people in school were glad to be back in education. Some participants said that they had fallen behind less than they expected to, while others felt that many young people had fallen behind during lockdown, including their younger siblings. Access to and familiarity with technology was cited as a key reason for this.
• There was no particular concern raised about not sitting exams, but many participants noted the pressure from increased levels of coursework. This was an issue particularly for young carers. There was also a feeling from some participants that there was a lack of communication and clarity on how the coursework based assessment model worked.
• For young people in further or higher education, experiences of online teaching was mostly negative. The lack of social contact, lack of motivation and uncertainty around how courses with practical elements would work were all mentioned. One young carer found that their increased caring responsibilities were not sufficiently considered.
• Young people who had been in employment had mixed experiences. Some had lost their jobs or been furloughed which was impacting their finances and they felt very uncertain about the availability of job opportunities in the future. However, for one participant the pandemic had a positive impact in terms of voluntary work and influencing government policy. For some young people, the pandemic had provided an opportunity to reassess their future plans, while others felt that their plans were now delayed or impossible.
• Most participants that needed it were provided with a device and data to be able to access their education, although some reported having had to get into debt to buy a laptop and some did not have enough data to be able to access all their learning activities. There was a strong preference for more face-to-face learning if that was possible.

Theme 2 - Relationships and friends

• For many participants, spending more time with their family during lockdown was a positive experience, providing a chance to relax, although at the same time many noted that it was stressful to be in a small space with a number of people trying to work and/or learn, which led to arguments.
• While most participants had been able to stay in touch with their friendship groups during lockdown and while physical distancing restrictions are in place, there was a feeling of social isolation for some, particularly for those with partners they were unable to see. Being unable to celebrate special events like birthdays and Eid in big groups was highlighted as a problem, although for one disabled participant, cultural events such as concerts moving online made them more accessible.

Theme 3 - Space

• Most participants said that they felt they had used outside space more than ever before and increased their physical activity levels, which was perceived as a positive. However, some participants were shielding or family members were shielding, so their experience of outdoor space was limited.
• Sharing indoor space and being around their family all the time had proved difficult as many did not have sufficient space for work or study.

Theme 4 - Perceptions of COVID-19 restrictions

• Participants agreed with social distancing, although found it difficult to comply in schools and when socialising with friends in public. Some reported their friendship groups not adhering to physical distancing. Disabled participants that were hard of hearing or partially sighted found that the 2 metre requirement made it hard for them to hear/see others. However, a participant with autism, found the increased personal space beneficial.
• The majority of participants agreed that face coverings should be worn in public and participants did not feel that wearing face coverings had a negative impact on them. The only concern around face coverings raised was from a young carer, who felt that others were not wearing face coverings when required or not wearing them correctly, making them feel unsafe due to the impact that this might have on their family.
• Young people were appreciative of mitigation measures taken in educational establishments. Young people that had an exemption from face coverings found that this was managed well through lanyards, although one participant had witnessed an incident where an individual with an exemption lanyard was stigmatised by another passenger on public transport.
• One place where many young people felt that mitigation measures and physical distancing was not adequately enforced was public transport.

Theme 5 - Social media

• Young people found social media useful for staying in touch with their friends and found that it helped reduce or remove social isolation or loneliness. However, for some social media was not a sufficient substitute for face-to-face contact, and felt that messaging had made their relationships less close. This was particularly the case for some young people with mental health issues or disabilities that make it difficult for them to read tone in messages. For some disabled participants, having to learn how to use assistive technology was a barrier.
• There was a high level of recognition of the widespread misinformation circulating on social media. Some participants felt they had spent too much time on their phone and that this had increased their existing mental health concerns.

Theme 6 – Mental health, wellbeing, support

• For many young people, the lockdown and current restrictions has made existing mental health concerns more pronounced, due to lack of time with friends and increased social media use, as noted above. Some disabled young people felt that new technologies others were using to keep in touch were not always accessible to them, increasing anxiety, stress and feelings of isolation.
• Spending time outdoors and with family and on hobbies were seen as factors that helped improve young people's mental health. One participant felt that their body image improved in the context of the pandemic and another felt more able to express their non-binary identity.
• Young people appreciated the support they were receiving from teachers and third sector organisations. Care experienced young people found the increased continuity in their support team during lockdown beneficial. Some participants in higher and further education and participants with mental health issues did not feel that they were given sufficient individualised support, and found a general lack of timely services. Some also struggled with online modes of delivery and would prefer face-to-face contact.

Theme 7 – Information

• The majority of participants said that they received information directly from the Scottish Government briefings or the BBC news website. Some participants mentioned getting information from social media, however, understood the risks that this information might not always be accurate. Others received information from family members. Participants from BME communities highlighted the lack of information in community languages, and some disabled participants said that more could be done to reach those that couldn't watch the daily briefings.

COVID-19 Early Years Resilience and Impact Survey (CEYRIS) Report 4 – full findings
Source: Public Health Scotland (PHS)
Date: 23 December 2020

PHS published three short topline reports in September which summarised the findings of their COVID-19 survey for parents of children aged 2-7 (see our October briefing for details). This report provides the full analysis of the data, including analysis by socio-demographic variables, including income, household structure, disability and parental mental health. The survey which ran from 22 Jun to 6 July received approximately 11,000 responses. The sample was self-selected and can therefore not be seen as nationally representative.

Key findings

• Children in affluent households were more likely to be doing well psychologically and behaviourally during lockdown than children in less well-off households. Children in the higher-income group were also more likely to sleep through the night, participate in home learning activities and be physically active. Although deterioration was identified across all income groups in terms of children's behaviour and life, the extent of the decline was worse for children in low-income households in all areas except physical activity.
• Parents in low-income households who wanted access to health visitor or GP services were less likely to have successfully accessed it compared with parents in high-income households. However, for services such as family support worker, nursery staff/childminder, school staff and voluntary/community organisations, the opposite was true.
• Children in two-adult households scored better on SDQ total difficulties scale (a measure of wellbeing) than children in single-adult households, although the difference was not as large as the difference by income. Children in single-parent households experienced a bigger decline in behaviour, sleep, concentration and eating than those from two-adult households, were less likely to participate in home learning activities and less likely to be physically active. However, children in single-adult households spoke to family and friends more frequently.
• A greater proportion of parents in single-adult households were unable to access the health visitor service when they needed it during lockdown. On the other hand, a greater proportion in two-adult households were unable to access a family support worker or nursery staff/childminder.
• The pattern for large families compared to smaller ones was more mixed. Children in large families had worse outcomes on some measures, but better on others.
• Children with a long-term health condition were less likely to receive a score of 'close to average' on SDQ, sleep through the night and to be able to concentrate. The decline during lockdown in relation to children's behaviour and life was more severe for children with a long-term health condition than those without.
• Children of parents with a long-term physical or mental health condition did less well than other children in relation to psychological wellbeing and behaviour during lockdown. They were also less likely to sleep through the night, and maintain normal eating behaviour. In all areas of child behaviour that were asked about in CEYRIS, the decline was worse for children whose parent has a long-term health condition than those without.
• Parents living with a long-term condition were more likely to want to access services during lockdown. However, in half of the services asked about, a smaller proportion of these parents managed to gain access to the services when compared with other parents.
• There is a clear association between how well children were doing emotionally and how well parents were doing emotionally during the lockdown period. For all child behaviours/areas of life asked about in the survey, there was a much bigger decline for children whose parents had low mental health and wellbeing at the same time. Parents who experienced a reduction in income during lockdown were more likely to have experienced poor mental health and wellbeing during the same period.

Public Health Scotland is running a second follow-up survey for parents of children aged 2-7. This went live on 23rd Nov and is expected to report early next year.

Evidence Review: The Socio-Economic Impact of COVID-19 on Children in Scotland
Source: Data for Children Collaborative with UNICEF
Date: November 2020

This international evidence review considers the socio-economic impact of COVID-19 on children (dependent children under 18) during the first six months of the pandemic (Mar-Sep). It takes a broad approach to defining 'socio-economic' disadvantage including income, health, wellbeing and educational attainment. The review considered evidence from a range of sources including grey literature and did not apply predetermined quality criteria. The report covers four themes: restrictions on non-essential jobs and services; closure of education and childcare facilities; and adverse childhood experiences. The report notes that many of the adverse socio-economic impacts may take years to manifest and that this will be an important area of research for many years to come (with a detailed list of evidence gaps provided in the Annex).

Key findings:

Restrictions on non-essential jobs and services

• The Coronavirus recession is likely to be severe with a slow recovery expected. The number of jobs expected to be lost is high. This is likely to have an impact on the level of child poverty which is known to have a wide range of harmful effects. Some families are likely to be particularly affected, including those on precarious contracts, those ineligible for support due to employment status and parents (particularly mothers).
• The impact on career prospects will likely be most keenly felt by young people, particularly during this recession which has impacted on many sectors that young people start their careers in.
• The reduction in household expenditure for some families is resulting in material deprivation which can have long lasting impacts on children's development, including on their health and educational attainment. Shorter term impacts might include increased risk of eviction, loss of savings and impacts on mental health and disrupted family life.
• Some groups of children have faced specific challenges and have ongoing support needs that may have been reduced due to the lockdown. Groups such as disabled children, those with additional support needs, young carers, care experienced young people and those in contact with youth justice services have faced particular challenges.

Closure of education and childcare facilities

• The loss of learning could have long-term impacts on educational attainment and potential future income. It is likely that this will widen the attainment gap even further. Although schools have now returned in Scotland, there is likely to remain disruption for the foreseeable future, for example if children need to self-isolate. It will be some time before we know the extent to which this has affected learning.
• Schools and childcare settings are crucial for children's development of social skills, discipline and self-motivation. Development of these skills are known to have long-term impacts on educational attainment, employment and health outcomes. The extent to which children were able to develop these skills at home during lockdown will vary (depending on whether parents had time to spend with children, the home environment and digital access). This is likely to negatively impact on children who are already disadvantaged in other respects, such as those growing up in poverty.

Home isolation

• Concerns are raised in the report about the impact on physical health and in particular reduced physical activities and – for low income families – poorer diets. That said, the report notes that some studies have reported improvements in activity levels and diet. Studies have suggested there may be urban/rural differences in behaviour as well as variation depending on size and income of household.
• A range of experiences which could have a negative impact on some children's mental health are described, including adverse experiences that the pandemic may have triggered (e.g. bereavement), infection fear and anxiety, isolation, time spent away from friends, loss of leisure activities, the change to routines and uncertainty over the future. The stressors associated with low income can also contribute to poor mental health which we know are a key feature of this pandemic. Whilst most studies indicate an increase in mental health issues in children due to lockdown, some studies report positive findings, for example due to more time being spent with parents and relief from the absence of stressors such as bullying at school.
• Quality of housing impacts on children's physical and mental health. Evidence tells us that children growing up in poor quality housing have a higher risk of severe ill-health and disability, slow growth, as well as lower educational attainment and this is particularly the case for children that experience homelessness. For those already living in crowded and unsafe conditions, the impact on health is likely to have been exacerbated by the lockdown restrictions. Evidence has also pointed to increased exposure to the virus due to poor quality housing, in particular where there is overcrowding.

Adverse childhood experiences

• The report considers evidence on the increased risk of adverse childhood experiences during lockdown. There is evidence that the pandemic has increased the likelihood of ACEs occurring (e.g. loss of a parent to the virus, domestic abuse, child neglect, household substance/alcohol use, online sexual exploitation), and reduced the opportunities to mitigate ACEs by timely intervention.
• There is some evidence on the increased risk of 'complicated grief' – where people are unable to grieve normally – and that some of the characteristics of the pandemic (e.g. not being able to say goodbye to a loved one) are risk factors for this type of grief.

The impact of COVID-19 on children and young people in Scotland: 2 to 4 year olds
Source: Public Health Scotland
Date: 25 November

This report is one of a planned series of papers by Public Health Scotland that will consider the possible positive and adverse consequences of COVID-19 on children and young people's development and wellbeing at different ages and stages of their lives. This report focuses on children aged 2 to 4 years and pulls together previously published information. It does not contain any new research.

The report concludes that COVID-19 and in particular the infection control measures, including lockdown, have had a profound impact on 2–4 year old children in Scotland. This age group sees rapid development and it is important that children are able to develop fully at each stage if they are to reach their full potential later.

The following key impacts were identified in the report:

• Access to services - A significant minority of parents found it difficult to access children's services during the pandemic. However, 70% of parents had indicated that they would have liked help with their children's response to COVID-19 during 'lockdown'. While some services were maintained, especially immunisation, other services were more limited, in particular child health reviews by health visitors, access to dental services and lower use of emergency services. As need was unlikely to have dropped this suggests children were not always receiving the care they needed.
• Service delivery - While some services were maintained, especially immunisation, other services were more limited, in particular child health reviews by health visitors, access to dental services and lower use of emergency services. As need was unlikely to have dropped this suggests children were not always receiving the care they needed.
• Development and wellbeing - Strengths and Difficulties Questionnaire (SDQ) scores for this age group showed a large decrease in those children scoring 'close to average' compared to a similar cohort of children assessed in 2019, showing that a substantial proportion of children were suffering from mental health and wellbeing difficulties during 'lockdown'.
• Learning experiences - At this age it is important children have the opportunity to mix with other children. This was severely curtailed during lockdown. In addition, not all children were able to access good quality outside space easily, and this was associated with household income, so active play was also curtailed for some children. However, parents saw an increase in their children's imaginative play. Children's play began to reflect their experience of COVID-19 factors such as isolation, curtailment of access to services and even death being apparent in their imaginative play.
• Social development - Many families saw a reduction in their income and parents often exhibited a high level of stress which would have affected the children.
• Physical development - Children had largely remained active in lockdown, although quality of sleep for many children had deteriorated.
• Family environment - Parents felt that lockdown had enabled them to maintain good relationships with their children except for a small minority who felt their relationship with their child had worsened.
• Physical development - Children had largely remained active in lockdown although quality of sleep for many children had deteriorated.