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

Children, young people and families – wider evidence

Sussex University published a short document in early May by a panel of mental health experts about the importance of play for children aged 3-11 and why it should be prioritised as lockdown measures are eased.  Some of the key points are:

• Loneliness and social isolation adversely affect children's short- and long-term mental health. Importantly, the duration of loneliness, rather than its intensity, is most strongly related to poor outcomes.
• Children across the UK currently have a play deficit because they are deprived of the chance to play with peers. Play with peers is critically important for children's social, cognitive and literacy development.
• Play has other benefits for children's holistic development and emotional wellbeing. Outdoor play, in particular, is linked to increased physical health as well as social and emotional health. Play is beneficial during times of anxiety, stress and adversity.
• In highly stressful situations (e.g. war zones, in hospital, in orphanages) research shows that playing with other children is therapeutic.

There is currently very little historic evidence on the impact of disease  containment measures on the wellbeing of children and young people.  A pre-release briefing from the University of Strathclyde's (Inspiring Children's Futures) "Learning from past and present epidemics: Informing better policy and practices that promote children's wellbeing" project reported that:

• Previous epidemics indicate that existing child wellbeing concerns are exacerbated and new ones emerge.
• New or exacerbated experiences of poverty and low income can affect access to services, nutritious food, adequate housing, and risks children's survival and development.
• Emergency measures to restrict movement impact on everyday childhood experiences: on children's friendships, their access to play and education, and to their birth families for those in alternative care, as well as on their autonomy.
• These measures also create new vulnerabilities, as well as increasing the number of vulnerable children, especially those who were not seen as at risk in the pre-epidemic period - leading to online exploitation, sexual exploitation, domestic abuse, neglect and challenges to children's mental health.
• Children's vulnerabilities are compounded by the impact on parenting, due to isolation and a lack of external support.
• Children can be physically and socially invisible.  It is important to develop responses tailored to children and young people, and their distinct experiences.  Ensuring young people are included and their agency recognised helps them support emergency measures.

Other research has shown that pandemic disease-containment responses may be traumatic for some children and families.  One American study^[i] of families who had experienced quarantine or isolation during the H1N1 pandemic found that the experience can be traumatizing to a significant proportion of children and parents.  The 2009 study which involved 586 parents (mostly female) found that almost a third of children (30%) and a quarter (25%) of parents who had experienced isolation or quarantine met the criteria for PTSD (based on parent and self-reports). Key factors that influenced parental PTSD scores were social-distancing measures (being isolated or quarantined), gender (women reported significantly higher rates of PTSD) and age (younger parents had higher rates of post-traumatic stress).  Key factors for child PTSD were parental PTSD (PTSD tended to co-occur in families) and social distancing measures. The study recommended a trauma-informed approach to understanding the impact of pandemics. 

Some messages from disasters literature^[ii] include:

• Children experience the atmosphere of panic and fear as acutely as adults.
• Children experience cumulative vulnerability.
• Poverty increases vulnerability before, during, and after a disaster.
• Children's recovery is influenced by economic, social, and structural factors.
• Displacement is very difficult for children.
• Schools should be prioritised in recovery, as they are important to both children and communities.
• Children can play an active role in recovery and listening to children's voices, and supporting their involvement in recovery activities should be a priority.

A number of rapid evidence reviews are underway in various academic settings.  Future briefings will cover the academic literature more fully.