School-Age Children's Wellbeing and School-Related Needs During the COVID-19 Pandemic

Well-Being of Children and Families in COVID-19 Hotspots in Chicago

BACKGROUND

Families in high-risk communities for COVID-19 transmission experienced a disproportionate burden during the pandemic. This study assessed these families' needs, changes in children's well-being, and perceptions related to the pandemic.

METHODS

Four online surveys were administered January 2021 to September 2021 to parents of students, enrolled in parochial, kindergarten-eighth grade schools in Chicago neighborhoods with higher COVID-19 incidence rates by ZIP code, compared to the city average, and higher resource need.

RESULTS

The response rate was 69.1% (n = 186 of 269) in the baseline survey; and other surveys were at 1 (n = 151), 3 (n = 145), and 5 months (n = 154). Of the sample, 83% of parents identified as Hispanic/Latinx with a mean age of 38.3 years (SD: 8.5). Approximately a quarter of parents reported difficulty paying cable and internet bills (26%) and paying utilities (25%). Parents reported children as happy (94% and 95%, p = .59) and hopeful (96% and 95%, p = .74) at 1-month (February to May 2021) and 5-month surveys (June to September 2021). Parents also reported fewer children were irritable (29% vs 19%, p = .03), felt lonely (17% vs 10%, p = .03), and felt isolated (28% vs 9%, p < .001) between those survey waves. The majority (67%) of parents felt that their child had no difficulty wearing a mask in public.

CONCLUSIONS

In this longitudinal study, Chicago parents rated children's well-being highly and reported a decrease in negative emotions over time. The areas of need identified may be particularly relevant for outreach and providing resources to Hispanic/Latino families in future emergencies or global health threats.

Social factors associated with self-reported changes in mental health symptoms among youth in the COVID-19 pandemic: a cross-sectional survey

BACKGROUND

Children and youth experienced marked impacts on day-to-day life in the COVID-19 pandemic that were associated with poorer familial and friend relationships, and greater mental health challenges. Few studies provide self-report data on mental health symptoms from children and youth themselves. We sought to examine the associations between social factors and child and youth self-reported symptoms of worsened mood, anxiety, and irritability during the COVID-19 pandemic.

METHODS

A nationally representative cross-sectional survey was administered online to collect self-report data across 10 Canadian provinces among children (11-14 years) and youth (15-18 years), April-May 2022. Age-appropriate questions were based on The Partnership for Maternal, Newborn & Child Health and the World Health Organization of the United Nations H6 + Technical Working Group on Adolescent Health and Well-Being consensus framework and the Coronavirus Health and Impact Survey. Associations between a priori defined social factors (e.g., relationship quality) and respondent self-reported mental health were evaluated using ordinal logistic regression models adjusted for age, sex, and geographic location.

RESULTS

We analyzed data from 483 (51.7%) children (11-14 years; 227, 47.0% girls) and 450 (48.3%) youth (15-18 years; 204, 45.3% girls). The parents of most children and youth had resided in Canada for over 20 years (678, 72.7%). Over one-quarter of children and youth self-identified as Black, Indigenous, or a Person of Color (134, 27.7%; 134, 29.8%, respectively). Over one-third of children and youth self-reported symptoms of worsened mood (149, 30.9%; 125, 27.8%, respectively), anxiety (181, 37.5%; 167, 37.1%, respectively), or irritability (160, 33.1%; 160, 35.6%, respectively) during, compared to pre-pandemic. In descending order of odds ratios (OR), for children and youth, worsened familial relationships (during compared to pre-pandemic) was associated with the self-reported symptoms of worsened mood (child: OR 4.22, 95%CI 2.51-6.88; youth: OR 6.65 95%CI 3.98-11.23), anxiety (child: OR 4.24, 95%CI2.69-6.75; youth: OR 5.28, 95%CI 3.17-8.86), and irritability (child: OR 2.83, 95%CI 1.76-4.56; youth: OR 6.46, 95%CI 3.88-10.90).

CONCLUSIONS

Self-reported data from a nationally representative sample of children and youth suggest strong associations between social factors and mental health during the COVID-19 pandemic. Interventions targeting child and youth familial relationships may positively impact child and youth mental health.

Health and Education Services During the COVID-19 Pandemic Among Young Children with Autism Spectrum Disorder and Other Developmental Disabilities

OBJECTIVE

Understanding how the COVID-19 pandemic affected children with disabilities is essential for future public health emergencies. We compared children with autism spectrum disorder (ASD) with those with another developmental disability (DD) and from the general population (POP) regarding (1) missed or delayed appointments for regular health/dental services, immunizations, and specialty services; (2) reasons for difficulty accessing care; and (3) use of remote learning and school supports.

METHOD

Caregivers of children previously enrolled in the Study to Explore Early Development, a case-control study of children with ASD implemented during 2017 to 2020, were recontacted during January-June 2021 to learn about services during March-December 2020. Children were classified as ASD, DD, or POP during the initial study and were aged 3.4 to 7.5 years when their caregivers were recontacted during the pandemic.

RESULTS

Over half of all children missed or delayed regular health/dental appointments (58.4%-65.2%). More children in the ASD versus DD and POP groups missed or delayed specialty services (75.7%, 58.3%, and 22.8%, respectively) and reported difficulties obtaining care of any type because of issues using telehealth and difficulty wearing a mask. During school closures, a smaller proportion of children with ASD versus another DD were offered live online classes (84.3% vs 91.1%), while a larger proportion had disrupted individualized education programs (50.0% vs 36.2%).

CONCLUSION

Minimizing service disruptions for all children and ensuring continuity of specialty care for children with ASD is essential for future public health emergencies. Children may need additional services to compensate for disruptions during the pandemic.

Hospital classroom experiences of hospitalized school-age pediatric oncology patients: A qualitative study

PURPOSE

In this study, it was aimed to examine the hospital classroom experiences of school-age children who received treatment and care at a pediatric oncology-hematology clinic in Turkey.

METHODS

The study was conducted using the in-depth interview method with the participation of 17 children who were hospitalized in the pediatric oncology-hematology clinic of a research and training hospital in the Ankara province of Turkey. The data were collected using a "Semi-Structured Interview Form". The interviews started with the question "How do you perform the assignments given by your teacher while you are hospitalized?", and the interviews were recorded as audio with the consent of the children and their parents.

RESULTS

As a result of the interviews, three main themes, (1) Learning, (2) Maintaining normalcy, and (3) Expectations, and 9 subthemes (teacher, continuation of learning, learning through play, feeling good, continuation of routines, peer interaction, communication with the school-teacher, basic sport activity, and tablet/internet access) were generated from the data.

CONCLUSIONS

Hospital classrooms had a significant role in increasing the children's adaptation to hospital conditions and ensuring the continuation of school/learning.

PRACTICE IMPLICATIONS

Pediatric nurses can refer children with long and repeated hospitalizations (e.g., pediatric oncology patients and children with chronic diseases) to hospital classrooms. Thus, children can adapt more easily to the procedures performed in the hospital.

Children's oral health and oral health care use during the first 2 years of the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has been associated with declines in children's oral health and oral health care use in 2020. The authors examined the pandemic effects on these outcomes into 2021.

METHODS

This cross-sectional study used data from the National Survey of Children's Health from 2017 through 2021. The authors compared parent's or caregiver's perceptions of the child's oral health and reported dental problems and dental visits across years, adjusting for child and household covariates and state of residence. The authors evaluated potential heterogeneity across demographic and socioeconomic subgroups.

RESULTS

In 2021, parents and caregivers were still more likely to perceive children's oral health as poor (odds ratio [OR], 1.90; 95% CI, 1.28 to 2.82) and less likely to report very good or excellent oral health (OR, 0.83; 95% CI, 0.76 to 0.92) than in 2019, similar to differences between 2020 and 2019. Dental visits were also less likely in 2021 than 2019 (OR, 0.74; 95% CI, 0.66 to 0.83). These differences between 2021 and 2019 were not explained by prepandemic trends and were observed across a range of demographic and socioeconomic subgroups.

CONCLUSIONS

Children's oral health as perceived by parents and caregivers and oral health care use were still worse in 2021 than before the pandemic both overall and across demographic and socioeconomic subgroups.

PRACTICAL IMPLICATIONS

The persistent adverse effects of the COVID-19 pandemic on children's oral health as perceived by parents and caregivers and shown through dental visits highlight the need to improve oral health care access and use and to evaluate the long-term effects of the pandemic on children's oral health.

Mental Health Trajectories of Children and Caregivers Using School-Based Health Centers During the COVID-19 Pandemic

INTRODUCTION

This was a prospective study of children registered at school-based health centers (SBHCs) in Canada. The objectives were to compare mental health trajectories of children and parents/caregivers who accessed SBHCs during the pandemic relative to those who did not.

METHOD

Parents/caregivers of children who attended SBHCs completed the Strengths and Difficulties Questionnaire (SDQ) and the Generalized Anxiety Disorder-7 (GAD-7) at three time points during the pandemic. The primary analysis used linear mixed models to examine the relationship between SBHC visits during the pandemic and children's SDQ score trajectories. The secondary analysis was the same for parents'/caregivers' GAD-7 scores.

RESULTS

There were 435 children included. SDQ and GAD-7 scores worsened over time for children and parents/caregivers who attended SBHCs during the pandemic compared to those who did not.

DISCUSSION

Children and parents/caregivers with worsening mental health symptoms may have sought care at SBHCs since they were accessible during the pandemic.

Caregivers' anxiety and perception of their children's wellbeing: a year into the COVID-19 pandemic

The COVID-19 pandemic and related social restrictions disrupted family routines affecting millions of youths and their caregivers worldwide. This study explored the relationship between caregivers' anxiety and their children's emotional states 1 year after COVID-19, as well as differences between caregivers' perceptions of their children's emotional states and reality. Sixty-eight caregiver-child pairs completed an online survey between March 31 and May 31, 2021. Our analysis showed positive correlations between caregivers' anxiety and children's wellbeing, worries about children's use of time, and a variety of negative emotional states in their children. Caregivers' anxiety about their children's wellbeing was negatively correlated with their children's perceptions of self-control. Caregivers' anxiety about their personal wellbeing was negatively correlated with children's feelings of busyness and positively associated to their children's fear. Caregivers' perception of COVID-19 as a challenging experience was positively associated with some of their children's negative emotions. Overall, caregivers were accurate about children's emotional experiences in the previous 3 months with some exceptions: their children felt lonelier and more worried about schoolwork and grades than their caregivers realized. These findings will help researchers and practitioners further explore the sources of caregivers' anxiety and their relationship with children's emotions and stress management as countries move toward a new normal.

Pilot Evaluation of the Elementary Social-Emotional Learning Program Sources of Strength

Schools and students have faced a variety of challenges during the 2020-2021 academic year as the COVID-19 pandemic continues. These issues have drawn attention to the increased need for robust social-emotional learning skills at the elementary level to address the deficits exacerbated by the pandemic. Sources of Strength is an evidence-based suicide prevention program for middle and high school students. In 2020, Sources of Strength launched an elementary school curriculum focused on promoting protective factors and resilience. Data were collected across 11 elementary schools (N = 1022; 3-5th graders) in the Great Plains region of the USA at two time points during the COVID-19 pandemic (T1: Fall of 2020, T2: Spring of 2021). We examine the effectiveness of the program using a pre- and post-test design measuring various student social-emotional outcomes including positive classroom climate, emotional problems, school belonging, help-seeking attitudes, bullying perpetration, peer victimization, student and teacher intervention, student well-being, and student resilience. The program was evaluated using multilevel regression models to examine the associations between self-reported student program exposure and student outcomes. Although comparisons between T1 and T2 indicated a worsening of several student outcomes, positive associations were found when accounting for the degree of student exposure to the program. Greater student exposure was associated with improved positive classroom climate, school belonging, help-seeking attitudes, student well-being, resiliency, and lower reports of emotional problems. Implications for research and practice are discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12310-023-09567-0.

Child Flourishing, School Engagement, Physical Activity, and Screen Time During the Coronavirus Disease 2019 Pandemic in 2020

OBJECTIVE

To examine changes in flourishing, school engagement, physical activity, and recreational screen time among school-aged children in the United States during the Coronavirus Disease 2019 (COVID-19) pandemic in 2020.

METHODS

In this cross-sectional study, data come from the 2018-2020 National Survey of Children's Health for 68,203 children aged 6 to 17 years. Flourishing is always/usually curious to learn, resilient and having self-regulation. School engagement is always/usually completing homework and having interest in doing well in school. Other outcomes are daily 60+ minutes physical activity or number of such days, and daily recreational screen time or 2+ hours/day. Weighted regression models compare 2020 to 2019 and 2019 to 2018 adjusting for child/household covariates and state indicators.

RESULTS

Among children age 6 to 17 years in 2020, there was a decline in flourishing (OR = 0.69; 95% CI, 0.63, 0.75), school engagement (OR = 0.71; 95% CI, 0.64, 0.79), physically active days (0.26 days, 95% CI, 35, 0.17), and daily 60+ minutes activity (OR = 0.91; 95% CI, 0.83, 1.00), and increase in daily recreational screen time (0.29 hours; 95% CI, 0.25, 0.34) and 2+ hours/day (OR = 1.65; 95% CI, 1.49-1.83) compared to 2019. These differences were observed across all evaluated demographic and socioeconomics subgroups. There were no significant differences between 2019 and 2018, indicating that the 2020-2019 differences were related to the pandemic rather than a continuation of prepandemic trends.

CONCLUSIONS

Children's flourishing, school engagement, and physical activity declined while recreational screen time increased during the COVID-19 pandemic in 2020. Monitoring these outcomes in the long-run is important to assessing needs and promoting children's learning and development.

Relationship between education and well-being in China

Well-being is often quantitatively measured based on individuals' income or health situation but the relationship between education and well-being has not been fully investigated. It is also important to compare well-being using different individual characteristics especially gender. This paper analyzes well-being using a unique dataset from the Chinese General Social Surveys in 2012, 2013, and 2015. Two measures of well-being are used: self-assessed unidimensional subjective well-being and parametrically estimated multidimensional objective well-being. Objective well-being is a composite parametric index with contributions from different domains of education influenced by identity, capability, and material well-being. These help in understanding the differences between and compare subjective and objective well-being. The results of our descriptive and regression analysis suggests that the multidimensional well-being index differs from subjective well-being in ranking individuals grouped by important common characteristics. These differences are captured by our study which helps to broaden the measurement and analysis of the multidimensionality of the well-being index. Education influences well-being positively, conditional on controlling for identity, capability, material and marital status, and Confucianism. Investments in education and female empowerment which target well-being measures will help reduce the dimensionality of the gender gap in rural China, in particular those attributed to Confucianism.

Brief report of protective factors associated with family and parental well-being during the COVID-19 pandemic in an outpatient child and adolescent psychiatric clinic

Families of children with mental health challenges may have been particularly vulnerable to emotional distress during the COVID-19 pandemic. This cross-sectional study surveyed 81 parents of children ages 6–17 years receiving mental health treatment in an outpatient clinic during the pandemic. We sought to characterize the impact of the pandemic on family relationships and parental well-being. Additionally, regression and ANCOVA models examined associations between four potentially protective factors—parents’ psychological resilience, perceived social support, positive family experiences during the pandemic, and children’s use of cognitive or behavioral coping strategies—with family relationships and parental well-being. Findings suggest that families of children with mental health conditions experienced remarkable challenges to family relationships, parental well-being, and parents’ perceived capacity to support their children’s mental health. Nearly 80% of parents reported a negative impact of the pandemic on their own well-being, and 60% reported reduced ability to support their children’s mental health. Simultaneously, protective factors appeared to mitigate the negative impact of the pandemic. Particularly, support within the family (e.g., co-parenting) and from external sources (e.g., mental health services) were associated with better self-reported well-being for parents and their capacity to support their children. Children’s use of coping tools, likely enhanced by mental health treatment, was also positively related to better family relationships and parental ability to support children with mental health challenges. Our findings highlight the need for enhancing supports for families at multiple levels including individual skill-building, family-based/parenting support, and community-based support.