Parents today are doing what no other generation of parents has ever done before in human history. They are parenting with all the challenges and worries of the pandemic, from health and economic issues to dealing with bereavement to pandemic fatigue. At the same time, never before in history has there been so much stress for parents and kids due to the internet and social media. There are digitally distracted parents. School curriculums are getting more and more advanced.
Combine these modern-day parenting challenges with the COVID pandemic, and you can see why it is such an exceptional challenge for all families. And it’s also a challenge for the pediatricians and professionals who are helping them!
In this article, we will discuss the effects of lockdowns on young children and how are we going to promote early childhood development through age-appropriate activities supervised by parents and caregivers. We will focus on activities for kids aged five years and below.
What are the negative effects of lockdown on young kids?
Since the lockdowns started two years ago, there has been much research from all over the world about their effect on children. We’ve listed some of the major effects of lockdown on young kids.
1. Effects on physical activity, sleep, and screen time.
A 2021 study was conducted to determine the global effect of the COVID-19 pandemic on physical activity, sedentary screen time, and sleep among 3- to 5-year-old children. This study involved families with kids 3-5 years old, from 14 different countries.
The research revealed that pre-pandemic, 48% of families adhere to the WHO screen time guidelines, which recommends <1 hour/day of sedentary screen time. However, after the COVID-19 lockdown restrictions were implemented, specifically between March-June 2020, when the surveys were sent out, the percentage of families adhering to the WHO screentime guidelines went down from 48% to 25%. This means that during the pandemic, the majority of young kids in this study had excessive exposure to recreational screen time.
In addition to this, outdoor time was cut by almost half – from 180 minutes to 106 minutes on weekdays, and from 213 mins to 116 mins on weekends. Furthermore, the average bedtime and waketime became an hour later.
Another interesting thing to note in this research would be the factors that are significantly correlated with how families were able to adhere to the WHO guidelines. As expected, the level of restrictions, as well as, the strictness of the quarantine, greatly affected the families’ adherence to the guidelines. Interestingly, families belonging to low-income countries actually did better in terms of increased physical activities and lesser screen time exposure.
The results of this study also highlighted the important role that parents play in supporting their children to be physically active. Parents who experienced stress and exhaustion, as well as, work/time constraints were unable to support their children to participate in healthy levels of movement behaviors. This suggests that when we support parents’ mental health – so they are better able to handle stress and feel less exhausted – it can really make a difference.
2. Effect on mental health.
In a meta-analysis of 15 studies that included a total of almost 23,000 children, a whopping 79.4% reported an overall worsening of behavior and having one or more psychological symptoms. Almost half of the children had depression and irritability, and other symptoms included anxiety, boredom, sleep disturbance, excessive fear, and inattention.
Of the caregivers, more than half reported anxiety, and almost 1/3 reported depression. It’s also interesting that most studies from Asia had a higher prevalence of psychological problems, compared with countries like Italy and Spain
Even before the pandemic, we’ve already been noticing a rise in mental health issues in kids. Combine that with the pandemic, and we have a mental health crisis in our midst.
3. Effects on social interaction.
Social interaction is a big concern. Factors like distancing protocols, use of masks, and school closures affect social interaction. There is interesting research about how the use of masks affects the ability of kids to recognize faces and read emotions. Masks hide smiles that are very important in the interactions that are needed for brain development. They also interfere with lip-reading which is important for language development.
Another thing we have to think of is what will happen in the future when kids will go back to face-to-face classes?
There is ongoing research about this in countries that have resumed face-to-face classes. Kids need our support now, and they will continue needing our support when the pandemic is over and they will “rejoin society”.
This is especially important for young kids. The young kids who were born during the pandemic have never known any other world. And young kids who were born before the pandemic don’t remember what the pre-pandemic world was like anymore.
What are the positive effects of the COVID-19 lockdown?
Despite the dire situation, studies have also pointed out some positive effects brought about by the COVID-19 lockdown. These include the following:
More time together as a family.
The stay-at-home, work-from-home, and virtual learning setup that resulted from the lockdown has led parents to reassess their work and career priorities. Many parents reported the desire to reach a better balance between career and family life post lockdown.
More parental involvement in learning and development.
In a study conducted by Leeds Trinity University in the UK, findings revealed that spending more time together as a family is beneficial for many children. The opportunity to have one-on-one learning at home has led to progression in writing, reading, and language skills. Furthermore, parents who prioritized their children’s well-being over educational attainment have reported better outcomes.
What can we do about this?
In 2020, a study was conducted in the Philippine General Hospital that focused on the needs and coping of parents during the pandemic. The study shows that information regarding services and information regarding how children grow and develop are the two greatest needs reported by parents. While this research was done on parents of patients with ASD or Autism Spectrum Disorder, this might also be true for all parents. Almost everyone reported needing information regarding services, and how children grow and develop.
As pediatricians, our support matter a lot. So here are some pieces of advice that we can give to parents of young kids.
1. Emphasize the importance of physical activity, sleep, and limiting screen time.
To help you create a balance between physical activity, sleep, and screen time, refer to the following guidelines:
- For children < 1-year-old
- At least 30 minutes of physical activity per day
- No sedentary screen time allowed
- 14-17 hours of good quality sleep for 0-3 months of age
- 12-16 hours of good quality sleep for 4-11 months of age
- For children 1-2 years old
- At least 180 minutes of physical activity per day
- For 1-year-olds, there should be no sedentary screen time
- For 2-year olds, limit screen time to no more than 60 minutes
- Good quality sleep of 11-14 hours
- For children 3-4 years old
- At least 180 minutes of physical activity, of which 60 minutes involve moderate to vigorous activities
- Sedentary screen time should not exceed 60 minutes per day
- 10-13 hours of good quality sleep
2. Emphasize the importance of age-appropriate play in ALL domains of development.
Age-appropriate play, not activities that are too advanced. Play should be child-directed free play, and not parent directing everything. There’s a whole industry around play and kids’ activities, and this industry is very good at marketing on the internet and social media. So parents are getting so stressed about this. But the truth is, simple activities are the best. It’s also important to include activities for all domains of development. And remember that academic skills are not the focus of early childhood.
What are examples of activities that are not developmentally appropriate?
One example is writing and tracing worksheets. Especially now that parents are turning to the internet for information about child development. And on the internet, there are so many “worksheets for 2 year old”, for 3 year old, so the parents think they need to force their kids to do this.
3. Make outdoor play a non-negotiable.
I believe that outdoor play should be a non-negotiable. So ideally, all families should find a way to let kids play outdoors, whether it’s a backyard or balcony. There should be outdoor spaces where kids can play safely with physical distancing. It’s actually this lack of outdoor play that we should worry about the most. The complaints we hear most often are things like, “my child hasn’t been to the mall, hasn’t eaten out at a restaurant, hasn’t been to a birthday party”. But developmentally speaking, kids don’t need malls or parties.
So if there’s something we should prioritize, it’s not getting kids back to the malls – but getting kids enough outdoor time. And in terms of COVID transmission, outdoor time is actually less risky.
4. Promote activities that develop your children’s fine motor skills.
Do free drawing, coloring, and painting – with actual crayons or paint and paper – not apps! Let babies and toddlers handle objects from nature such as leaves, stems, the bark of trees, and fruit peels. You can also use simple toys like wooden blocks, connecting blocks, or stacking rings.
Remember to watch out for small objects that can be choking hazards. If a toy can fit in a choke tube or the cardboard tube of a toilet paper roll, then it’s a choking hazard!
5. Help your child build language skills.
There is growing evidence that the COVID-19 lockdowns may have a negative impact on our children’s language abilities. Research shows an increasing number of children aged 3-5 years old struggling with their language skills.
So what can we do about this?
Here are easy to remember tips on how you can help your child build their language skills:
P – point to objects and talk with kids about them.
Q– ask questions about things around you.
R – respond to what the child says, even if their words are not yet clear. Read books with your child.
S – sing action songs and nursery rhymes.
T– talk with the child. Take turns speaking and listening.
6. Stick to a daily routine.
Even while in quarantine, ideally the family should have a routine. This does not need to be too strict, but as much as possible try to wake up at the same time every day. One of the problems they found in the research is that while in lockdown, parents and kids tend to lose track of time.
Having a routine helps them keep track of this.
Give age-appropriate choices. For example, toddlers can choose what to wear. Kids should also be responsible for age-appropriate self-care tasks. If the child can do it themselves, don’t do it for them anymore. Let them participate when getting dressed, taking a bath, and especially with feeding. They can also help with household chores. Even young kids can do things such as help set the table or make a sandwich.
7. Help build social and emotional skills.
Put away all gadgets, remove all distractions, and just BE with your child. For babies and younger toddlers, a game of peek-a-boo or hide and seek are great activities to help build these skills. Teach sharing and taking turns and encourage pretend plays. Build social skills by doing video chats with loved ones. And lastly, acknowledge that it’s okay to feel emotions such as sadness, anxiety, and anger – whether it’s the child or the caregiver who is feeling that.
8. Focus on the connection between parent and child.
The most important factor in building resilience is that the child feels safe and loved. When kids are coping with stress or feeling overwhelmed, having a reliable supportive caregiver makes that stressor tolerable, and children learn how to cope and adapt.
Yes, there are many kinds of research showing all these negative effects of growing up in the pandemic, but there are many things we can do to help kids through this time.
Part of developmental surveillance includes watching out for the mental health problems of the parents because a parent with mental health issues will have difficulty building connections with the child.