The indirect effects of the pandemic on children and adolescents are as substantial – if not more so – than the impact of being infected with Covid-19, paediatricians say.
A research review from the Murdoch Children’s Research Institute led by paediatrician Prof Sharon Goldfeld said interventions needed to be developed now to address growing disparities in child health and wellbeing due to the pandemic.
Goldfeld said children were facing a “generation-defining disruption” with public health restrictions and interventions such as online learning, social distancing, increased screen time, reduced access to healthcare, less community sport and less outside play all having repercussions.
“The public health measures have resulted in positive benefits for some, while others have been adversely and inequitably impacted,” Goldfeld said. “Children and adolescents experiencing adversity before the pandemic have been disproportionately affected, potentially leading to a widening of disparities in child health, wellbeing, and developmental outcomes.”
The review, published in the Medical Journal of Australia (MJA) on Monday, includes findings from a Royal Children’s hospital poll that found one-third (36%) of Australian parents felt that the pandemic had negatively affected the mental health of their child, and that 31% of parents had delayed or avoided medical care for a sick or injured child due to concerns about catching the virus. A separate study found some children and adolescents infected with the virus experienced stigma and mental health distress such as difficulty sleeping, having nightmares and withdrawing from friends.
The review also refers to Kids Helpline data, and paediatric emergency department data, that shows a rapid rise in mental health and self-harm presentations.
Associate Prof Nicholas Wood, a paediatrician with the Children’s Hospital Westmead, said he had heard reports of children not wanting to leave their house because they were so anxious and worried about Covid.
“I think there’s going to have to be some effort put into resilience-building programs for children, whether that’s through schools or communities,” he said. “There has also always been an issue with access to mental health support in the community. It’s very hard to get your children into a psychologist or psychiatrist, and we must be thinking about these and other services children will need to be accessing during and post-pandemic.”
A survey of 5,000 teachers cited in the MJA review found only 35% of them reported their students were learning effectively during lockdowns. The achievement gap between advantaged and disadvantaged students grows at triple the rate during remote learning, the review estimated.
Goldfeld said some families lacked the resources and time needed to support their children during remote education.
“It will be difficult to predict how long it will take those with lost learning to catch-up, but strategies to identify those left behind and targeted long-term interventions for those especially in low socioeconomic school settings will be critical,” she said.
Goldfeld said even areas such as child nutrition and child safety had been impacted due to reduced family income and job losses during lockdowns, and parental mental health issues and stresses.
“Job loss and reduced income is a known risk factor for harsh parenting and maltreatment,” she said.
The review concluded that those children requiring extra care and intervention as a result of the pandemic need to be urgently identified so that intervention programs can be targeted towards them. These programs need to be reviewed for efficacy, the authors of the review wrote.
Addressing financial instability through parent financial supplements, more investment in children’s health and wellbeing at school, and screening programs for mental health and wellbeing on return to school were among the other measures suggested by the authors.
