Children experienced ‘relatively modest’ developmental delays during pandemic

Key takeaways:

• There were modest declines in developmental scores among children during the COVID-19 pandemic.
• The developmental changes did not concern parents, researchers found.

Young children in the United States experienced “relatively modest” decreases in developmental scores during the COVID-19 pandemic, according to a study published in JAMA Pediatrics.

The aim of the study was to “provide some insight for parents and caregivers, educators, and health care providers about how the COVID pandemic might have influenced child development,” according to one of the researchers.

“The pandemic was such a seismic disruption to the lives of families across the U.S.,” Sara B. Johnson, PhD, MPH, director of the Rales Center for the Integration of Health and Education at Johns Hopkins Children’s Center, told Healio. “There has been a lot of uncertainty about what being isolated from friends and extended family, closures of schools and child care, job loss, and other family stresses might mean for children’s development. Until now, though, there hasn’t been a large study of children across the U.S. to help answer this question.”

Johnson and colleagues randomly selected more than 50,000 children aged 5 years or younger from a sample of over 500,000 children whose parents or caregivers completed the Ages and Stages Questionnaire-3, or ASQ-3.

“The ASQ-3 is a developmental screener widely used to monitor development in primary care, and measures five areas: language and communication, gross motor, fine motor, problem-solving, and personal-social,” Johnson said. “It also asks caregivers whether they are worried about their children’s behavior or have any worries about the child.”

Johnson and colleagues compared ASQ-3 scores during a 24-month pre-pandemic baseline period from March 2018 to February 2020 with scores from a 24-month pandemic period from June 2020 to May 2022, as well as a brief “buffer” between the pre-pandemic and pandemic period, taking into account characteristics of the children and caregivers that might affect scores.

They found decreases of about 3% in the communication domain, 2% in the problem-solving domain and 2% in the personal-social skill domain and no changes in fine or gross motor skill domains during the pandemic

Among infants aged 0 to 12 months, similarly modest effects were observed, with decreases of only 3% in the communication domain and 2% in the problem-solving domain.

Johnson was surprised by what she called the “relatively modest” changes.

“We were also surprised that the changes we saw were similar for infants as for older children,” Johnson said “We thought infants, whose early development is so influenced by interactions with their caregivers, might show improvements in developmental milestones from pre-pandemic to pandemic since many spent a lot more time with their caregivers during lockdown. However, this was a very challenging time for many families, and we don’t know much about what else families might have been juggling, such as other children, remote work, economic stresses.”

Despite decreases in development scores, the proportion of caregivers who said they had concerns about their child’s behavior was similar before and during the pandemic and the proportion of caregivers who reported general worries about their children was only slightly higher during the pandemic, Johnson noted.

“This suggests that changes in development didn’t alarm most parents,” Johnson said.

She said it will be important for future studies to continue to follow these large samples of children because of the possibility that new challenges will emerge as they age into kindergarten.

“I think the results of this study may be helpful to providers in allaying caregivers’ fears that the pandemic was associated with substantial developmental harm. Our results don’t support that,” Johnson said. “That said, continued developmental surveillance in primary care is important since we don’t yet know the long-term implications of these changes. It is particularly important to engage families in primary care who were disconnected during the pandemic.”

References:

Johnson SB, et al. JAMA Pediatr. 2024;doi:10.1001/jamapediatrics.2024.0683.

Study finds COVID-19 pandemic led to some, but not many developmental milestone delays in infants and young children. https://www.eurekalert.org/news-releases/1041771. Published Apr. 22, 2024. Accessed Apr. 23, 2024.