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COVID-19 Resource Center

Disclosures: The authors report no relevant financial disclosures.
March 19, 2021
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Children receiving virtual schooling at increased risk for mental health problems

Disclosures: The authors report no relevant financial disclosures.
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Virtual school instruction may pose greater risks to parental and child mental health than in-person instruction, according to study results published in MMWR.

“Changes in modes of instruction have presented psychosocial stressors to children and parents that can increase risks to mental health and well-being and might exacerbate educational and health disparities,” Jorge V. Verlenden, PhD, of the CDC’s division of adolescent and school health at the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, and colleagues wrote. “CDC examined differences in child and parent experiences and indicators of well-being according to children’s mode of school instruction (i.e., in-person only [in-person], virtual-only [virtual], or combined virtual and in-person [combined]) using data from the COVID Experiences nationwide survey.”

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The investigators used the NORC at the University of Chicago AmeriSpeak panel to administer the survey online or via telephone between Oct. 8, 2020, and Nov. 13, 2020, to 1,290 parents with children aged 5 to 12 years. A total of 45.7%, 30.9% and 23.4% of respondents reported that their child received virtual instruction, in-person instruction or combined instruction, respectively. Parents provided data related to their child’s experiences and wellbeing, such as changes since the pandemic’s onset in physical activity and time spent outdoors; physical, mental and emotional health status prior to and after the pandemic began; and current anxiety and depression measures. Further, they provided responses on their own well-being and experiences, such as emotional distress, job stability and childcare challenges.

Results showed decreased rates of physical activity, time spent outdoors, in-person time with friends and virtual time with friends, as well as worsened mental or emotional health, among children who received virtual instruction vs. those who received in-person instruction, according to parental report. Parents of children who received combined instruction reported the same outcomes for their child as those of children who received virtual instruction, except for decreased virtual time with friends, compared with those who received in-person instruction. Further, those who received combined instruction had higher rates of physical activity and time spent outdoors vs. those who received virtual instruction.

Parents whose children received virtual instruction vs. those whose children receiving in-person instruction were more likely to report loss of work, job stability concerns, childcare challenges, conflict between working and providing childcare, emotional distress and sleeping difficulties. Those whose children received combined instruction were more likely vs. those whose children received in-person instruction to report loss of work and conflict between working and providing childcare. Those whose children received virtual instruction vs. those whose children received combined instruction were more likely to report experiencing emotional distress.

“Children receiving virtual or combined instruction and their parents might need additional support to mitigate stress, including linkage to social and mental health services and opportunities to engage in safe physical activity to reduce risks associated with chronic health conditions,” Verlenden and colleagues wrote. “Culturally applicable support programming and resources might be warranted to meet community needs, ensure equitable access to services and address health or educational inequities for families from racial and ethnic minority groups. These findings highlight the importance of in-person learning for children’s physical and mental well-being and for parents’ emotional well-being. Community-wide actions to reduce COVID-19 incidence and support mitigation strategies in schools are critically important to support students’ return to in-person learning.”