A new study from Johns Hopkins Children’s Center reports children 5 years old and younger experienced only modest delays in developmental milestones due to the COVID-19 pandemic disruptions and restrictions.
The study was the first of its scope in the United States. Researchers say parents and pediatric professionals should be cautiously optimistic about how kids will fare following the pandemic.
However, while the impact was small, the study’s authors point out that even a small increase in the percentage of children who need support could place a burden on an already-strained medical system.
A Large-Scale Study of Pandemic Effects
The disruptions and restrictions of the COVID-19 pandemic and related lockdowns had well-documented impacts on many people, including families. Previous studies have linked the pandemic to lower child health-related quality of life, including another Johns Hopkins study that shows a 77% increase in new pediatric diagnoses of type 2 diabetes during the first two years of the pandemic.
However, the effects of the pandemic on the development of very young American children were unclear because previous studies were done outside the United States or in small samples.
Researchers looked at the milestone status of more than 50,000 children aged 0-5 during the pandemic. Data from the Comprehensive Health and Decision Information System (CHADIS), a web-based screening tool, was used to look for links between the pandemic’s disruptions and changes in developmental milestone scores. More than 5,000 doctors’ offices across 48 states use this system.
The data came from the Ages and Stages Questionnaire III (ASQ-3), a standardized measure of child development that parents complete as part of pediatric care. Parents or caregivers respond to questions that assess children’s development in five areas: communication, gross motor, fine motor, problem-solving, and personal-social.
The study found that caregivers report decreased scores in communication (3% lower), problem-solving skills (2% lower), and personal-social skills (2% lower). Social distancing and childcare closures likely impacted the development of these skills, which boost children’s social interaction. There was no change in scores for gross or fine motor skills.
The researchers anticipated less developmental impact in infants, hypothesizing that these infants would have had more time with their caregivers during the pandemic since many adults worked from home. Their prediction was only partially true. While there was no increase in personal-social delays among infants, the rise in communication and problem-solving delays was the same for infants as for older children.
During the pandemic, it would be natural for parents to worry more about their children and report more concerns with their development. Researchers considered this and found that parental worries about their child’s development increased only slightly during the pandemic.
Hope and Caution for the Future
“We found, overall, that while there are some changes, the sky is not falling,” says Dr. Sara Johnson, Ph.D., M.P.H., one of the study’s authors. However, the full report cautions additional impacts may appear later.
“It is important for us to continue to keep an eye on kids of all ages in terms of development, so we can understand whether these changes have longer-term implications for children or if new challenges emerge as children age,” says Johnson.
She also points out that a 2-3% increase in developmental delays, while a small change, is still significant for the medical population that treats these children. This increase could translate to more than 1,500 additional monthly referrals, placing a strain on the already overburdened developmental pediatricians who specialize in treating developmental delays.
According to an article published by the American Academy of Pediatrics, the United States is already experiencing a crisis in the care of children with developmental-behavioral concerns.
There were just 755 board-certified developmental-behavioral pediatricians (DBPs) in the U.S. in 2023, and these practitioners are not equally accessible in all parts of the country. North Dakota, Wyoming, and New Mexico, have no DBPs at all. Added pressure from pandemic-induced developmental delays will only make accessing these doctors worse.
The Impact Going Forward
The Johns Hopkins study offers parents and caregivers some reassurance about the impact of the COVID-19 pandemic on children under the age of five. While there were modest delays in certain developmental areas, these delays were limited.
It’s important, however, to remain vigilant as children grow older, as possible long-term effects may emerge. The relatively small impact is also significant for the medical community, underscoring the need to commit to the growth of already strained resources like developmental pediatricians.
