Child behavior problems during COVID-19: Associations with parent distress and child social-emotional skills

Effectiveness of group-based indicated prevention in children identified with disruptive behavior problems: results of an implementation study in the German health care system

BACKGROUND

Subclinical disruptive behavior problems often occur during childhood and are a risk factor for developing a mental disorder later in life. To prevent a manifestation of dysfunctional disruptive behavior, early intervention is critical. This study aimed to examine the effectiveness of an indicated prevention program in children with disruptive behavior problems.

METHODS

Screening for disruptive behavior problems was conducted using the Strength and Difficulties Questionnaire during routine pediatric health check-ups. Depending on their risk status (normal vs. borderline vs. abnormal), children received a recommendation for no intervention, an indicated prevention program (i.a. "Baghira") or further diagnostics. Questionnaires such as the Child Behavior Checklist and the Parent Rating Scale for Conduct Disorder (DISYPS Competence scale) were administered at three time points (T0: pre-intervention, T1: 6 months after screening/ post-intervention, T2: 6 months after T1). Children who participated in "Baghira" (BA n = 171), a cognitive-behavioral group program for children with disruptive behaviors, were compared to children screened as normal (NOR n = 881) or received a recommendation for "Baghira" but refused participation (NO BA n = 46).

RESULTS

Disruptive behavior problems decreased (BA: β = - 3.61, p <.001) and prosocial behavior increased (BA: β = 1.67, p <.001) in the BA compared to the NOR group from T0 to T1. These effects were maintained at T2 follow-up (BA: β = - 1.60; p =.035; β = 1.12; p =.019). However, the NO BA group also improved in prosocial behavior and from T0 to T1.

CONCLUSION

Although an improvement in disruptive behavior symptoms as well as an increase in prosocial behavior were observed, controlled studies using matched or stratified designs are needed to replicate the effectiveness of "Baghira" in a prevention context, apart from the Covid-19 pandemic, to improve children's mental health.

Smart Beginnings Predicts Reduced Externalizing Behavior Via Parental Negative Demeanor During Discipline

The goal of this study was to examine the impacts of the Smart Beginnings (SB) intervention, a tiered model that combines universal primary prevention and targeted secondary prevention, on parental negative affect during discipline and children's externalizing behavior. Analyses included 273 families who were randomly assigned to SB or control groups at birth. Parental negative affect during discipline and child externalizing behavior were assessed through parent report at age four and six, respectively. Compared to the control group, families in SB had significantly reduced parental negative affect during discipline, with indirect effects on children's externalizing behavior through impacts on parent affect during discipline, both for the full sample and specifically for families with increased risks. Findings suggest that interventions aimed at promoting positive parent-child interactions may have important impacts on parenting behaviors and may prevent the onset of child behavior problems, with important implications for the implementation of preventive interventions. This study examined the impacts of the Smart Beginnings (SB) tiered model, which combines universal primary prevention and targeted secondary prevention, on parental negative demeanor during discipline-negative parental behavioral traits that are expressed through anger, verbal aggression, or demeaning behavior-and children's externalizing behavior. Analyses included 273 families randomly assigned to SB or control groups at birth. Parental negative demeanor during discipline was assessed through parent report (Socolar Discipline Survey) at age four and child externalizing behavior (CBCL) at age six. Compared to controls, regression analyses indicated that families in SB had significantly reduced parental negative demeanor during discipline, with mediation analyses suggesting indirect effects on child externalizing through impacts on parent demeanor during discipline, moderated by family risk level. Findings indicate that interventions aimed at promoting positive parent-child interactions may impact parenting behaviors and prevent onset of child behavior problems, with important implications for implementation of preventive interventions.

The Impact of COVID-19 on the Language Skills of Preschool Children: Data from a School Screening Project for Language Disorders in Greece

Background/Objectives: The COVID-19 pandemic has significantly affected children's lives, particularly preschool-aged children who undergo rapid biological and psychosocial development. This study aimed to investigate the effects of the COVID-19 pandemic on the language skills of preschool children in Greece. Methods: To that end, a widely used screening tool was applied in a screening project involving 213 preschoolers. Language skills were assessed in three groups of children aged 2-4 years old before, during and after the pandemic. Results: A significant increase in the number of children with atypical language skills profile was identified in relation to the preschoolers after the pandemic versus those before or during the pandemic period. A higher prevalence of atypical profiles was observed in girls than in boys. Interestingly, an increase in the number of successfully produced or repeated words and pseudowords, along with enhanced expressive abilities, was observed during the pandemic compared to the periods before and after. Conclusions:Our findings suggest that post-pandemic preschool children exhibit higher rates of atypical language skill profiles compared to those assessed before and during the pan-demic. Given the importance of language development as a critical aspect of children's overall personality and well-being, further research is needed to explore the impact of specific pandemic-related factors on language competency. These factors include mask-wearing, increased screen time, reduced social interaction and exposure to language-rich environments, as well as impaired mental health and parental distress. Additionally, personalized interventions should be developed to support healthier developmental outcomes.

A Snapshot of Peer Relationships in Children and Youth: Pre- Versus During COVID-19

Strong peer relationships are an essential component of a healthy, happy, and long lifetime. Given that there is little understanding of the impact of COVID-19 on peer relationships, this study explored the effects of the COVID waves on peer relationships for clinically referred children and youth while controlling for age, sex, and income. 11,281 children and youth between the ages of 4 and 18 years, who were receiving services from mental health agencies across Ontario from January 2018-March 2022, were assessed using the interRAI ChYMH. Chi-square tests of independence and logistic regression analysis was performed. Overall, as expected, there were significantly fewer peer relationship difficulties during COVID-19 compared to the pre-pandemic period. Despite the general decline of peer issues, individuals between the ages of 8-18, particularly males, were more likely to experience peer relationship difficulties compared to those 4-7 years old. Additionally, children from the lowest income households experienced greater peer relationship difficulties during COVID-19 when compared to those from the highest income households. The findings from this study demonstrate the nuanced changes in social behaviours due to the ongoing pandemic for children and youth and highlight those youth who are most in need of social and behavioural interventions.

The COVID-19 pandemic and social cognitive outcomes in early childhood

The COVID-19 pandemic and ensuing lockdowns led to sweeping changes in the everyday lives of children and families, including school closures, remote work and learning, and social distancing. To date no study has examined whether these profound changes in young children's day to day social interactions impacted the development of social cognition skills in early childhood. To address this question, we compared the performance of two cohorts of 3.5- to 5.5-year-old children tested before and after the COVID-19 lockdowns on several measures of false-belief understanding, a critical social cognition skill that undergoes important developments in this age range. Controlling for age and language skills, children tested after the pandemic demonstrated significantly worse false-belief understanding than those tested before the pandemic, and this difference was larger for children from lower socioeconomic status (SES) backgrounds. These results suggest that the pandemic negatively impacted the development of social cognition skills in early childhood, especially for lower SES children.

The impact of lockdown on child adjustment: a propensity score matched analysis

The COVID-19 pandemic has had an inestimable impact worldwide, challenging the daily lives and interactions of children and their families. In 2022, Shanghai implemented a three-month lockdown in response to an acceleration of positive cases during the pandemic period. This restrictive policy provided insight into the impact of the lockdown on children's social adjustment and the role of parent-child conflict during this process. Mothers of preschool-aged children participated in this study and completed the Chinese version of Child-Parent Relationship Scale (CPRS) and the Strengths and Difficulties Questionnaire (SDQ). Using Propensity Score Matching (PSM) method, two matched groups were formed: pre-lockdown group and post-lockdown group, with a total of 574 preschoolers (N = 297 in each group; Mage = 4.36, SD = 0.86) were recruited. The results showed that the lockdown directly impacted children's emotional symptoms. Additionally, the parent-child conflict mediated relationship between the lockdown and children's adjustment. Specifically, parent-child conflict deteriorated children's emotional symptoms, hyperactivity-attention problems, and prosocial behaviors. These findings highlight the significant impact of the severe lockdown on children's social adjustment and the role of parent-child interactions during this period.

Impact of COVID-19 on emotional and behavioral problems among preschool children: a meta-analysis

The impact of the Coronavirus Disease 2019 (COVID-19) on society is continuous, resulting in negative psychological consequences. Given the vulnerability and sensitivity to the environment among preschool children, their emotional and behavioral problems deserve more attention. The current study aimed to explore the impact of the epidemic on preschool children's mental health by determining the pooled prevalence of emotional and behavioral problems amidst the Coronavirus Disease 2019 pandemic and to reveal potential reasons for variations between studies. Published studies were searched in Embase, PubMed, ProQuest, PsycINFO, Web of Science, CNKI, and Wanfang. Based on the inclusion criteria outlined in this study, a total of 10 studies encompassing 38,059 participants were incorporated. Employing a random-effect model for estimating the prevalence of emotional and behavioral problems, the results revealed a pooled prevalence rate of 24.3% (95% CI, 0.15-0.38; I²=99.9%) among preschool children. This rate surpasses the pre-outbreak prevalence observed in different countries, signifying a detrimental influence of the epidemic on the mental well-being of preschoolers. Therefore, mental health care and recovery are essential for the vulnerable group during and after the public health crisis. Specific emotional and behavioral problems among preschool children are expected to be researched in the future to provide more targeted guidance for intervention.

Maternal distress during the COVID-19 outbreak: A socio-ecological perspective

INTRODUCTION

Mothers faced an increased risk of adverse mental health outcomes during the COVID-19 pandemic compared to other populations. However, there is little data on the factors that placed mothers at increased risk of distress.

AIMS

The present study explored a range of individual, familial, and environmental factors associated with psychological distress in mothers during the COVID-19 pandemic.

METHOD

This repeated cross-sectional study was composed of a convenience sample of mothers who completed an online survey that included a demographic questionnaire, an emotion regulation questionnaire, and the Depression, Anxiety, and Stress scale. The survey was administered during the second and third lockdowns in Israel in 2020-2021.

RESULTS

The study included 575 mothers (M age = 39). The findings of a hierarchical regression indicated that individual-level factors, composed of age and emotion regulation tendencies predicted psychological distress. The family-level factors of household income and number of children in the family also predicted distress. In terms of environmental-level factors, COVID-19-related media consumption and school status (open or closed) were also significant predictors of psychological distress. Importantly, the results showed that the most important predictors of psychological distress in mothers during the COVID-19 outbreak were school closures, household income, and the use of adaptive and maladaptive emotion regulation strategies.

CONCLUSIONS

The findings highlight the intersection of individual, familial, and environmental factors in mothers' mental health during crises.

COVID-19 Stress and Child Behavior: Examining Discrimination and Social Support in Racially Diverse ECHO Cohorts

OBJECTIVE

To examine the additive or moderating influences of caregiver COVID-19-related stress, social support, and discrimination on children's behavior problems across racially diverse populations.

METHOD

In this Environmental influences on Child Health Outcomes (ECHO) cohort study (N = 1,999 caregiver/child pairs), we operationalized caregiver COVID-19-related stress in 2 ways: first, as the number of stressors (eg, financial concerns, social distancing); and second, as the level of pandemic-related traumatic stress symptoms reported via questionnaires administered between April 2020 and August 2022. At the same assessment visit, caregivers also reported their current levels of discrimination, and a subsample (n = 968) reported their emotional and instrumental support. Either concurrently or at a later assessment visit, caregivers reported on their children's internalizing and externalizing behavior problems using the Child Behavior Checklist for Ages 6-18 (CBCL/6-18).

RESULTS

Multivariable analyses controlling for maternal education, marital status, child age, and child sex revealed that COVID-19-related stress (caregiver stressors and symptoms) and discrimination were positively associated, and that perceived support was negatively associated with child internalizing and externalizing behavior problems. Unexpectedly, neither emotional nor instrumental support attenuated the relationship between caregiver COVID-19-related stressors nor traumatic stress symptoms and child behavior problems. In the subset of Black American participants, caregiver perceived discrimination moderated the relationship between caregiver COVID-19 traumatic stress symptoms and child internalizing problems, such that the association was stronger at higher levels of discrimination.

CONCLUSION

Our findings highlight the potential importance of relieving caregiver stress and increasing caregiver social support to optimize children's behavioral outcomes.

Kids these days and kids those days: Investigating perceptions of children's social skills from 1988 to 2007

Behavior rating scales are frequently used assessment tools designed to measure social skills. Use of norm-referenced assessments such as behavior rating scales requires examiners and test publishers to consider when norms become obsolete and norm-referenced scores can no longer be validly interpreted. A fundamental factor influencing norm obsolescence regards changes in baseline levels of targeted traits within the population. Yet, limited research exists regarding how social skills may change at a population level over time as measured by established assessment tools. Thus, the present study investigates population trends in social skills of K-12 children as rated by parents, teachers, and students by concordantly linking the Social Skills Rating System (SSRS; nparent = 833, nteacher = 1215, nstudent = 4105) and the Social Skills Improvement System-Rating Scales (SSIS-RS; nparent = 2400, nteacher = 750, nstudent = 800) using validity samples collected during the development of the SSIS-RS (nparent = 240, nteacher = 221, nstudent = 224). Analyses evaluated differences between ratings on the standardization data from 1988 and 2007 by informant, sex, grade level, and sex by grade level. After applying linear linking techniques, we conducted a series of statistical comparisons that revealed a general upward trend of ratings for the 2007 sample compared to the 1988 sample, with important differences across sex, grade level, and informant. We conclude with a discussion of the implications of these findings for consideration and assessment of children's social skills.

Short-term and long-term effects of the COVID-19 pandemic on child psychological well-being: a four-wave longitudinal study

As the COVID-19 pandemic further unfolds, it becomes a key theoretical and practical question to identify trajectories of child psychological well-being and to explore risk and resilience factors for developmental adjustment. The current study addressed this research gap by means of an ecological design: A (lockdown)-B (relaxation)-B (relaxation)-A (lockdown). We collected parental reports via online questionnaires over four measurement occasions during the COVID-19 pandemic in Germany (non-probabilistic sample): from the first lockdown (T1-spring 2020, N = 1769) to the following period of relaxation (T2-summer 2020, n = 873; T3-fall 2020, n = 729) on to the second lockdown (T4-winter 2020/21, n = 748). Key measures at T1-T4 were child emotional and behavioral problems as well as hyperactivity, child emotional and family-related well-being, parental strain, and parent-child relationship quality. We found evidence for quadratic growth models. While child problem behaviors (b = 0.32, p < 0.001) and emotional well-being (b = - 0.33, p < 0.001) improved after the first lockdown during subsequent periods of relaxation before worsening again in the second lockdown, child family-related well-being steadily decreased over all four measurement points (T1-T2: p < 0.001; T2-T3: p = 0.045; T3-T4: p = 0.030). Importantly, parental stress emerged as a strong risk factor (ps < 0.11) and the parent-child relationship quality constituted a resilience factor (p = 0.049) for child psychological well-being. These findings have major implications for policies aiming to further child health during the COVID-19 pandemic.

Making "Fast Friends" Online in Middle Childhood and Early Adolescence

Close peer relationships are critical to children's and adolescents' healthy development and well-being, yet youth sometimes struggle to make friends. The present work tested whether an online version of the Fast Friends procedure could engender closeness among 9- to 13-year-old youth. Participant dyads (N = 131), matched in age and gender, were randomly assigned to answer personal questions that encourage self-disclosure and play a collaborative game (Fast Friends condition) or to engage in similar activities without self-disclosure or collaboration (control condition). Fast Friends dyads reported feeling closer and expressed more interest in future contact than control dyads. The discussion addresses potential future uses and implications of an online Fast Friends procedure.

Exploring the potential impact of group identity on post-traumatic growth in the aftermath of Corona outbreak: function of social-emotional competence as a mediator

Background

This research endeavors to examine the potential effects of human and societal interactions on individuals' post-traumatic growth in the aftermath of the Corona outbreak. To achieve the aforementioned objective, the current research investigates the correlations between post-traumatic growth and group identity, while also examining the potential mediating function of social-emotional competence.

Methods

A cross-sectional design included a representative sample of 2,637 high school students located in the capital territory of Pakistan using convenience sampling method. To explore the associations, correlation and mediation analyzes utilizing the group identification scale, the social-emotional competence scale, and the post-traumatic growth scale was performed with SPSS PROCESS 4 macro and AMOS.

Results

The findings demonstrated that group identification emerged as a substantial predictor substantially associated with post-traumatic growth. Moreover, the relationship linking group identification and post-traumatic growth was found to be partially moderated by social-emotional competence.

Conclusion

The phenomenon of group identification can exert influence on post-traumatic growth through both direct and mediating pathways, with the latter being essentially mediated by social-emotional competence. The aforementioned outcomes possess significant academic and practical implications concerning the promotion of post-traumatic growth and the improvement of psychological well-being after the Corona outbreak.

Increases in adolescent firearm injuries were associated with school closures during COVID-19

BACKGROUND

Mitigation measures, including school closures, were enacted to protect the public during the COVID-19 pandemic. However, the negative effects of mitigation measures are not fully known. Adolescents are uniquely vulnerable to policy changes since many depend on schools for physical, mental, and/or nutritional support.  This study explores the statistical relationships between school closures and adolescent firearm injuries (AFI) during the pandemic.

METHODS

Data were drawn from a collaborative registry of 4 trauma centers in Atlanta, GA (2 adult and 2 pediatric). Firearm injuries affecting adolescents aged 11-21 years from 1/1/2016 to 6/30/2021 were evaluated. Local economic and COVID data were obtained from the Bureau of Labor Statistics and the Georgia Department of Health. Linear models of AFI were created based on COVID cases, school closure, unemployment, and wage changes.

RESULTS

There were 1,330 AFI at Atlanta trauma centers during the study period, 1,130 of whom resided in the 10 metro counties. A significant spike in injuries was observed during Spring 2020. A season-adjusted time series of AFI was found to be non- stationary (p = 0.60). After adjustment for unemployment, seasonal variation, wage changes, county baseline injury rate, and county-level COVID incidence, each additional day of unplanned school closure in Atlanta was associated with 0.69 (95% CI 0.34- 1.04, p < 0.001) additional AFIs across the city.

CONCLUSION

AFI increased during the COVID pandemic. This rise in violence is statistically attributable in part to school closures after adjustment for COVID cases, unemployment, and seasonal variation. These findings reinforce the need to consider the direct implications on public health and adolescent safety when implementing public policy.

The Association Between Group Identity and Post-Traumatic Growth in the Post COVID-19 Era: The Mediating Effect of Social-Emotional Competence

Purpose

To investigate the impact of human-society relationships on individual post-traumatic growth (PTG) in the post COVID-19 era, this study examined the association between group identity (GI) and PTG, and explored the mediating role of social-emotional competence (SEC).

Patients and Methods

In this cross-sectional study, we surveyed 1203 high school students in an eastern region of China using the GI Scale, the SEC Scale, and the PTG Scale. We conducted correlation and mediation analyses using SPSS 23.0 and PROCESS software.

Results

The results indicated that GI was a significant positive predictor of PTG (β=0.219, p<0.001), and that the pathway between GI and PTG was partially mediated by SEC (Effect=0.074, 95% CI= [0.045,0.104]).

Conclusion

GI can have both direct and indirect effects on PTG, with the latter mediated by SEC. These findings hold important theoretical and practical implications for promoting PTG and enhancing mental health in the post COVID-19 era.

The global impact of COVID-19 on child protection professionals: A scoping review and thematic analysis

BACKGROUND

The COVID-19 pandemic triggered new risks for child maltreatment (CM) and exacerbated existing challenges for families and children, elevating the importance of child protection professionals (CPPs) while also adding barriers to their work. During the pandemic, many CPPs experienced increased workloads, a disrupted work environment, and personal pandemic-related hardships. However, the scope of how COVID-19 impacted CPPs globally, as well as their adopted coping strategies, have not been well explored.

OBJECTIVE

This study addresses these gaps in the research by conducting an international scoping review to explore and analyze these topics.

METHOD

The scoping review was performed in six languages: English, Hebrew, Arabic, French, Spanish, and Portuguese, across 16 databases. Sixteen manuscripts were included in the final thematic analysis of this review.

RESULTS

Two main themes were identified: 1) the impact of COVID-19 on CPPs, and 2) the coping and adaptation strategies employed by CPPs during COVID-19. This review revealed and emphasized the importance of CPPs' resilience during COVID-19, underpinned by the theoretical framework of the social ecology of resilience.

CONCLUSIONS

This study highlights the responsibility of social ecologies and organizational structures to create readiness for a rapid response in times of crisis as well as valuable evidence to inform how CPPs, children, and families may be better supported in the event of a future crisis.

Why Do Iranian Preschool-Aged Children Spend too Much Time in Front of Screens? A Preliminary Qualitative Study

There is evidence that Iranian preschool children are increasingly spending their time in front of screens (screen time: ST; time spent with any screen such as TVs, computers, tablets, smartphones, game consoles, or video games), but few studies have explored the possible causes of such an increase. Given this, the present study aimed to qualitatively explore determinants of excessive ST in Iranian children. To this end, parents of preschool children were interviewed, and their answers were qualitatively clustered to identify additional important factors. Key informant interviews were conducted with parents of preschool children in Tehran (Iran). A semi-structured interview was developed to assess child and family life, daily routine, family rules, family interactions, and home climate as possible contributing factors to ST. Parents' audiotaped statements were transcripted verbatim, coded, and clustered into main themes using thematic analysis with the MaxQda^® software. A total of 20 parents of children aged 2 to 7 were interviewed, and a total of 6 key themes and 28 subthemes were extracted from their interviews. The results of the analysis identified a broad range of both independent and interrelated factors leading to the development and maintenance of ST behaviors among preschool children. Our findings indicate that the central concept is the family. Considering screen-related behaviors, family life encompasses parental health literacy (e.g., parenting pattern, monitoring standards, thoughtful parenting), family psychological atmosphere (e.g., presence of parents, family norms, parent-parent and parent-child interaction, congruency/incongruency of parents with each other) and the digital structure of the home. The child's and parents' actions and characteristics can influence family interactions. A child's and parent's behavior is also influenced by social/cultural factors. Parents' behaviors and attitudes, family communications, and interactions contribute to healthy ST habits in children. It is not possible to examine the child's behavior without considering the family and the dominant environment, since the behavior of family members as a whole affects each family member. Given this, interventions should make parents aware of their role and responsibilities in reducing children's ST and consider the family system as a whole, and interventions also can benefit from considering the parental perceptions of children's behaviors.

Internalizing and externalizing symptoms in children during the COVID-19 pandemic: a systematic mixed studies review

Introduction

Given the vulnerability of children during the COVID-19 pandemic, paying close attention to their wellbeing at the time is warranted. The present protocol-based systematic mixed-studies review examines papers published during 2020-2022, focusing on the impact of the COVID-19 pandemic on children's internalizing/externalizing symptoms and the determinants thereof.

Method

PROSPERO: CRD42022385284. Five databases were searched and the PRISMA diagram was applied. The inclusion criteria were: papers published in English in peer-reviewed journals; papers published between January 2020 and October 2022 involving children aged 5-13 years; qualitative, quantitative, and mixed studies. The standardized Mixed Method Appraisal Tool protocol was used to appraise the quality of the studies.

Results

Thirty-four studies involving 40,976 participants in total were analyzed. Their principal characteristics were tabulated. The results showed that children's internalizing/externalizing symptoms increased during the pandemic, largely as a result of disengagement from play activities and excessive use of the internet. Girls showed more internalizing symptoms and boys more externalizing symptoms. Distress was the strongest parental factor mediating children's internalizing/externalizing symptoms. The quality of the studies was appraised as low (n = 12), medium (n = 12), and high (n = 10).

Conclusion

Gender-based interventions should be designed for children and parents. The studies reviewed were cross-sectional, so long-term patterns and outcomes could not be predicted. Future researchers might consider a longitudinal approach to determine the long-term effects of the pandemic on children's internalizing and externalizing symptoms.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022385284, identifier: CRD42022385284.

Estimation and linkage between behavioral problems and social emotional competence among Pakistani young school children

Behavioral problems are commonly occurring concerns in school children and if left unidentified can result in worse outcomes in any society. The research aims to explore the prevalence of behavioral problems and its association with social emotional competence in young school children from a community sample of Islamabad, Pakistan. The cross-sectional study was conducted from April to June 2021 in four public primary schools in Islamabad, Pakistan. Two stage cluster sampling was used to select study sites. The sample comprised 426 school children (males = 182, females = 195) aged 4-8 years (Mean age = 6.5, SD = 1.09), from three different grades kindergarten, 1, and 2, respectively. The Child Behavior Checklist (CBCL) and Social Emotional Development Assessment (SEDA) were used to screen behavioral problems and social emotional competences of children. Data were analyzed using Stata 17. Prevalence for overall behavioral problems accounted for 65.4% (4-6 years) and 36.2% (6-8 years) in the abnormal (borderline and clinical) ranges of total problems. Social emotional competence scores were found significantly negatively associated with behavioral problems of children. The high prevalence necessitates the provision of mental health care to school-aged children. The findings should be taken as a call to Pakistan's policymakers, clinicians, and researchers to develop proper screening and management protocols for early intervention.

Changes in social behavioral developmental risks in preschool children after the first COVID-19 wave: a prospective longitudinal cohort study

The impact of the COVID-19 pandemic on social-emotional developmental risks (SE-DR) of preschool children is largely unknown. Therefore, the aim of this prospective longitudinal dynamic cohort study was to assess changes in preschoolers' SE-DR from before the pandemic to after the first COVID-19 wave. SE-DR were assessed annually with the instrument "Dortmund Developmental Screening for Preschools" (DESK). Longitudinal DESK data from 3- to 4-year-old children who participated both in survey wave (SW) three (DESK-SW3, 2019) and SW four (DESK-SW4, 2020) from August 1 to November 30 were used, respectively. Additionally, data from previous pre-pandemic SW were analyzed to contextualize the observed changes (SW1: 2017; SW2: 2018). A total of N = 786 children were included in the analysis. In the pre-pandemic DESK-SW3, the proportion of children with SE-DR was 18.2%, whereas in DESK-SW4 after the first COVID-19 wave, the proportion decreased to 12.4% (p = 0.001). Thus, the prevalence rate ratio (PRR) was 0.68. Compared to data from previous SW (SW1-SW2: PRR = 0.88; SW2-SW3: PRR = 0.82), this result represents a notable improvement. However, only short-term effects were described, and the study region had one of the highest preschool return rates in Germany. Further studies are needed to examine long-term effects of the pandemic on preschoolers' SE-DR.

Mental Health Is a Family Affair-Systematic Review and Meta-Analysis on the Associations between Mental Health Problems in Parents and Children during the COVID-19 Pandemic

As a multidimensional and universal stressor, the COVID-19 pandemic negatively affected the mental health of children, adolescents, and adults worldwide. In particular, families faced numerous restrictions and challenges. From the literature, it is well known that parental mental health problems and child mental health outcomes are associated. Hence, this review aims to summarize the current research on the associations of parental mental health symptoms and child mental health outcomes during the COVID-19 pandemic. We conducted a systematic literature search in Web of Science (all databases) and identified 431 records, of which 83 articles with data of over 80,000 families were included in 38 meta-analyses. A total of 25 meta-analyses resulted in significant small to medium associations between parental mental health symptoms and child mental health outcomes (r = 0.19 to 0.46, p < 0.05). The largest effects were observed for the associations of parenting stress and child mental health outcomes. A dysfunctional parent-child interaction has been identified as a key mechanism for the transmission of mental disorders. Thus, specific parenting interventions are needed to foster healthy parent-child interactions, to promote the mental health of families, and to reduce the negative impacts of the COVID-19 pandemic.

Examining the Contributions of Parents' Daily Hassles and Parenting Approaches to Children's Behavior Problems during the COVID-19 Pandemic

The present study was designed to examine the direct and indirect contributions of parenting daily hassles and approaches to children's externalizing and internalizing behavior problems during the COVID-19 pandemic. The sample for this study was 338 preschool children (53.6% girls, M_age = 56.33 months, SD = 15.14) and their parents in Turkey. Parents reported their daily hassles, parenting approaches, and children's behavior problems. Findings from the structural equation model showed that higher levels of parenting daily hassles predicted higher levels of externalizing and internalizing behavior problems. In addition, we found an indirect effect of daily hassles on children's internalizing behaviors via positive parenting. Further, there was an indirect path from parenting daily hassles to children's externalizing behaviors through the negative parenting approach. Results are discussed in the context of the COVID-19 pandemic.

Improving Surveillance and Epidemic Response in Ohio Childcare Settings

At the start of the Coronavirus Disease of 2019 (COVID-19) pandemic, the risk of cases in childcare programs was unknown. Thus, a rapid-response research approach was launched in Ohio childcare settings. Passive surveillance data from a state-operated incident reporting system were evaluated to estimate the number of COVID-19 cases from 15 August 2020 to 1 January 2021. Additionally, active surveillance with self-administered reverse transcriptase-polymerase chain reaction (RT-PCR) tests were conducted among staff at 46 childcare programs. Finally, six zoom-based focus groups with program administrators were used to gain feedback. Staff and children in childcare settings contributed 0.38% and 0.15% of the COVID-19 cases in Ohio during this timeframe, respectively. RT-PCR testing identified 3 unrecognized cases (0.88% of tests), and all occurred when the statewide positivity rate was >5%. Focus groups revealed that access to affordable cleaning supplies, masks, and reliable staffing were critical. Perhaps most importantly, we conclude that expanding the incident reporting system to include a childcare census would allow for the tracking of future health problems with highly valuable incidence rate estimations.

Mindful Parenting Mediated Between Mothers’ Perceived Stress During COVID-19 and Child Adjustment

Objectives

Maternal stress is associated with a myriad of maladjusted outcomes among children. To identify the role of mindful parenting between mothers’ stress and child adjustment during the COVID-19 pandemic, this study tested competing hypotheses with mothers’ mindful parenting as a mediator versus a moderator.

Methods

A total of 172 Chinese mothers of preschool-aged children participated in this study. Participants completed a self-report measure of stress during COVID-19 and mindful parenting, as well as a mother-report measure of children’s prosocial behavior, internalizing problems, and externalizing problems. Structural equation models were conducted to examine the mediation versus moderation effects of mindful parenting between mothers’ stress during COVID-19 and child adjustment, after controlling for family income, children’s age, sex, and adjustment at baseline.

Results

Findings indicated that mindful parenting mediated the link between mothers’ stress during COVID-19 and child adjustment, including internalizing problems, externalizing problems, and prosocial behavior. A test of competing hypothesis showed that mindful parenting did not moderate between mothers’ stress during COVID-19 and child adjustment.

Conclusions

This study revealed the mediating effects of mindful parenting between mothers’ perceived stress during COVID-19 and child adjustment. The findings inform researchers and practitioners about mindful parenting as a potential mechanism between maternal stress and child adjustment during the pandemic.

A systematic review of current status and challenges of vaccinating children against SARS-CoV-2

The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has inflicted immense damage to countries, economies and societies worldwide. Authorized COVID-19 vaccines based on different platforms have been widely inoculated in adults, showing up to 100% immunogenicity with significant efficacy in preventing SARS-CoV-2 infections and the occurrence of severe COVID-19. It has also greatly slowed the evolution of SARS-CoV-2 variants, as shown in clinical trials and real-world evidence. However, the total dosage of COVID-19 vaccines for children is much smaller than that for adults due to limitations from parental concern of vaccine safety, presenting a potential obstacle in ending the COVID-19 pandemic. SARS-CoV-2 not only increases the risk of severe multisystem inflammatory syndrome (MIS-C) in children, but also negatively affects children's psychology and academics, indirectly hindering the maintenance and progress of normal social order. Therefore, this article examines the clinical manifestations of children infected with SARS-CoV-2, the status of vaccination against COVID-19 in children, vaccination-related adverse events, and the unique immune mechanisms of children. In particular, the necessity and challenges of vaccinating children against SARS-CoV-2 were highlighted from the perspectives of society and family. In summary, parental hesitancy is unnecessary as adverse events after COVID-19 vaccination have been proven to be infrequent, comprise of mild symptoms, and have a good prognosis.

Parental psychological distress and child maladjustment: Exploring the moderating role of sibling relationship quality

The aim of this study was to investigate whether the quality of the sibling relationship moderates the association between parental psychological distress and child maladjustment (i.e., internalizing and externalizing problems). We extended previous literature by studying mothers and fathers separately and by including an observational measure of the quality of the sibling relationship. Participants were 52 two-parent families from a community sample who had at least two children living at home. Only one child (aged 6–10 years) was targeted for the study and studied in relation to his/her siblings. Mothers and fathers completed a self-reported questionnaire on their psychological distress and individually assessed their child’s social-emotional maladjustment. The targeted child’s interactions with his/her siblings were observed by independent judges during a home-visit. Results indicate that both maternal and paternal psychological distress are significant predictors of child social-emotional maladjustment. Moderation analyses reveal that children of distressed fathers are at lower risk of social-emotional maladjustment when they engage in highly positive interactions with their siblings. Post hoc analyses suggest that only sibling empathy (not teaching nor companionship) is a significant moderator of the association between paternal psychological distress and child maladjustment. The results of this study provide further evidence of the influence that fathers have in their child’s development and highlight the importance of using a systemic family approach to promote children’s social-emotional adaptation in the context of parental distress.

Time at Home during the COVID-19 Pandemic: Findings from Focus Groups with Hispanic Parents

The COVID-19 pandemic upended family life, forcing many families to reorganize their daily routines. Hispanic families have been especially affected by the pandemic, experiencing cumulative stressors and increased risks of contracting the virus, hospitalization, and morbidity. To date, there is limited research examining home life within Hispanic families during the pandemic. Given the extended amount of time for which families have been isolated at home together, identifying factors that may enhance or detract from well-being within the home is important in advancing efforts to support at-risk families. In this qualitative study, 29 Hispanic parents (primarily mothers) living in California participated in one of eight focus groups conducted in Spanish. Parents described activities and behaviors during the first year of the COVID-19 pandemic. The following six themes were identified using reflexive thematic analysis: (1) parents focused on family time; (2) children adapted to the changes of the pandemic; (3) parents and children engaged in physical activity; (4) children mainly entertained themselves with screens; (5) COVID-19 media coverage was accessible in the home; and (6) parents worried about the virus, and its effects on the future. While findings include anxiety around the virus and its attendant effects, family strengths were also present throughout the discussions. Public policy should consider ways to leverage family strengths to preserve family relationships and routines during future public health crises.