Researchers at Johns Hopkins Children's Center express that the study results offer a sense of reassurance, instilling "guarded optimism" regarding the developmental outcomes of young children who have been exposed to restrictions stemming from the pandemic.
A study conducted by the Johns Hopkins Children's Center has found that infants and children up to the age of 5 experienced only "modest" delays in reaching developmental milestones due to disruptions and restrictions from the COVID-19 pandemic.
In a report on the study that was recently published in JAMA Pediatrics, investigators evaluated possible links between pandemic-related disruptions to everyday life and changes in developmental milestone screening scores. The data were from the Comprehensive Health and Decision Information System (CHADIS), a web-based screening platform caregivers use to complete surveys about their children's development. It is used by more than 5,000 pediatric practices in 48 U.S. states.
Using the Ages and Stages Questionnaire-3 (ASQ-3), a caregiver-completed measure of child development routinely collected as part of pediatric care, researchers say they found only small decreases in communication, problem-solving, and personal-social skills, and no changes in fine or gross motor skills among children in the study.
"We found, overall, that while there are some changes, the sky is not falling, and that is a really important and reassuring finding," says Sara Johnson, Ph.D., M.P.H., corresponding author of the study, director of the Rales Center for the Integration of Health and Education at Johns Hopkins Children's Center, and Blanket Fort Foundation professor of pediatrics at the Johns Hopkins University School of Medicine.
Impact of the Pandemic on Families
Numerous studies, the researchers say, found the COVID-19 pandemic and related lockdown restrictions disrupted the lives of many people, including families with young children. Everyday life and daily routines were upended, as schools and child care centers closed, many people began working from home and social contacts diminished. Many experienced increased stress, anxiety, and social isolation due to these changes and activity cancellations.
Research has also shown the pandemic is linked to lower child health-related quality of life, increased mental health concerns, decreased sleep, and increased risk of obesity. However, the impact of the pandemic on developmental milestones among young children in the U.S. remained unclear, in part because studies designed to address them were done outside the United States, or in small samples. In the new study, Children's Center researchers looked at the developmental milestone status of 50,205 children, ages 0 to 5 years, drawn from a sample of more than half a million children whose parents or caregivers completed the ASQ-3. The ASQ-3 assesses children's developmental milestones in five skill domains: communication, gross motor, fine motor, problem-solving, and personal-social.
Researchers compared the children before and during the pandemic from 2018 to 2022 and found ASQ-3 score decreases in the communication (about 3%), problem-solving (about 2%) and personal-social (about 2%) skill domains. They found no changes in fine or gross motor skill domains. When looking specifically at infants 0–12 months old, similarly modest effects were observed, and there were only decreases in the communication domain (about 3%) and problem-solving domain (about 2%).
"We thought it was possible infants might experience less impact than the older kids, given that many caregivers may have spent more time at home with their very young children," says Johnson. "But we saw generally the same things in infants as we did for older kids."
Also, given an increase in parent and caregiver worry and stress, researchers investigated whether parents and caregivers reported more worries about their child during the pandemic, regardless of milestone achievement, and found worries about their child only increased slightly during the pandemic, compared to before the pandemic.
Study Limitations and Long-Term Considerations
While the researchers say the findings are reassuring, they add that the implications for children's long-term development remain unclear.
"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.
Johnson and her team of investigators believe their study findings will aid in planning for future public health crises, and also demonstrate the importance of shoring up the clinical infrastructure of overburdened health systems in the U.S., particularly developmental-behavioral pediatricians, who are specially trained to evaluate and treat developmental concerns. These resources will be essential to respond to the developmental needs of children now and in the future.
The investigators cautioned that the study did not factor in some variables that might have changed the findings, such as prenatal substance abuse and other health conditions. In addition, infants born preterm were excluded from the study, which may underestimate developmental impacts for this subgroup. Researchers also cannot rule out "selection bias" among healthcare providers participating in CHADIS, and there was no comparison group of children who weren't exposed to COVID-19 pandemic restrictions.
Reference: "Developmental Milestone Attainment in US Children Before and During the COVID-19 Pandemic" by Sara B. Johnson, Molly Kuehn, Jennifer O. Lambert, J. Paul Spin, Lauren M. Klein, Barbara Howard, Raymond Sturner and Eliana M. Perrin, 22 April 2024, JAMA Pediatrics.
DOI: 10.1001/jamapediatrics.2024.0683
Along with Johnson, the study authors from Johns Hopkins include Molly Kuehn, Jennifer Lambert, Lauren Klein, Barbara Howard (also with CHADIS Inc.), Raymond Sturner (also with the Center for Promotion of Child Development through Primary Care), and Eliana Perrin. J. Paul Spin from EVERSANA was also an author.
The study was funded by the Johns Hopkins Population Center and its infrastructure grant (P2CHD042854) from the National Institute of Child Health and Human Development (NICHD).
News
New book from NanoappsMedical Inc – Molecular Manufacturing: The Future of Nanomedicine
This book explores the revolutionary potential of atomically precise manufacturing technologies to transform global healthcare, as well as practically every other sector across society. This forward-thinking volume examines how envisaged Factory@Home systems might enable the cost-effective [...]
A Virus Designed in the Lab Could Help Defeat Antibiotic Resistance
Scientists can now design bacteria-killing viruses from DNA, opening a faster path to fighting superbugs. Bacteriophages have been used as treatments for bacterial infections for more than a century. Interest in these viruses is rising [...]
Sleep Deprivation Triggers a Strange Brain Cleanup
When you don’t sleep enough, your brain may clean itself at the exact moment you need it to think. Most people recognize the sensation. After a night of inadequate sleep, staying focused becomes harder [...]
Lab-grown corticospinal neurons offer new models for ALS and spinal injuries
Researchers have developed a way to grow a highly specialized subset of brain nerve cells that are involved in motor neuron disease and damaged in spinal injuries. Their study, published today in eLife as the final [...]
Urgent warning over deadly ‘brain swelling’ virus amid fears it could spread globally
Airports across Asia have been put on high alert after India confirmed two cases of the deadly Nipah virus in the state of West Bengal over the past month. Thailand, Nepal and Vietnam are among the [...]
This Vaccine Stops Bird Flu Before It Reaches the Lungs
A new nasal spray vaccine could stop bird flu at the door — blocking infection, reducing spread, and helping head off the next pandemic. Since first appearing in the United States in 2014, H5N1 [...]
These two viruses may become the next public health threats, scientists say
Two emerging pathogens with animal origins—influenza D virus and canine coronavirus—have so far been quietly flying under the radar, but researchers warn conditions are ripe for the viruses to spread more widely among humans. [...]
COVID-19 viral fragments shown to target and kill specific immune cells
COVID-19 viral fragments shown to target and kill specific immune cells in UCLA-led study Clues about extreme cases and omicron’s effects come from a cross-disciplinary international research team New research shows that after the [...]
Smaller Than a Grain of Salt: Engineers Create the World’s Tiniest Wireless Brain Implant
A salt-grain-sized neural implant can record and transmit brain activity wirelessly for extended periods. Researchers at Cornell University, working with collaborators, have created an extremely small neural implant that can sit on a grain of [...]
Scientists Develop a New Way To See Inside the Human Body Using 3D Color Imaging
A newly developed imaging method blends ultrasound and photoacoustics to capture both tissue structure and blood-vessel function in 3D. By blending two powerful imaging methods, researchers from Caltech and USC have developed a new way to [...]
Brain waves could help paralyzed patients move again
People with spinal cord injuries often lose the ability to move their arms or legs. In many cases, the nerves in the limbs remain healthy, and the brain continues to function normally. The loss of [...]
Scientists Discover a New “Cleanup Hub” Inside the Human Brain
A newly identified lymphatic drainage pathway along the middle meningeal artery reveals how the human brain clears waste. How does the brain clear away waste? This task is handled by the brain’s lymphatic drainage [...]
New Drug Slashes Dangerous Blood Fats by Nearly 40% in First Human Trial
Scientists have found a way to fine-tune a central fat-control pathway in the liver, reducing harmful blood triglycerides while preserving beneficial cholesterol functions. When we eat, the body turns surplus calories into molecules called [...]
A Simple Brain Scan May Help Restore Movement After Paralysis
A brain cap and smart algorithms may one day help paralyzed patients turn thought into movement—no surgery required. People with spinal cord injuries often experience partial or complete loss of movement in their arms [...]
Plant Discovery Could Transform How Medicines Are Made
Scientists have uncovered an unexpected way plants make powerful chemicals, revealing hidden biological connections that could transform how medicines are discovered and produced. Plants produce protective chemicals called alkaloids as part of their natural [...]
Scientists Develop IV Therapy That Repairs the Brain After Stroke
New nanomaterial passes the blood-brain barrier to reduce damaging inflammation after the most common form of stroke. When someone experiences a stroke, doctors must quickly restore blood flow to the brain to prevent death. [...]
