Q: What might parents and teachers expect to see regarding children’s mental health as they begin school this fall?

A: Worry or anxiety during this period would be expected and is a normal response. Children’s adjustment to the new school format, whether it’s remote or hybrid, would vary a lot based on age and a child’s individual personality or temperament, as well as the family’s overall experience of the pandemic. Both the disease aspects of the pandemic and also the economic stressors—if a parent or caregiver has lost a job, if there has been income or residential instability—are all part of the child’s experience and will play a role in the child’s adjustment. Some children could be experiencing the pandemic as a traumatic event—for instance if they’ve lost a grandparent or a loved one to COVID complications.

In younger kids, psychological distress might manifest as new or worsening behavioral problems, difficulty separating from parents or caregivers, or somatic symptoms such as aches and pains or changes in sleep or appetite. Older kids can also experience somatic symptoms, as well as fear, nervousness, stress, irritability, and hypervigilance. In the academic context, symptoms could include difficulty concentrating, difficulty with motivation, or school refusal.

A recent study in the U.S. that surveyed parents suggests that about 27% of parents and roughly 14% of children are experiencing worsening mental health problems during the pandemic. Rates of distress were highest among families with young children, who may have lost access to child care, and among single-parent families. We also know that some communities or subgroups have been disproportionately affected by the pandemic, including underresourced or minority communities, and children in these communities may be at higher risk for mental health concerns. Also, children with preexisting mental health concerns, children who have learning disabilities or any other challenges that have required individualized learning plans, and children with medical vulnerabilities may experience greater adjustment issues or mental health concerns at this time.