Growing Up in Unprecedented Times

Children’s daily health behaviors during COVID-19.

Posted Dec 07, 2020

 Kelly Sikkema on Unsplash
Source: Image source: Kelly Sikkema on Unsplash

The COVID-19 pandemic has reshaped how people live, work, and interact with one another. Social distancing and quarantine regulations have impacted many facets of the everyday behavior of adults and children alike. These restrictions have widely influenced the way children learn, play, and get active. For many kids, official guidelines have limited the amount of time they spend in public areas such as parks and playgrounds (Government of Canada, 2020). In addition, most children are attending school virtually for part or all of the week (Moore et al., 2020). The pandemic has also had a widespread impact on the mental health of children and adolescents. High rates of anxiety, depression, and posttraumatic stress disorder have been identified among children across the world (De Miranda et al., 2020).

Parents and researchers have found themselves understandably concerned about how this changing lifestyle is impacting kids’ health. Healthy amounts of physical activity, limited screen time, and adequate sleep contribute to the physical and mental development of children (Carson et al., 2016). These behaviors also greatly impact children’s mental health and susceptibility to emotional disorders. Healthy amounts of sleep and screen time and adequate physical activity are correlated with improved mental health (Weatherson et al., 2020).

Prior to COVID-19, health experts and government officials had worked to develop 24-hour activity guidelines for children. These recommendations include suggested amounts of these three key health behaviors—physical activity, limited sedentary screen time, and sleep—reported by age group (World Health Organization, 2019; Carson et al., 2016). These values are displayed in the table below.

 World Health Organization, 2019; Carson et al., 2016.
Source: Figure 1: Physical activity, sedentary screen time, and sleep guidelines for children ages 0-17. Source: World Health Organization, 2019; Carson et al., 2016.

How are children moving, using screens, and sleeping during the pandemic? It is widely known, and quite obvious to parents, that COVID-19 restrictions have made it either more difficult or impossible for children to meet the overall guidelines for daily health behaviors. A group of researchers surveyed 1,472 Canadian parents in hopes of clarifying the extent to which COVID-19 has affected these health behaviors in children.

 Annie Spratt on Unsplash
Source: Image Source: Annie Spratt on Unsplash

The Impact of COVID-19 on Children’s Health Behaviors

Unsurprisingly, researchers found that children (ages 5-11) and youth (ages 12-17) were spending less time being physically active and more time being inactive during the pandemic. Only 18.2 percent of participants were found to be meeting the physical activity guidelines. Likewise, only 11.3 percent of participants were meeting the sedentary screen time guidelines. Researchers also found that children and youths were getting more sleep than usual, with 71.1 percent meeting the sleep recommendations (Moore et al., 2020). This is good news since adequate sleep is associated with greater mental well-being and because it allows the brain to process the day’s events, which may help people cope with the physical and emotional isolation of quarantine (De Miranda et al., 2020; Richardson et al., 2019). However, the overall findings of the study showed a strong negative impact of COVID-19 on children and youth’s activity: Only 4.8 percent of children and 0.6 percent of youth were meeting the combined health behavior guidelines during COVID-19 restrictions (Moore et al., 2020).

The physical distancing demands of COVID-19 have made it especially challenging for parents to encourage children and youth to meet the physical activity and screen time guidelines. Children and youth experienced a significant decline in all physical activities except household chores. The most dramatic decline was with outdoor physical activity and sport. These findings are a predictable result of the general instructions to “stay home” which have been commonplace since the outbreak of the virus. The increase in screen time in children and youth is also consistent with families’ lifestyle changes in response to COVID-19. For many families, digital media is a powerful way to cope with the disruptions brought on by the pandemic (Vanderloo et al., 2020). With more people than ever engaging in remote learning and virtual socialization, adhering to the guidelines for daily sedentary screen time is often impossible.

During these unprecedented times, parents should not blame themselves for their children’s changing daily routines. Virtual school and social activities often make it inconceivable to adhere to official guidelines for screen time. The suspension of active group recreations such as recess and team sports combined with the closing of outdoor spaces have had unavoidable consequences on children’s ability to move and play as normal. In addition, quarantine regulations have largely coincided with periods of cold or unpleasant weather, which also impact the amount of time children spend being active outside. We are forced to accept that the official health behavior guidelines are not realistic for the vast majority of people right now, and we must instead focus on doing our best with the resources we have available.

During this stressful time, it is important for parents to look after their mental health as well as that of their children. For some, it may be possible to engage in socially distant outdoor activities such as walking or hiking. Others may find it helpful to seek active indoor activities such as interactive dance or exercise games via a television or gaming device. These physical activities promote good mental health and, if done together, may help strengthen family relationships (De Miranda et al., 2020). Though we should not feel pressured to strive for an impossible ideal, we may find ourselves able to adapt our lifestyles in small but impactful ways.

 Ketut Subiyanto on Pexels
Source: Image Source: Ketut Subiyanto on Pexels

Children and families are finding ways to adapt their daily health behaviors to the current situation. 50.4 percent of respondents indicated that their child was doing more indoor activities. Similarly, 22.7 percent reported that their child was engaging in more outdoor activities. These activities included indoor hobbies such as arts and crafts, puzzles and games, and video games as well as outdoor pursuits such as biking, walking, hiking, and sports activities. In addition, 16.4 percent reported using online resources or apps to support physical activity (Moore et al., 2020). Although COVID-19 poses a great challenge to the development of healthy behaviors, these habits may be even more important now than before. Adopting healthy daily behaviors can help to mitigate the negative mental and physical health impacts on children and youth of this pandemic (Hongyan et al., 2020).

Tips for Improving Daily Health Behaviors

  • Start new hobbies and activities as a family. If possible, consider an active leisure pursuit such as hiking, biking, or a sports activity.
  • Encourage your children to play and be active in innovative and safe ways. This may include getting outdoors as much as possible, using online health or physical activity apps, and/or playing active video games such as Just Dance.
  • If possible, engage in physical activity yourself. Parental encouragement for and engagement in healthy daily behaviors were found to be most strongly associated with healthy daily behaviors in children and youth (Moore et al., 2020).
  • Continue to set routines for your children, including time for screens, regular sleep and wake times, and time for family activities. Limit leisure screen time to 2 hours per day and encourage non-screen playtime whenever possible.
  • Take care of your mental health, and encourage your children to do the same. There are many ways to do this in addition to practicing healthy behaviors. Keeping in touch with friends and family, taking a break when you need one, and being able to talk about your feelings with another person all promote good mental health.

Kendall Ertel (Yale undergraduate) and Reuma Gadassi Polack (postdoctoral fellow at Yale) contributed to this post.

Facebook image: Motortion Films/Shutterstock

References

Carson, V., Chaput, J.P., Janssen, I., & Tremblay, M.S. (2016). Health associations with

meeting new 24-hour movement guidelines for Canadian children and

youth. Preventive Medicine, 95, 7–13.

Government of Canada. Coronavirus disease (COVID-19): Canada’s

response. 2020 [cited Oct 2020]. Available from: https://www.canada.ca/

en/public-health/services/diseases/2019-novel-coronavirus-infection/

Canadas-reponse.html.

De Miranda, D.M., Da Silva Athannasio, B., Oliveira, A.C.S., & Simoes-e-Silva, A.C. (2020). How is COVID-19 pandemic impacting mental health of children and adolescents? International Journal of Disaster Risk Reduction, vol. 51.

Hongyan, G., Okely, A.D., Aguilar-Farias, N., et al. (2020). Promoting healthy movement

behaviours among children during the COVID-19 pandemic. Lancet Child

And Adolescent Health.

Moore, S.A., Faulkner, G., Rhodes, R.E., Brussoni, M., Chulak-Bozzer, T., Ferguson, L.J., Mitra, R., O’Reilly, N., Spence, J.C., Vanderloo, L.M., & Tremblay, M.S. (2020). Impact of the COVID-19 virus outbreak on movement and play behaviors of Canadian children and youth: a national survey. International Journal of Behavioral Nutrition and Physical Activity, 17(85).

Richardson, C., Oar, E., Fardouly, J., Magson, N., Johnco, C., Forbes, M., & Rapee, R. (2019). The moderating role of sleep in the relationship between social isolation and internalising problems in early adolescence. Child Psychiatry & Human Development

Vanderloo, L.M., Carlsey, S., Aglipay, M., Cost, K.T., Maguire, J., & Birken, C.S. (2020). Applying harm reduction principles to address screen time in young children amidst the COVID-19 pandemic. Journal of Developmental & Behavioral Pediatrics, 41(5), 335-336.

Weatherson, K., Gierc, M., Patte, K., Qian, W., Leatherdale, S., & Faulkner, G. (2020). Complete mental health status and associations with physical activity, screen time, and sleep in youth. Mental Health and Physical Activity, 19.

World Health Organization. WHO guidelines on physical activity, sedentary

behaviour and sleep for children under 5 years of age. 2019 [cited Oct

2020]. Available from: https://apps.who.int/iris/bitstream/handle/1

0665/311664/9789241550536-eng.pdf?sequence=1&isAllowed=y.