Objectives
Despite significant disruption to school during the COVID-19 pandemic, research on the impact on children is sparse. This study examines in-person and virtual learning contexts and the impact of school format on mental health (MH).
Methods
Children and adolescents were recruited from community and clinical settings. Parents and children responded to online surveys about school experiences (November 2020), and MH symptoms (February/March 2021), including school format, instruction, and changes to learning activities. Standardized measures of depression, anxiety, inattention, and hyperactivity were collected. Hierarchical regression analyses were carried out to assess the impact of school format on MH. An interaction effect tested whether school format was differentially associated with MH for children with and without a prepandemic MH diagnosis.
Results
Children (N = 1011; ages 6-18 years) attending school in person (n = 549) engaged in high levels of participation in COVID-19 public health measures and low levels of social activities or academic support. An online school format in high school was associated with poorer MH outcomes (p < .05). Children with no previous MH condition that attended school virtually experienced a similar magnitude of MH symptoms as those with previous MH conditions (p > .05). Among children who attended school in a hybrid in-person format, children with no previous MH conditions experienced fewer MH symptoms as their same-age peers with prior MH problems (p < .05).
Conclusions
Children attending school in person had limited engagement in social activities and academic support. The virtual school format was associated with worse MH outcomes in high school. Efforts to address the learning contexts to protect the MH of children are needed.
SAC, AD, DDD
Footnotes
Supported by Canadian Institutes for Health Research Grant 173092; Ontario Ministry of Health Grant 700; the Centre of Brain and Mental Health, SickKids; the Leong Centre for Healthy Children, SickKids; the Miner’s Lamp Innovation Fund in Prevention and Early Detection of Severe Mental Illness, University of Toronto; and the Ontario Brain Institute