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COVID-19 pandemic led to ‘modest’ developmental delays in children

While causing significant disruptions across various aspects of life, the COVID-19 pandemic led to only “modest” developmental delays among infants and children up to five years old. This is the conclusion of a new study led by the Johns Hopkins Children’s Center.

The experts closely examined the potential correlation between pandemic-induced changes in daily life and children’s developmental outcomes.

Evaluating child development

The researchers utilized data from the Comprehensive Health and Decision Information System (CHADIS) – a web-based platform where caregivers report on child development across over 5,000 pediatric practices in 48 U.S. states.

The study was based on the Ages and Stages Questionnaire-3 (ASQ-3). This caregiver-completed assessment forms a routine part of pediatric care, evaluating child development in areas such as communication, problem-solving, and personal-social skills, along with fine and gross motor skills.

Developmental delays in children 

The findings suggested slight decreases in communication, problem-solving, and personal-social skills, yet no notable changes were observed in the motor skills domains. 

“We found, overall, that while there are some changes, the sky is not falling, and that is a really important and reassuring finding,” said corresponding author Sara Johnson, the  director of the Rales Center for the Integration of Health and Education at Johns Hopkins Children’s Center.

The backdrop of the research is the extensive disruption wrought by the COVID-19 pandemic and related lockdowns, which upended routines for families globally – shuttering schools, moving work to homes, and reducing social and physical activities. This led to increased levels of stress, anxiety, and social isolation, impacting both physical and mental health across all age groups.

Pandemic linked to modest developmental delays

Despite broader concerns, the research team, upon analyzing developmental data from 50,205 children aged between 0 and 5 years, noted only modest developmental delays, primarily in communication and problem-solving skills. 

These effects were consistent across age groups, from infants to older children, suggesting that increased caregiver time at home may have mitigated more significant impacts.

Additionally, the study explored whether pandemic-related stresses led caregivers to worry more about their children’s development, finding only a slight increase in concerns during the pandemic compared to pre-pandemic times.

While the findings provide some reassurance about children’s resilience to profound disruptions, the long-term implications of these modest developmental delays remain uncertain. 

“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,” explained Johnson.

Broader implications of the study

Looking forward, the insights from this study are pivotal for preparing for future public health crises. They underscore the necessity of enhancing the clinical infrastructure to support developmental and behavioral pediatric services, ensuring that children’s developmental needs are adequately met both now and in the future.

The study acknowledges certain limitations, such as excluding variables like prenatal substance abuse and the exclusion of preterm infants, which might skew the understanding of the pandemic’s full impact on developmental outcomes. 

Moreover, the potential for selection bias among participating healthcare providers in the CHADIS database could affect the generalizability of the findings. These factors underscore the need for continued research to fully ascertain the developmental consequences of the COVID-19 pandemic on young children.

How did the pandemic impact children’s lives?

The pandemic highlighted and often exacerbated existing disparities in access to resources, support, and opportunities for children, influencing their developmental trajectories in profound ways.


School closures and the shift to remote learning disrupted traditional educational experiences, leading to learning losses for many children. This was especially pronounced in communities with limited access to technology or where students received less support at home.

Social development

With social distancing measures and lockdowns, many children missed out on crucial aspects of social development. The lack of in-person interactions with peers during critical developmental periods affected their social skills and emotional intelligence.

Mental health

The pandemic has been linked to increased rates of anxiety, depression, and other mental health issues in children. The isolation, uncertainty, and changes in routine contributed to stress and emotional distress.

Physical health

Physical activity levels dropped for many children due to restrictions on outdoor play and sports. This change has implications for physical health, including increased rates of obesity and related health conditions.

Safety and abuse

For some children, staying at home meant an increased risk of exposure to domestic violence and abuse. The protective environments provided by schools and community programs were less accessible.

Nutritional access

Many children rely on schools for nutritious meals. School closures impacted their access to these critical resources, increasing food insecurity among vulnerable populations.

The study is published in the Journal of Pediatrics.


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