How the pandemic is changing children's brains

An article in Nature that reviews several preliminary studies warns that the collateral effects of the pandemic, such as the Covid protocols, home confinements, distance education and, in general, the restrictions imposed to contain infections, could be influencing the development of future generations from the moment of their birth.

Although children have generally done well when infected with SARS-CoV-2, research suggests that pandemic-related stress during pregnancy may be negatively affecting fetal brain development in some children.

In addition, exhausted parents and caregivers may be interacting differently or engaging less with their young children, which could impact the future development of children's physical and mental abilities, concludes a paper published in Nature reviewing the findings. carried out on the effects of two years of pandemic on children. The conclusions are surprising.

In one of the studies, researchers have evaluated the impact of the SARS-CoV-2 coronavirus on the differences in neurological development between two groups of babies.

The researchers, coordinated by Dani Dumitriu of New York Presbyterian Morgan Stanley Children's Hospital and Morgan Firestein of Columbia University, compared the motor and communication skills of infants up to six months of age born before and during the pandemic, using the databases they had from 2017 onwards.

Just a few days after analyzing the first data, they found that children born during the pandemic had lower averages on tests of gross motor skills, fine motor skills, and communication skills compared to those born earlier, regardless of which biological parents had been. previously infected or not.

The researchers pointed to "something that distills the pandemic itself," they point out in the study published in the latest issue of the journal Nature. "Lockdowns, while crucial in controlling the spread of coronavirus, have isolated many young families, robbing them of leisure time and social interactions. Many parents and other caregivers, stressed and on guard, have been unable to provide the time they need. infants and young children."

"We want to document how much this situation is affecting child development, parent-child relationships, and peer relationships," James Griffin of the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Bethesda, Maryland, says in Nature.

Researchers around the world are beginning to publish their first findings in a setting where it is difficult to find solid conclusions, especially since many child development research laboratories have closed during the pandemic."

Early data suggests that some babies born during the last two years may be experiencing developmental delays, while others may have thrived if their caregivers were able to be home for extended periods and there were more chances for siblings to interact with each other. "As with many aspects of health during the pandemic, social and economic inequalities determine how much these side effects of lockdowns affect the most.

Cognitive and school delay before which it will be necessary to catch up

Early studies also suggest that the use of masks has not negatively affected children's emotional development. But prenatal stress could contribute to some changes in brain connections, according to the first studies, many of them preliminary in nature, which have not yet been subjected to the peer review process of scientists, which gives greater consistency to their conclusions. In fact, some researchers believe that many of these developmentally delayed children will be able to catch up quickly.

One lab that was open during the pandemic, the Advanced Infant Imaging Laboratory at Brown University in Providence, Rhode Island, documented effects on motor, visual, and language skills as part of a seven-year National Institutes study. of Health (NIH) on early childhood development.

Sean Deoni and his colleagues use magnetic resonance imaging (MRI) and other techniques to study how environmental factors shape brain development in infants, and they saw early on that children were taking much longer to pass assessments, which led them to compare annual averages and the variations of the infants' neurodevelopmental score. They found that scores during the pandemic were much worse than in previous years.

The researchers found that between the end of 2020 and the beginning of 2021, babies born into the pandemic scored almost two standard deviations lower than those born earlier when they compared results obtained with tests similar to those used to determine IQ. The biggest drops were among families with lower incomes, more among boys than girls, and what fell the most were gross motor skills, once selection bias had been ruled out.

And why might babies born during the pandemic be experiencing cognitive, and especially motor, deficits? Deoni suspects the problems stem from a lack of human-to-human interaction: the number and variety of words parents pass on to their children is less than in years past, and infants and toddlers aren't practicing gross motor skills in the classroom. same extent as before because they do not regularly play with other children or go to playgrounds. "And unfortunately, those skills laid the foundation for all other skills," concludes this Nature expert.

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Increasingly, experts are also suggesting that so-called "distance education" and online learning may be widening already wide gaps in learning and development between children from low-income and affluent backgrounds and between white children and children of color.

Researchers from the Netherlands have reported that children fared worse on national assessments in 2020 compared to the previous three years, with learning loss increasing by 60% among children from families of lower socioeconomic status.

In parts of sub-Saharan Africa, including Ethiopia, Kenya, Liberia, Tanzania and Uganda, research suggests that some children have lost up to a full year of school learning. And in the United States, after the first shutdown, a report by the consulting firm McKinsey suggested that students of color started school in the fall three to five months behind white students, among whom this delay was from one to three months.

Masks hinder, but do not hinder

Another important question concerns the use of masks, which hide parts of the face and prevent expression through facial features and hinder communicative and emotional expression, which could also be affecting emotional and linguistic development in children.

Edward Tronick, a psychologist at the University of Massachusetts, Boston, is popular for his 1975 Still Face experiment, which showed that when birth parents suddenly became serious when interacting with their babies, their children initially tried to get their attention, but without success, little by little they gave up and became more and more sullen and cautious.

Tronick has published a similar study to see if masks have a similar effect in which parents recorded their interactions with their babies before, during and after they put on a mask. These experts found that although the babies noticed when their parents put them on, changing the gesture, looking away or pointing at the mask, they continued to communicate with their parents as before. "The mask only interrupts a communication channel, these experts explain. "The parent who wears it is still able to convey the message they need: I am here, talking to you, I am here for you, I still connect with you."

Masks also don't seem to interfere as much with emotional or language perception. A study published in May found that two-year-olds understand words spoken by adults wearing opaque masks. Children "compensate for information deficits more easily than we think," says the study's lead author, Leher Singh, a psychologist at the National University of Singapore.

Other researchers in the United States have determined that masks make it difficult for school children to perceive the emotions of adults in a similar way to the effect caused by wearing sunglasses, but the vast majority of children are able to filter this effect and get the message that is being transmitted to them. "There are many other cues that children can use to analyze how other people are feeling, such as words, body language, or context," explains study lead author Ashley Ruba of the University of Wisconsin-Madison.

Stress in pregnancy weakened brain connections

Other researchers are trying to figure out whether the pandemic could be affecting the development of children before they are born. Catherine Lebel, of the Developmental Neuroimaging Laboratory at the University of Calgary in Canada, and her colleagues surveyed more than 8,000 pregnant people during the pandemic. Almost half had symptoms of anxiety and a third had depression, a much higher percentage than in the years before the pandemic. How did this stress affect the development of babies in the womb?

To find out, the researchers scanned the brains of 75 of the babies three months after birth with MRI and found that babies born to people who suffered more prenatal distress (more symptoms of anxiety or depression) showed different structural connections between their amygdala, a brain region involved in emotional processing, and the prefrontal cortex, an area responsible for executive functioning skills, they pointed out in a preprint published last October.

In another earlier study, Lebel and her team established the link between prenatal depression and brain wiring differences in those same areas, suggesting that in children, these brain changes correlate with aggressive and hyperactive behavior in the prenatal period. preschool. Other teams have found that changes in the connection between these areas in adults are risk factors for depression and anxiety, as they are brain areas involved in processing emotions and many other different behaviors.

Other research has established a similar association between prenatal pandemic stress and child development. Livio Provenzi's team, from the IRCCS Mondino Foundation in Pavia, Italy, found that three-month-old babies of people who suffered more stress and anxiety during pregnancy had more problems regulating their emotions and attention: they were less able to maintain their attention to social stimuli, for example, and were more difficult to calm than babies of people who were less stressed and anxious during pregnancy.

This expert is now studying the effect of maternal stressors on children's brains and behavior. She points out that while there's a lot of concern about how prenatal stress might affect pandemic babies, it doesn't mean kids are going to have problems for the rest of their lives. "Children are very adaptable and malleable and we hope that things get better and that they get over what happened."

In fact, research done to measure post-traumatic stress disorder after natural disasters suggests that while stress in the womb can be harmful to babies, it doesn't always have lasting effects. "Children born to people who experienced considerable stress after the 2011 floods in Queensland, Australia, showed deficits in problem-solving and social skills at six months of age, compared with children born to people who experienced less stress. stress. But 30 months later these results no longer correlated with stress, and the more responsive parents were to the needs of their infants and toddlers after birth, the better off they were."

Scientists say it's too early to draw meaningful interpretations around "pandemic babies." Therefore, some of these early findings, often unpublished, may not reflect reality, while the parents who have participated in these early studies may not be a representative sample because they may have been conditioned by behaviors they had previously observed in other children. .

"Parents can move forward by playing and talking to their young children on a regular basis and by giving them opportunities to play with others in safe environments. And health policies put in place to support pregnant and postpartum families and children during the pandemic could also make a difference. the difference", concludes Provenzi.

Nature 601, 180-183 (2022) doi: https://doi.org/10.1038/d41586-022-00027-4