Written evidence submitted by UsForThem (CLL0057)
UsForThem is a lobby group of parents who believe that children's interests should be put first in any decision impacting them. Children have been disproportionately affected by the pandemic response while the disease itself does not directly affect them. This paper addresses the deployment of non-pharmaceutical interventions like lockdown and social distancing rules to manage the pandemic; testing and contact tracing, and Government communications and public health messaging. This paper has been compiled by UsForThem members who include a panel of clinical and educational psychologists and paediatricians.
Part 1: The impact on the education and development of our children from Pre-School to University
1) Pre- School
a) Importance of 'normal' developmental opportunities
b) Lack of 'normal' developmental opportunities
i) Limited focus on parent-led activities
ii) Unclear guidance means some activities have not reopened, are only available digitally or potentially developmentally damaging
2) School
a) Academic Impact
b) Disproportional impact on lower socio-economic groups and Special Educational Needs and Disabilities (SEND)
c) Impact on sports and other extracurricular activities
d) Quarantining healthy children is unnecessary and damaging to their futures
3) Universities
Part 2: The impact on the family, safeguarding and illness
Part 3: The impact on the mental health of children
1) Impact of fear messaging, increased restrictions and unpredictability
2) Masks
3) Short and long term impacts
Part 4: Questions to ask Government
Part 5: Recommendations
Part 1: The impact on the education of our children from Pre-School to University
1) Pre- School
a) Importance of 'normal' developmental opportunities
Physical touch, play, and social interaction are essential to cognitive, social-emotional and linguistic development. Research suggests there are critical periods, where skills and brain structures are best able to develop, and after which even the presentation of similar developmental opportunities, does not enable the same developmental outcomes[i] . Therefore, delays in the provision of developmental opportunities such as being able to play, socialise, touch, and attend nursery or school, need to be very carefully considered.
b) Lack of 'normal' development opportunities
i) Limited focus on parent-led activities (community playgroups, music groups, drop-in sessions where parents stay with their children rather than full/half day nursery)
Any lifting of restrictions for early years' settings appears to prioritise the economic need for childcare over children's developmental needs. Specifically, the role that primary caregivers have in facilitating and supporting early years development has been overlooked. Formal childcare settings are open, but parent-led activities are limited as children in most of the country can only visit another private residence if their parents are not present (i.e. for childcare needs).
ii) Unclear guidance means some activities have never restarted, are only available digitally or potentially developmentally damaging
No single department has responsibility for this sector, so there are no specific guidelines which has led to much confusion for parents, providers, venues, and even local councils. During the recent lockdown, the Office for Product Safety and Standards was issuing additional, stricter guidance than the Department for Education.
Some groups have processes which harm children's development – such as placing 'mobile toddlers' in playpens to enforce social distancing. Others enforce masks when the parent is seated within their allocated (and socially distanced) place for sensory and music classes.
Local authorities continue with restrictions after they have been lifted at a national level. Four weeks after the Government permitted the reopening of playgrounds, Sheffield City Council had only reopened 8/100 play facilities, whilst many Council Children's Centres have yet to restart any in-person groups. These digital provisions ignore previous health advice that early adaptation of screen time negatively impacts the development of healthy attention spans.
2) School
a) Academic Impact
78% of parents[ii] say Covid-19 regulations have negatively impacted their child's education since March. Only 12% of state schools were offering more than 5 hours of remote learning compared to 39% of independent schools [iii]. It is therefore unsurprising that children's education has suffered, such as a decline in literacy and writing stamina [iv]. Declining writing stamina raises concerns for pupils' exams.
Acknowledgement of this has meant that schools have increased curriculum time for numeracy and literacy to compensate. However, this has led to a reduction in curriculum time for lessons such as science, humanities, art, PE and music.
b) Disproportional impact on lower socio-economic groups and Special Educational Needs and Disabilities (SEND)
Deprived children enter school around 11 months behind their peers [v] and during lockdown spend 4.5hrs a week less time in education than better-off children [vi]. This was partly driven by lack of access to remote learning, lack of space to study [vii] as well as state schools in deprived areas offering more limited resources. SEND pupils have fallen further behind and not all multi-agency support has returned[viii].
c) Impact on sports and other extracurricular activities
Music and PE have already been significantly changed, including banning singing or instruments, and not playing team sports. The reduction in school and external physical activity meant that only 19% of children reached the Chief Medical Officer's guidelines of exercise [ix]and 39% of parents say their children put on weight [x]so exacerbating the obesity crisis. Extra-curricular activities are important opportunities for children to express themselves, which improves their health and wellbeing.
d) Quarantining healthy children is unnecessary and damages their futures
Research suggests school children are not drivers of transmission[xi] and that asymptomatic cases are unlikely to be contagious [xii] . This makes the current policy of excluding all contacts of a positive child misguided as well as damaging. Almost 900,000 state school children are currently missing a fortnight’s education when only 18,000 children had positive tests. [xiii] Quarantining has unintended consequences such as the children retaking GCSEs who could not complete their exams, and the exam boards had not prepared for this contingency so their GCSEs are either based on an average of the papers they did or ungraded as they could not complete enough papers. This is exceptionally distressing for the young people involved who have twice had exams interrupted and will affect their long-term educational/employment prospects.
3) Universities
Most universities switched to remote learning quickly; however, tutorial and seminar provision took longer to go online, and provision was reduced. Subjects requiring laboratory work and studio access continue to miss out on large sections of learning and practical experience.
Many students had to continue paying for accommodation. This was particularly hard for those in care or estranged from their families. The lack of jobs within the hospitality sector has impacted students' ability to pay for their education.[xiv]
Part 2: The impact on the family, safeguarding and illness
The extended period of homeschooling driven by closures and isolations detrimentally impacted the family. Parents found it stressful combining working and homeschooling experiencing 4 hours extra childcare and less leisure time[xv] . This has put pressure on parental relationships, with 62% of Relate counsellors reporting an increase in disagreements about parenting[xvi]. There has been a 50% increase in calls concerning children living with domestic violence[xvii]. Tensions between parents and children increased with 75% of parents asked reporting that they have been more cross or argued with their children since lockdown[xviii]. 38% of families said that their income had reduced since Covid-19 and these were mainly families on low incomes[xix]. Research has shown that those parents who lost income were significantly more likely to get frustrated with their child[xx]. Covid regulations have made visits and interaction with extended family harder and almost 3/4s of parents believe their child's relationships with their extended family have got worse[xxi]. This is especially problematical for larger families who under the Rule of 6 may be unable to meet any friends or family, even in public open spaces.
Paediatricians have noted that children are presenting later [xxii]with illnesses, especially diabetes, sepsis and cancer. Baby weighing clinics are still mostly closed and health visitors home visits continue to be restricted. It was also concerning that child protection concerns were being picked up much later than usual.
Part 3: The impact on the mental health and development of children
All aspects of health and development contribute to a child's wellbeing, with it being widely recognised that emotional and psychological health is of equal importance to physical health[xxiii]. We know that children's learning, growth and development 'is not just something that happens. It requires attention - and much more investment'[xxiv]. Crucially, this investment includes the nurturing of a child's emotional and physical connection with loved ones, engagement in play and leisure activities, provision of a sense of structure, safety and predictability and a sense of community belonging. It is crucial to consider how these areas are being directly impeded by current covid-19 measures and the potential consequences of this.
1) Impact of fear messaging, increased restrictions and unpredictability
An increase in fearful messaging, and therefore levels of individual fear, will reduce children's sense of safety, impacting their ability to thrive and learn[xxv]. This sense of fear and unease is likely to be exacerbated by the lack of consistency, routine and predictability of everyday life. Especially for children, consistency, routine and predictability are crucial for wellbeing and development. This is particularly the case for children with additional needs such as Autism Spectrum Condition who often suffer more substantially without these. Specifically, ever-extending and changing 'lockdowns,' continuously changing guidance for teachers and schools (implemented inconsistently across the school system), and the impact of having to isolate suddenly at any time due to the 'bubble' system, are disrupting these crucially important needs for children. Restrictions such as social distancing, hazardous tape around playground equipment and Perspex separating desks all impede the developmental needs of children described above. Many of these environmental cues will also have the effect of triggering reminders of death, contagion and illness within children's minds, either consciously or subconsciously, likely increasing their feelings of fear.
To increase compliance with pandemic related restrictions, the Government has used a strategy to deliberately increase fear[xxvi] amongst the population, often at a subconscious level [xxvii]. The psychological ethics of this strategy are questionable in and of themselves given professional codes of ethics (relating to issues of informed consent and appropriate use of psychological techniques[xxviii]). However, the ethics of these techniques concerning children are even more questionable, and these techniques will impact children through the presence of restrictions in their day to day environments, most notably in educational settings. As children's brains are not fully formed, they will be unable to contextualise information relating to risk and harm in the same ways as adults. This could leave them feeling more fear and confusion.
Additionally, children are egocentric (assume things are about themselves), meaning they can easily misattribute bad things happening as happening because of them [xxix]. The narrative that children could ‘kill granny' places an inappropriate emotional burden on children, who may not be able to contextualise this responsibility appropriately. It also means children are something to fear for vulnerable people leading to excluding children from libraries and places of worship. There is an apparent absence of consideration on how this psychologically affects children who are exempt from mask-wearing.
UsforThem have collected evidence written by children on the impact of the lockdown (Appendices A and B).
2) Masks
Some authors state that up to 93% of all human communication is non-verbal [xxx], emphasising the importance of facial expressions. Masks cause an impairment of non-verbal communication via the blocking of facial expressions and difficulties in areas such as emotion recognition[xxxi], which are crucial for multiple aspects of social interaction. Removal of facial expressions can cause distress [xxxii] and covering the face can lead to a sense of social isolation, anonymity and changes in social dynamics such as increased distrust and aggression [xxxiii].
It seems plausible that masks could be at least partially responsible for the decline in phonics skills observed in educational settings [xxxiv], as they block observation of the lips/mouth and can also impair the auditory aspect of speech. Given the importance of language development in educational and emotional/behavioural outcomes, this raises concerns. Additionally, developing healthy attachments are widely accepted as important for long-term positive psychosocial outcomes[xxxv]. This development relies upon processes such as learning to recognise loved ones, reading and mirroring facial expressions and hearing intonation of voice. It has been suggested that mask-wearing by caregivers is potentially detrimental to the neurodevelopment of babies and crucial early bonding[xxxvi]. This phenomenon is likely to remain relevant well past infant development, as human interaction and attachment develop throughout life. It is concerning if early-years and school providers wearing masks which obscure facial expressions.
Further, masks and the messaging around them has allowed for the discrimination, such as labelling exempt children as 'selfish' or being told they cannot speak in the school playground (by teachers). Children are made to wear visual identifiers of exemptions (by schools), e.g. a badge or a yellow star. Having to 'wear one's disability' in such a public manner may have implications for internalising beliefs of deficit, e.g. that 'there is something wrong with me' ' associated with adverse psychological outcomes. Campaigns like 'heroes wear masks,' are highly likely to cause further discrimination and lower self-worth/ self-esteem of the minority group. Being visually identified as a minority has many well documented negative implications for physical and psychological health[xxxvii].
We are concerned that prolonged mask-wearing is likely to have long term implications for child health and development. We believe there are serious liability issues involved for schools and that there is an urgent need to review the DfE policies on face coverings in educational settings.
3) Short and long-term impacts
The mental health of children and young people has suffered severely during recent months, with 80% of those surveyed reporting a deterioration[xxxviii]. One in six now qualify for a potential mental health issue[xxxix]. There have been increases in self-harm[xl], abuse [xli] and a concerning signal of increased child suicide[xlii]. In educational settings, increases in anxiety, difficulties with concentration and motivation, concerns regarding increased aggression, anti-social and risk-taking behaviour, have all been reported. Specifically, in early-years settings, there has been a noted decline in communication, literacy, and language skills across the ages. Across all age groups, deficits in social skills and even developmental regression have been noted[xliii]
Figure 1: Word Cloud based on the three words that are associated by parents about the impact of the regulations on their children .
Although there are already evident short-term outcomes evidencing the harms measures are causing to children, it is crucial to recognise that many of the detrimental outcomes from the topics discussed, will not yet be in a form which can be easily reported. This does not mean they are not occurring. For example, children develop beliefs about themselves, others and the world, based on their environment and interactions. Without specific intervention, these beliefs stay with people throughout their lives. Beliefs about people being dangerous and the world being a scary place often lead to negative long-term psychological outcomes[xliv]. The longer the referenced measures are in place for, especially in child-focused settings, the increased likelihood of occurrence and severity of negative psychosocial consequences. Additionally, testing healthy children, especially repeatedly, increases the likelihood of them developing beliefs that they are not safe and healthy human beings unless they are continuously reassured to be so by an external test/person. This gives rise to concerns around the development of anxiety disorders and profoundly dysfunctional beliefs, leading to adverse long-term outcomes.
Part 4: Questions for the Government:
1) Why are young children still included in social distancing restrictions? Scotland/ Wales allowed free play for under 12s with no increase of transmission attributed to this age group?
2) Why are children and teachers wearing masks? Why have there been no risk assessments / ongoing monitoring as recommended by WHO Guidance?
3) Why aren't recovery figures shown?
4) Why are impact assessments not taken for decisions despite the UN Convention stating the need for children to be a primary consideration?
5) Why are children being forced to isolate for being a contact when they are at minimal risk individually and are not significant transmitters of the disease[xlv]?
Part 5: Recommendations
1) In educational and early-learning settings make mask-wearing entirely voluntary and do not stigmatise those who cannot wear them.
2) Do not test primary children who display Covid symptoms unless they are very sick as in the Netherlands [xlvi]
3) Do not quarantine school children based on their in-school contacts as in the Netherlands [xlvii]
4) Exclude children under 12 from the social distancing rules (align with Wales and Scotland).
5) Stop fear messaging - contextualise with recovery rates, numbers in context and stop children feeling they are to blame for the spread of the pandemic.
6) Risk assessments and monitoring for Non-Pharmaceutical Interventions for children.
7) Explore the impact of covid-19 within schools implementing minimal measures and consider whether this can be advised to other schools across the country – consistent guidance not heads choosing and making this minimal
8) Allow and enable sport in all tiers (allow travel and ensure facilities are open.)
9) One government department needs to be responsible for supporting non-Ofsted regulated early years settings, overseeing the urgent publication of specific guidance to support the reopening of community early-years facilities.
10) Expand support bubbles from parents of under 1s to parents of under 5s.
11) Remove children <12 years old from the Rule of 6, as in Scotland.
This paper has been compiled by UsforThem and contributors include
Dr Harrie Bunker-Smith (BSc, MSc, DClinPsy) Clinical Psychologist
Livia Pontes (BSc, MSc ClinPsy) Chartered Clinical Psychologist
Dr Rosamond AK Jones (MBBS, MD, FRCPCH) Retired Consultant Paediatrician
Appendix A: Children’s views on Covid-19 regulations
“I am currently in year 11 therefore studying to take my GCSES which are supposed to be taking place in June of next year. As you can imagine, the situation that we are living with is stressful for all pupils but especially year 11s and year 13s. At the time I am writing to you , I have been told by my school that I have to self-isolate for 2 weeks as I have been in ' close contact ' with someone with the virus and this has brought me great deals of stress as now I am having a unfair disadvantage to my fellow pupils who are learning the correct content in school. Currently in my school around 150 pupils and 17 teachers are self-isolating and it's at the point where we sit back and think is keeping schools open the right decision for everyone. This is happening in many schools across Bristol and the whole country and I find it insane how we're supposed to be doing our GCSES in just a matter of months. “(Email to UsforThem, November 2020)
