CIE0385
We are senior academics from the University of Cambridge who represent many disciplines that contribute to applied research related to child development. Individuals are listed at the end of the document for reference and include experts in Economics, Education, Psychology, Psychiatry, Neuroscience, and Epidemiology.
Our collaboration aims to optimise the application of evidence to policy and practice for the benefit of children, young people, their families / carers and the practitioners working with them. For each issue, we first present relevant research evidence that identifies key challenges for education and children’s services, as well as any very recent evidence gathered during the pandemic itself, and then suggest what the policy response might be.
The Covid-19 pandemic has had unprecedented impact, affecting the entire nation and with severe disruption for children, their families, schools and children’s services. It also occurred against a backdrop of increasing concern about the purpose of the education system and children’s services (1-3), as well as increasing concern about the mental health of children and young people (4). Children, teachers and other practitioners had to adjust rapidly to the Lockdown, and will continue to flexibly adapt as society begins to open up. The move to remote schooling for most of the school population, combined with the change to remote working or emergency only responses from other services, raised significant immediate challenges that schools and children’s services have had to manage. The policy and practice response to these challenges, however, offers an opportunity to improve systems that were functioning poorly to start with i.e. to consolidate and build on any beneficial changes in the longer term. While additional resource will be needed to mitigate the impact of the pandemic on children, evidence suggests that there are significant costs to the limitations of the current system and hence this crisis potentially offers opportunities for service improvement, and ultimately to reduce future costs. For example, the cost of mental health conditions falls mainly on the school system, with repeated meetings that are rarely therapeutic (5,6). We have effective interventions for significant behavioural problems, which cost very little compared to the costs incurred by education, social care, criminal justice and health if these difficulties persist (8). However we have insufficient provision to meet current levels of need (9,10).
Our evidence covers learning loss, school, community and family factors, as well as specific issues for some vulnerable groups. We provide evidence on all these issues, with specific suggestions for policy. However, we start by noting the following over-arching principles that guide our evidence for the committee:-
From these principles flow the following policy recommendations, which are expanded upon in the text that follows:-
At the end of the document we list useful evidence-based sources of information that can guide policy decisions and practice recommendations as a reference and that could be usefully disseminated across agencies working with children.
There is a significant relationship between instruction time and achievement (14), with each additional hour of schooling per week yielding around a 6% of a standard deviation improvement in test scores. As a result of the pandemic most children are not receiving face-to-face instruction and the quality of remote schooling has been highly variable. A loss of 3-4 hours of each main subject per week for a term equates to about an hour over an entire academic year, i.e. 6% of a standard deviation (see Burgess, 2020 for further evidence, 15). The actual loss of learning may be greater given other stresses on families and will vary by context, depending on what schools are able to provide as well as what families are able to access (see 3.3, 16). It is very clear however, that there will be very substantial loss to children’s achievement and attainment.
The pandemic, and government response to it, will have a substantial impact on academic achievement, but this will likely be for subtly different reasons at different age ranges. The earlier years of a child’s life are pivotal for their development and investment in children during this time is particularly valuable, in terms of improving their cognitive and non-cognitive skills, the latter including skills such as self-regulation of behaviour, feeling in control of one’s own life (locus of control) and pro social behaviours (see Heckman et al. 2011 (17) and Britton and Vignoles, 2019 (18) for a summary). Hence the negative impact from a lack of face-to-face school provision is likely to be large for children in the early years and primary school (19). Older children and adolescents will be significantly affected by the increased social isolation, which is likely to have a major negative impact on adolescents in particular (20). Furthermore, any inequalities in attainment that worsen in later adolescence, as students approach key high stakes examinations (GCSEs and A levels), will have a much longer-term impact on their educational and labour market trajectories. It is therefore clear that learning loss will be evident for all ages, with the driving factors being dependent on, and sensitive to, developmental stage (19,20).
The evidence is also clear that the socio-economic gap in academic achievement will widen as a result of the pandemic for three related reasons:
i) Even under normal circumstances, a socio-economic gap in achievement emerges in the earliest years of a child’s life and widens during primary school and into secondary school (21). For those children whose parents cannot compensate for the lack of face-to-face schooling, reduced school provision during this phase will be particularly detrimental to their achievement.
ii) Low income has a causal negative impact on children’s outcomes, including their learning outcomes. A £860 increase in household income has been associated with gains in cognitive test scores of around 5-27% of a standard deviation (22). One likely mediating mechanism is parental stress. The pandemic has triggered both reductions in household income and increases in parental stress, so this evidence is highly relevant.
iii) Family environment – the sole social domain for young children during Lockdown – is a major determinant of children’s academic achievement (see also Britton and Vignoles, 2017 for a summary; 19). Well-educated parents invest more time and resource in their children during normal times. This explains much of the socio-economic gap in achievement. There is also some evidence that socio-economically advantaged parents tend to compensate for any deterioration in schooling to a greater extent (23). This implies that socio-economically advantaged parents who can provide more resources for their children (laptops, books, on-line resources etc.) will also be undertaking compensatory behaviours and this will exacerbate the learning gap. Multiple international and UK studies also highlight that economic stress affects children’s emotional, social and academic attainment by initiating a cascade of family stress processes that amplify poor parental mental health (depression), leading to elevated interparental/carer conflict and more negative parenting practices, which in turn affect negative outcomes for children and adolescents (24), these processes are likely to be amplified for multiple households during and as a result of the pandemic.
Some evidence that these three factors will culminate in widening the attainment gap is the impact of summer vacation periods. During the summer break, in some countries more socio-economically disadvantaged students experience a decline in their cognitive test scores. Alexander et al, (2007) for example, examined the impact of the long summer vacation in Maryland schools in the US. This evidence is relevant because the US system entails a sizeable summer break of around 3 months (25). Given that remote schooling has been happening in the UK since March, and that very little face to face schooling is likely to happen before September, this evidence of the impact of a long break seems relevant, though we recognise that schools have still been teaching even whilst they have been physically closed. Alexander et al. (2007) classified children according to their socio-economic status, based on parental education, income and occupation (25). More socio-economically advantaged children improved on the CAT battery of test scores (both reading comprehension and mathematics) following the summer break (e.g. on average by 52 CAT-R points per summer). By contrast disadvantaged children made losses or did not make gains, the so-called ‘summer slide’. Whilst this evidence may not help us quantify the extent of learning loss, it does support the conclusion that the crisis is likely to have widened existing inequalities in academic achievement.
There are large differences in cognitive skills directly related to classroom learning. For example, children with poor working memory – the capacity to hold in mind and manipulate small amounts of information for brief periods of time – are typically slower learners (26). Of the children falling into the bottom 10% on this cognitive skill relative to their peers, around 80% will have significant reading and maths problems, usually both. This is because these children learn more slowly in a typical classroom environment. But skilled teachers are able to mitigate this by altering the learning environment (27). In other words, children with poorer cognitive skills tend to be more sensitive to the learning environment (e.g. 28-30). This will likely mean they have been less able to adapt to home learning, and when schools restart with social distancing, alterations in class make-up and learning environment, children with poorer cognitive skills will find these unusual learning circumstances more challenging. Some children with cognitive difficulties will already be identified via a diagnosed learning difficulty, but most will not (31).
Furthermore, these differences are likely compounded by the socio-economic disparities identified above. Take for example learning to read. Socio-economic background directly negatively impacts reading development, as well as all the cognitive skills that contribute to it, including speeded sound decoding skills, the ability to differentiate word-like sounds, letter knowledge and non-verbal reasoning skills (32). In the absence of a formal school environment, these cognitive skills may well fall back, especially in children facing the added challenge of socio-economic disadvantage and family stress. Again, this will likely mean that these children will make a slow start when formal schooling resumes.
Preliminary evidence of compensatory behaviours by parents comes from a recent Sutton Trust survey (2020) which suggests that during this period middle class parents are spending more time with their children than working class parents. Forty four percent of middle class parents are spending more than four hours a day on home schooling (33). One third of working class parents are doing so. Recent evidence from the Institute for Fiscal Studies (IFS; 34) has confirmed that children from wealthier families are spending more time on home learning. Children from the top fifth of the family income distribution are spending 75 minutes more per day on educational activities than children in the bottom fifth of households. Furthermore, school provision is highly variable. Again, IFS evidence suggests that two thirds of secondary school pupils from the richest fifth of households are receiving online classes and videoconferencing with teachers. This compares to just under half of children from the poorest fifth of families. Meanwhile, around 80% of secondary school pupils in private schools are receiving online classes, which confirms that existing inequalities in academic achievement will widen through this crisis.
Poorer students have already faced additional barriers to their learning, specifically many lack a computer or access to the internet. Sutton Trust evidence (2020) indicates that schools in deprived areas are reporting that about a third of their primary and secondary school pupils lack access to an appropriate device to do online / remote learning (33).
When restarting face-to-face school, prioritise support for disadvantaged students to reintegrate with the learning environment, and allow sufficient time for them to do so. Schools should not try to cram more learning into a shorter period since this may leave some students even further behind. For example, those who have had better home support will tend to be able to progress more rapidly than those who have effectively had a gap in learning. Those who find learning more difficult and get less support from home will struggle to learn the same material more rapidly. Serious consideration needs to be given to interventions (see below) designed to mitigate learning loss of socio-economically disadvantaged pupils.
● The capacity of children’s services to support vulnerable children and young people
● Support for pupils and families during closures
● The effect on disadvantaged groups (particularly the most vulnerable groups; 28-29)
The overarching question is how, in the current situation, structures are supporting the development of:
● Children and young people (particularly vulnerable groups including those with special educational needs and disabilities)
● Parents in supporting children and young people’s development
● Teachers in supporting children and young people’s development
And, what the particular and systemic issues are in achieving this.
Vulnerable children are particularly at risk with school closures and Lockdown arrangements. A recent survey of vulnerable young people (44) reveals that young people feel their mental health has got worse. They are anxious about their families’ health, the impact of school and university closures, as well as loss of routine and social connections. A NSPCC survey (45) of those receiving counselling highlighted young people’s anxieties about difficult family relationships and suffering abuse, and difficulties in doing schoolwork. Young people with neurodevelopmental difficulties such as Autism are reporting an increase in anxiety during isolation. These children were already at an elevated risk of school related anxiety and refusal (46, 47) and providing them the support they need to return to school will require a coordinated approach involving schools, mental health services, and social services (see 3.5; 48).
A survey of over 5000 parents / carers (50) showed that parents/carers are most stressed about work, but also very anxious about their child’s emotional wellbeing. Children were concerned with the health of family members, missing school, and wanted support around emotional wellbeing, education and coming out of social isolation. The behaviour of children with SEN/ND is a particular stressor for parents in the current context. Parents sought more online resources to assist them with these demands.
There is an increased set of different and varied demands on teachers. A survey of over 2800 Irish primary teachers (42) on the impact of school closure identified some benefits (e.g. personal safety), but staff felt under pressure to provide online learning with some teachers reporting they felt angry, unprepared and out-of-depth as well as lacking equipment; well over half requested guidance, guidelines and clarity on the organisation of distance learning. If teachers do not feel efficacious, coupled with a lack of control this will be undermining two of three core needs identified as being essential for wellbeing according to self-determination theory (40). Furthermore, teachers were worried about catching up when the schools re-open and were worried about some children staying at home without the support they usually receive in school. Given that the context is a pandemic, other issues come to the fore. Research shows that teachers require confidence building in particular issues such as bereavement of parents or family members (50) and traumatic experiences with children.
There is clear evidence that young people’s mental health and wellbeing is most effectively cared for when professionals work across organisational divides (51).
The way of working is equally important. Approaches should not increase the anxiety of young people and teachers but should be collaborative, supportive and confidence building. Young people address emotions, including difficult ones, best through the processes that schools can offer i.e. through expressing their feelings in drama, art, playing and story-telling and through having nurturing adults around them. Warm and supportive teacher pupil relationships are important for all children, but particularly for children who face adversities; poor teacher pupil relationships predict the onset of mental health conditions, as well as academic attainment (53,54). There is anecdotal evidence that teachers and NHS CAMH services have been able to work especially closely during social isolation to support individual children.
The home and community environments that children and adolescents experience affect their emotional, social, behavioural and academic development. Relationships between parents/carers, between parents and children and between siblings as well as relationships with extended family affect children’s development in multiple domains (55). Access to community resources, open spaces, clubs, peer networks, play areas and sporting facilities also affect children’s social and emotional development (56, 57). The home and community based environments that children experience affect their propensity to learn and also enhance learning across cognitive and non-cognitive domains (58).
Importantly, child protection services interface with family, community and educational systems that children experience through engagement with professional agencies that safeguard children and adolescents from risk and harm. The Covid-19 pandemic has fundamentally shifted child protection operational practices, processes and procedures constituting substantial challenges for the safety of young people outside of the structure and oversight of in-person education and other children protection services and agencies.
Mirroring international data, evidence of increasing rates of children’s exposure to domestic violence and parental conflict have been reported in England and Wales since March 2020 (59). Yet, standard practice provision in identifying, accessing and supporting young people at risk of physical, sexual, psychological or other forms of neglect and abuse have been severely compromised during the period of the pandemic, with the likelihood of continued disruption in the future. Significant concern has been raised regarding the increased propensity for young people to experience heightened risk as a result of staying at home, while also staying away from school and other formal and informal (e.g. clubs) social settings that allow activation of child protection services. Policy makers, educators, social workers, other practitioners, parents, families and children urgently need new knowledge and practice guidance to help meet the support and protection needs of vulnerable young people when very few are attending schools or other activities where the welfare can be monitored.
While there is some evidence highlighting the efficacy of ‘on-line’ practice in psychotherapy (60), relatively little is known about how education and child protection practice can best be delivered effectively through ‘virtual’ home visits or how in-person interactions with children and families can best be done while maintaining social distancing, and potential continued absence from school.
The increase need for school-based assessment and signposting of emotional, psychological and other forms of risk is likely to be exponentially greater following the lock down period and return to school, likely placing unsustainable strain on school-based child protection and service delivery agencies.
Starting school is often exciting and enjoyable, but also brings new challenges that can be particularly difficult for some children. While traditional models of ‘school readiness’ emphasised children’s early literacy and numeracy skills, research evidence has led to a wider view that encompasses whole-child characteristics (e.g., wellbeing), as well as support from both families and schools (61). Likewise, current accounts of resilience go beyond child characteristics (e.g., verbal ability, temperament) to include multiple interdependent factors, that range from characteristics of the child to characteristics of the family, the school and the neighbourhood (62). A broad interpretation of school readiness makes sense from a policy perspective, in that families, schools (and indeed, communities) should share the responsibility of enabling all children to thrive during this important transition. For children either starting school or moving from Reception to Year 1 in 2020, this shared responsibility is vital, as social distancing will make it very difficult for young children to make friends and feel comfortable in the school environment. At the same time, this crisis offers opportunities to transform the educational system in ways that may help to address pressing challenges that result from the much deeper problems of climate change.
For example, outdoor learning is not only a solution to the problem of social distancing, but also provides an opportunity to transform pedagogy in order to foster children’s confidence, curiosity and connectedness to nature and their local communities; to equip children with important life-skills and to foster active life-styles. Adopting a ‘walking curriculum’ would enable schools to capitalise on community resources (local parks, nature reserves, places of cultural interest). Closing off local streets and using these spaces to teach young children to ride a bicycle would enable schools to provide opportunities for exercise and social interaction (e.g., by using bikes to play socially-distanced versions of ‘follow my leader’), as well as fostering children’s physical and social confidence. While social distancing will make it much more challenging for children to build social relationships, shared activities (e.g., an outdoor choir or percussion class) foster inclusivity and develop children’s attentional skills. Importantly, there is emerging evidence to suggest that outdoor learning is especially beneficial for children with special educational needs (63). As social distancing will also increase demands on teachers, this enriched curriculum may depend upon community support, but this dependence also provides a means of consolidating the many positive community initiatives that have emerged across this pandemic.
Staggered entry to school (in terms of both start dates and daily routines) may be deemed necessary for health reasons, but present a challenge to parents seeking to build up supportive relationships with each other. This social network is a key source of informational and emotional support and also serves to widen children’s social horizons. Involving parents in the KS1 curriculum changes proposed above might therefore also help strengthen ties between parents and contribute to lifelong learning.
Longitudinal and cross-cultural findings demonstrate that literacy and numeracy skills depend upon cognitive processes (aka ‘executive functions’) that are associated with the prefrontal cortex (PFC; among other brain areas), and that enable children to inhibit impulsive responses, hold ideas or instructions in mind and shift flexibly between activities or goals (64, 65). The PFC can be likened to the miner’s canary, in that it is sensitive to exposure to adverse environments that affect children’s wellbeing (66). Consistent with this view, executive functions mediate the impact of exposure to parental risk factors (e.g., depression, poor parenting strategies) and children’s behavioural adjustment and academic performance (67, 68). Conversely, school-based interventions that adopt a holistic approach to promote child wellbeing have beneficial effects on children’s executive functions (for a review, see Diamond & Lee 2011; 69) and hence on their academic progress. More fundamentally, however, children’s experiences of starting school are profoundly coloured by their relationships with peers and teachers (e.g., 70, 71), such that individual differences in children’s social competencies (e.g., emotional regulation, autonomy, pro-sociality) are pivotal to success across the transition to school and, potentially, long-term outcomes.
The development of executive functions and other cognitive processes is not limited to childhood, but also occurs throughout adolescence. Executive functions such as the ability to inhibit inappropriate responses, make decisions and plan actions develop across adolescence (72), as do non-cognitive skills such as perspective taking and emotion regulation (73). The PFC as well as other brain regions involved in higher level cognitive processes, social and emotional behaviour, undergo substantial and protracted development across childhood and adolescence (defined as 10-24 years; 74). Adolescence is a period of continued brain plasticity and learning and can be considered a sensitive period of development. There is evidence that certain cognitive skills, including non-verbal reasoning, learning during late adolescence and early adulthood yields greater improvement than learning earlier in adolescence, which highlights the relevance of this late developmental stage for education (75).
Feeling insufficiently connected to other people and loneliness are associated with substantial and lasting negative consequences on physical and mental health (76). Due to social distancing measures, society is undergoing a period of intense and widespread reduction of face-to-face social contact. The potential negative effects of social distancing might be particularly profound during adolescence, a period of life characterized by heightened sensitivity to social stimuli and need for peer interaction (73). Adolescents are at a unique period in their lives when the social environment performs crucial functions in promoting social learning, development of self-identity and mental health (19). The use of social media and other digital media are deeply embedded in the social structures of young people and might fill some of the social voids left by school closures and social distancing. We need to understand more about whether this is the case. Importantly, we believe that it is unlikely that social media and online learning can replace face-to-face peer interactions and teaching without consequences on development in adolescence.
Adolescents show an increased propensity to be influenced by their peers, particularly when it comes to risky decisions. Adolescents tend to take more risks when with friends than when alone, and they are more influenced by other teenagers’ perception of risk than by adults’ risk perception (e.g., 73, 77). Peers can also promote positive, prosocial behaviour. For example, adolescents are more socially influenced than adults to engage in prosocial behaviours (78), and more likely to volunteer in the community if their peers also volunteer (79).
Adolescents might be more likely to engage in social distancing and online schooling if their friends are (80). Behaviour change interventions, and campaigns aimed at influencing adolescent behaviour, are most likely to work when they afford adolescents choice, autonomy and respect (81). One successful approach is to provide adolescents with the autonomy to alter peer norms through developing and delivering their own campaigns. This was demonstrated by a study that utilised a peer-led approach to reduce rates of school-based peer victimisation and bullying (82).
The unprecedented changes experienced by all during the Lockdown present profound psychosocial to mental health, in particular due to the social distancing and greater exposure to risks that this may entail (83). The impact on individuals will be mediated by their social and home circumstances as well as their developmental stage, which may further compound social and educational disadvantage; population data from Glasgow demonstrated a significant mental health social gradient at school entry that widened over the next two years (84, 85). Infection with the virus itself may have biological impacts on the central nervous system while psychological responses to severe illness, particularly after treatment in Intensive Care Units, are common (83).
Mental health has a reciprocal relationship with academic attainment, so is an important consideration for the education sector (86, 87). The pandemic occurred against mounting evidence of deteriorating mental health in young people, particularly among young women in their late teens, as well as indications that the outcomes of poor childhood mental health have worsened in recent years (88-91). Our most recent estimates suggest that pre-pandemic 1 in 8 school-age children had clinically impairing mental health conditions, rising to nearly a quarter of 16-19 year old girls (Sadler et al., 2018). We need to balance the prompt detection of clinically impairing mental health conditions against pathologizing adjustment reactions within the normal range. Many children are likely to adjust and cope without lasting difficulty. For example, the largest population-based survey of children who were looked after by the state in the UK showed that fewer half had and an impairing mental health condition, while one in 10 were thriving, defined as scoring in the optimal range for all subscales of the Strengths and Difficulties Questionnaire, compared to 50% of the children living in private households; 92). The universality of the experience may help children to process their experiences, while the small amount of evidence focusing on children suggests that universal psychological “debriefing” is not helpful and may be harmful (93). Trauma Focused Cognitive Behavioural Therapy is effective for the minority who develop Post Traumatic Stress Disorder (94). Similarly, previous research suggest that anxiety, particularly around infection, health and separation, are likely to increase (but importantly anxiety disorders respond well to psychological treatment, such as cognitive behavioural therapy; 96). In contrast, data from surveys recruited on-line and social media suggest that anxiety symptoms in adults have decreased after an initial rise during lock down (97), while the parents are reporting sharp increases in emotional and behavioural problems among children, but decreased emotional and increased restlessness among adolescents, who themselves are reporting no mental health changes (98). Such studies risk selection bias, given the lack of a sample frame (99). If, as is likely, those most interested and concerned about mental health click survey links, the impact of mental health may be inflated, while those on the wrong side of the digital divide, who are likely to be among the most vulnerable will be excluded. Significant attrition, which is likely with survey fatigue over time, mean that reported changes in psychological distress should be interpreted with extreme caution for the same reasons. Studies from established samples that include pre-pandemic mental health measures are more informative about prevalence and suggest increased anxiety levels and reduced wellbeing, particularly among young adults (99,100). Sadly we lack any such data on children under the age of 16, although we are aware of some in the field.
Bullying is probably the most tractable public mental health problem facing developed countries (101). A regrettably common experience, it predicts depression, anxiety, psychosomatic symptoms, eating difficulties, self-harm and suicide into adulthood as well as lower educational attainment (101-104). Classroom management and social structure are associated with substantial differences in the level of reported bullying (105) and whole-school interventions are more effective than curriculum-based interventions or behavioural and social skills training (106). At secondary school level, evidence suggests that peer led interventions are more effective than adult led (see section 4.21). Fear of bullying may deter some children from returning to school (49, 98, 82, 107).
Children who have pre-existing mental health conditions, as well as those who have directly experienced Covid-19 infection, hospitalisation or bereavement will be at higher risk. Some of those with pre-existing mental health conditions may struggle due to the additional situational stress or reduced access to support during Lockdown, while those for whom school was a stressful environment may experience reduced anxiety or behavioural difficulties while at home, but find it difficult to return after a long and unexpected break. Children with separation, social or generalised anxiety may find it particularly hard to get back to school as their anxiety levels often increase at the end of an ordinary break. Pupils at key transition stages (see 19-21) may need additional support, as they are facing an unfamiliar environment at a time of heightened vigilance, with less preparation and support from friends. Similarly, children with neurodevelopmental disorders, particularly if they have prominent autistic traits, for whom even minor changes in routine can cause considerable distress, may struggle with the inevitable differences in the school environment.
https://www.depressd.ca/covid-19-mental-health
https://www.acamh.org/learning/
https://www.rcpsych.ac.uk/mental-health/parents-and-young-people
https://www.mentallyhealthyschools.org.uk/
https://educationendowmentfoundation.org.uk/evidence-summaries/teaching-learning-toolkit/
https://educationendowmentfoundation.org.uk/tools/
Tamsin Ford CBE, Professor of Child and Adolescent Psychiatry
Duncan Astle, Professor of Cognitive Neuroscience
Sarah-Jayne Blakemore, Professor of Psychology and Cognitive Neuroscience
Gordon Harold, Professor of Education and Mental Health
Claire Hughes, Professor of Developmental Psychology
Ayla Humphrey, Consultant Clinical Psychologist and Affiliated Lecturer, Department of Psychiatry
Colleen Mclaughlin, Professor of Education
Ros McLellan, Senior Lecturer in Education
Anna Vignoles CBE, Professor of Education
We are extremely grateful for the support of Lauren Cross, Research Assistant in the Department of Psychiatry at the University of Cambridge, for her support in formatting this document.
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[1] Vignoles (a contributor to this note) is a Nuffield Foundation Trustee. The Nuffield Early Language Intervention was independently evaluated by the Education Endowment Foundation (37) and was developed by an independent academic team (38). Vignoles has no personal interest in the intervention.