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SINCE lockdown began in the UK, Cathy Creswell at the University of Oxford and her colleagues have been surveying thousands of families to find out how they are affected by the covid-19 pandemic. The Co-SPACE Study has now published its first findings from a longitudinal study that questioned people over several months.

What has your survey of families during lockdown shown?

More than 10,000 people have now taken part. Our first report was at the beginning of April, looking at the first 1500 people. What we saw then has remained pretty consistent all the way through, which was that families were certainly feeling under a great deal of stress. Parents were particularly struggling with balancing work and childcare, and the most common concern they were reporting was about their children鈥檚 emotional wellbeing. We could see that very early on, but we couldn鈥檛 obviously see the direct impact that lockdown had.

Now you have data over a longer period, how have young people changed during the lockdown?

From our longitudinal data in June, that was from about 3000 people, so far we are seeing significant increases in behavioural problems, emotional symptoms and attention and impulsivity problems in primary school age children [age 4 to 10].

In secondary school age students [age 11 to 16], based on parent reports, we actually saw a reduction in emotional symptoms over time and no change in behavioural problems. We only have a small subset of teenagers who are self-reporting, but again they weren鈥檛 reporting an increase in difficulties either.

We need to keep looking at it carefully, but it does fit with what many families have told us, which is that, for many young people of secondary school age, not having the pressures of school does seem to have brought some benefits in terms of their mental health.

How do you explain the differences you have seen between primary and secondary school children?

Younger children will require more adult input. The majority of adults in our sample are trying to work and look after children, and we know that they are struggling with that. In our early report, two-thirds of parents said they didn鈥檛 feel that they were adequately meeting the needs of both their children and their work.

One hypothesis at this point is that it is easier for adolescents to connect with peers electronically, without seeing them face-to-face. Through lockdown, it鈥檚 been much easier for older young people to be able to keep their social contacts going. For younger children, doing chats on Zoom, that鈥檚 not how they would normally interact. And it would need adult organisation, and in many cases adults are quite stretched.

What does anxiety about this situation look like in younger kids?

The emotional symptoms are: being tearful, being clingy, being sad or worried. The behavioural stuff is disobedience or tantrums.

Everyone I speak to about their experience during lockdown says this sounds very familiar. If these findings do nothing else but help normalise people鈥檚 experiences, hopefully that is helpful. Just so parents don鈥檛 feel they are doing a terrible job, or their children are a nightmare, but see that actually it鈥檚 just a really hard situation.

What can parents do? Are there any strategies that are known to work?

For managing behaviour in primary school aged children, there are good evidence-based approaches that involve parents developing strategies, skills and confidence to manage their children鈥檚 behaviour. We need to kind of up our game, and put a bit more focus on managing behaviour than we might have in other situations.

鈥淔or those in secondary school, not having the pressures of school has mental health benefits鈥�

For anxiety-related problems, we have good evidence that cognitive behavioural approaches are effective. In our studies, we have found that you can get really good outcomes for children by working directly with parents, where you are giving them skills to manage their children鈥檚 anxiety in their day-to-day lives, rather than children having to go to appointments (for practical tips, see 鈥�Helping children cope鈥�).

How representative of the population is your sample?

There is quite a lot of bias in the sample, so we are quite cautious to not make claims about the wider population. In our sample, the numbers of children and young people with pre-existing mental health problems is pretty much what you would expect in the population. We have probably got a slightly higher number of children or young people with special educational needs. These are obviously groups that we are concerned about at the moment and we were keen to track them.

What have you found in groups with special educational needs and pre-existing mental health issues?

Amongst these groups, we have seen a reduction in reported mental health symptoms over time. Again, this is consistent with what we are hearing from lots of families, which is that being able to do things at their own pace and not having the same pressures of school means many young people have been doing well.

The important thing to say is that their mental health symptoms are still elevated, they are still higher than the groups who don鈥檛 have those difficulties. There is also a lot of variability, but overall there has been a bit of an improvement over time. Many families have told us that they are really concerned about how this may change as things start to get back to normal.

Could the easing of restrictions make things more difficult?

Absolutely. For young children, this has been quite a big chunk of their lives and there has been this message that interacting with other people is potentially dangerous, so it will be really important for us to be thinking about how we support children to overcome that, in a way that still fits with whatever the guidance is at the time.

Another thing that we are hearing from quite a lot of families at the moment, those with younger children, but also children who might have particular issues, for example those with autism, is that ambiguity in the rules is more challenging. These things can then cause frustration, which can lead to other difficulties.

What have you learned about the pressures of school and how that plays into anxiety in young people?

This situation has certainly raised a lot of questions about schools and how we approach schooling as a culture. It will be important to see what happens as children start going back to school.

We know that mental health problems in teenagers in the UK are high, particularly among girls and particularly as they move into the later school years. And we know that levels of school stress are extremely high among UK school students. So I think it does give us a good opportunity to understand that a bit more and be able to think about whether it has to be like that, or whether there are different approaches to education.

How long term or serious are these anxiety problems in children?

So far, when looking at change over time, we have just been looking at anxiety symptoms. For most people, they are within the normal range. But the measures that we use allow us to look at the probability of someone meeting a diagnostic criteria.

鈥淧arents shouldn鈥檛 feel they are doing a terrible job or their children are a nightmare. It鈥檚 just hard鈥�

Studies with adults during lockdown suggest increases in cases of anxiety disorders. This has been particularly the case among adults who are married or in civil partnerships, according to data from the Office for National Statistics. This may be due to juggling work with home schooling. This is quite striking and fits with stress levels reported in our study. We are going to look at whether these criteria are increasingly being met by school children in our next report.

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