Pandemic's Impact on Children and Teens Studied

A Collaboration Among Surveillance and Mental Health Experts

Highlights

  • To determine if health-seeking behaviors had changed, CDC experts studied pediatric emergency department (ED) data before and during the pandemic.
  • CDC scientists collaborated with health departments, as well as federal agencies, to look for mental and behavioral health concerns.
  • These efforts produced two reports that give insight into the pandemic's impact on children and teens.
  • Clinicians treated the findings as a call to action. More work is needed to understand key findings and develop interventions.
Adolescents wear masks as they wait at a doctor's office

Full story

To better understand the COVID-19 pandemic's profound effect on the physical and mental well-being of children and teens, experts delved into the science, guided by near real-time data from ED visits. Scientists from CDC's National Syndromic Surveillance Program (NSSP),12 state and local health departments, and several federal agencies used these data to look for emerging health threats, including mental and behavioral health concerns.

Studies show the COVID-19 pandemic has exacerbated the ongoing children’s mental health crisis.3

To determine if health-seeking behaviors had changed, NSSP experts began collaborating with colleagues across CDC centers in November 2022 to study pediatric ED data before and during the pandemic. This collaboration among syndromic surveillance and mental and behavioral health experts produced two reports that give insight into the pandemic's impact. The studies were published in CDC's Morbidity and Mortality Weekly Report in February 2022.

Both studies examine data for pediatrics (age 0–17 years) from 2019 through January 2022. The first report4 examines overall pediatric ED visits. Findings indicate that although pediatric ED visits decreased overall, the weekly number and proportion of ED visits increased for certain injuries, some chronic diseases, and behavioral health concerns. For example, weekly visits among older children (5–11) and teens (12–17) increased for self-harm, drug poisoning, and psychosocial concerns during 2020, 2021, and 2022 when compared to 2019.4

The second report 5shows that teenage girls may have experienced the largest overall increase in behavioral and psychosocial concerns. The proportion of ED visits for eating disorders doubled and tic disorders more than tripled in this population as well. (Other studies have also noticed increases in tic-like symptoms among girls during the pandemic.)67

NSSP data are excellent for monitoring health and behavioral trends in emergency care-seeking behavior. Taken together, these two reports show the importance of early and increased awareness for health concerns that could arise due to delayed medical care and heightened emotional distress during the pandemic, especially among children and teens. Medical professionals; parents and caregivers; educators; and others who work with children and teens can use these data to help identify symptoms of behavioral and psychosocial concerns and unhealthy coping behaviors that might need further intervention.

Following the studies, the program continued to monitor ED visits with the goal of using these data to inform interventions. Surveillance and mental health experts continued to improve their understanding of the pandemic's impact on people's physical and mental well-being through collaboration.

Why this matters

The intent of this work was to raise awareness of the pandemic's impact on children and teens—and that's exactly what happened.

Clinicians began treating these findings as a call to action. More work is needed to understand the differences between tics and functional tic-like symptoms and why more girls than boys were affected during the pandemic.

As more is learned about this topic, clinicians will be able to develop targeted interventions. Parents and caregivers will be better prepared to recognize the warning signs in children and teens and seek the right help at the right time.

Resources

More on Tic-like Behaviors: "Rising Incidence of Functional Tic-Like Behaviors. What's happening? Why now?"

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Content Source:
National Syndromic Surveillance Program (NSSP)
  1. CDC’s National Syndromic Surveillance Program (NSSP) makes the tools and processes for conducting syndromic surveillance available to public health departments at no cost. CDC NSSP provides a large repository of guidance and user documents, technical and analytic support, and assistance with onboarding facilities to ensure data quality and transmittal comply with standards. CDC supports a highly engaged NSSP Community of Practice facilitated by the Council of State and Territorial Epidemiologists (CSTE).
  2. A syndrome is a grouping of related symptoms that, taken together, is a good indicator of a specific disease or health event (an injury, chronic disease, infectious disease, etc.). As surveillance experts learn more about health events, they will refine the syndromes and data-searching parameters.
  3. Mental Health Surveillance Among Children — United States, 2013–2019 | MMWR (cdc.gov)
  4. Pediatric Emergency Department Visits Before and During the COVID-19 Pandemic—United States, January 2019–January 2022.
  5. Pediatric Emergency Department Visits Associated with Mental Health Conditions Before and During the COVID-19 Pandemic—United States, January 2019–January 2022.
  6. Rapid Onset Functional Tic-Like Behaviors in Young Females During the COVID-19 Pandemic – Pringsheim – 2021 – Movement Disorders – Wiley Online Library
  7. Stop that! It's not Tourette's but a new type of mass sociogenic illness | Brain | Oxford Academic (oup.com)