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Comment & Response
November 23, 2020

Coronavirus Disease 2019 and Effects of School Closure for Children and Their Families

Author Affiliations
  • 1Department of Mental Health and Pathological Addiction, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
  • 2Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Perugia, Italy
  • 3Center for Translational, Phenomenological and Developmental Psychopathology, Perugia University Hospital, Perugia, Italy
JAMA Pediatr. 2021;175(2):210. doi:10.1001/jamapediatrics.2020.3586

To the Editor Risks for mental health of children and adolescents in the era of the coronavirus disease 2019 (COVID-19) pandemic, owing to school closure and quarantine, have been delineated by Golberstein et al.1 We further extend their implications of school closure for children and their families, an issue that undergoes a deafening silence in the public debate.

Mental health of children and adolescents undergoes a sudden stress test during quarantine1 that causes a complete, sudden, and unprepared loss of direct social relationships with peers, representing a significant human need and stimulus for well-being, socioemotional development, and self-identity in this age range. Direct social relationships are limited to family members, with increased risks of loneliness; especially in the absence of home outdoor spaces, school closure significantly increases the risks for (1) physical health; (2) addiction to video games and binge watching (clearly exceeding daily time limits of screen exposure indicated by pediatric guidelines); and (3) alteration of circadian rhythms. Moreover, compulsory coexistence with family members may increase the risk of direct or assisted verbal or physical domestic violence. Finally, school closure may have profound effect on academic achievement, especially in the youngest children and in children of families with low socioeconomic status.2,3 If school closure will be confirmed for the remaining months and also summer camps will be impeded, the well-known summer learning gap will be amplified,4 especially for children of families at low socioeconomic status and for children with preexisting neurodevelopmental or mental health conditions of vulnerability. Families with low socioeconomic status have less available possibilities in terms of suitable places to do homework, electronic devices, internet access, and owned books2,3; parents themselves in the case of low socioeconomic status, exemplified by the immigrant parent-child acculturation gap,5 may be less able to motivate and help them in this new experience of online schooling. Therefore, educational systems should plan and finance extraordinary ad hoc interventions to reduce long-lasting effects of prolonged school closures, especially for more disadvantaged children, focused but not limited to learning. Moreover, school closure is a serious and impeding problem also for working parents if they are allowed to return to work, considering that other family members who can provide resources, such as grandparents, are probably quarantined themselves. In conclusion, medical, educational, and economic competencies should implement strategic plans for a progressive restart of educational activities that may ensure a calculated trade-off between risk of COVID-19 infection, reduction of learning gap, and restart of working for parents.

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Article Information

Corresponding Author: Michele Poletti, PsyD, Department of Mental Health, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia 42122, Italy (michele.poletti2@ausl.re.it).

Published Online: November 23, 2020. doi:10.1001/jamapediatrics.2020.3586

Conflict of Interest Disclosures: None reported.

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