Consensus Study Report
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This activity was supported by contracts between the National Academy of Sciences and the Administration for Children and Families, a division of the U.S. Department of Health and Human Services, (#75N98021C00032) and the Robert Wood Johnson Foundation (#78561). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-69695-1
International Standard Book Number-10: 0-309-69695-X
Digital Object Identifier: https://doi.org/10.17226/26809
Library of Congress Control Number: 2023939024
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2023. Addressing the Long-Term Effects of the COVID-19 Pandemic on Children and Families. Washington, DC: The National Academies Press. https://doi.org/10.17226/26809.
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COMMITTEE ON ADDRESSING THE LONG-TERM IMPACT OF THE COVID-19 PANDEMIC ON CHILDREN AND FAMILIES
TUMAINI RUCKER COKER (Chair), University of Washington, Seattle Children’s
TINA L. CHENG, Cincinnati Children’s Hospital, University of Cincinnati
JOSHUA GOODMAN, Boston University
NIA JENEE HEARD-GARRIS, Northwestern University
STEPHANIE M. JONES, Harvard University
VELMA MCBRIDE MURRY, Vanderbilt University
CYRIL “KENT” MCGUIRE, William and Flora Hewlett Foundation
ROBERT S. PYNOOS, University of California, Los Angeles
MICHELLE SARCHE, University of Colorado
FLORENCIA TORCHE, Stanford University
JOSEPH L. WRIGHT, University of Maryland Medical System
MARCI YBARRA, University of Wisconsin
Staff
JENNIFER APPLETON GOOTMAN, Study Director (from March 2022)
SUZANNE LEMENESTREL, Study Director (until January 2022)
ADAM JONES, Research Associate
SUNIA YOUNG, Senior Program Assistant (from July 2022)
MARISSA GLOVER, Senior Program Assistant (until July 2022)
EMILY P. BACKES, Deputy Board Director
ALEJANDRA CASILLAS, National Academy of Medicine Emerging Leader in Health and Medicine Scholar
BOARD ON CHILDREN, YOUTH, AND FAMILIES
DAVID V. BRITT (Chair), Sesame Workshop (retired)
HAROLYN M. BELCHER, Kennedy Krieger Institute and Johns Hopkins University School of Medicine
RICHARD F. CATALANO, JR., University of Washington School of Social Work
TAMMY CHANG, University of Michigan
DIMITRI A. CHRISTAKIS, Seattle Children’s Research Institute, University of Washington
GREG J. DUNCAN, University of California, Irvine
NANCY E. HILL, Harvard University
STEPHANIE J. MONROE, Wrenwood Group
JAMES M. PERRIN, Harvard Medical School and MassGeneral Hospital for Children
NISHA SACHDEV, Premnas Partners
MARTIN TEICHER, Harvard Medical School and McLean Hospital
JONATHAN TODRES, Georgia State University College of Law
JOANNA L. WILLIAMS, Rutgers University
Staff
NATACHA BLAIN, Director
EMILY P. BACKES, Deputy Director
Acknowledgments
An ad hoc committee of the National Academies of Sciences, Engineering, and Medicine was convened to study the consequences of and solutions to the long-term effects of COVID-19 on children living in high-risk communities. The committee was asked to focus specifically on the physical and mental health of children and their caregivers by collecting information and data from a broad set of sources, including, but not limited to, public information-gathering sessions, input from those collecting real-time data on the health and mental health effects of the virus, and reviews of the national responses of other countries that have been effective in their responses to COVID-19 for children and families.
The committee thanks the sponsors of this study for their support: the Administration for Children and Families, a division of the U.S. Department of Health and Human Services, and the Robert Wood Johnson Foundation.
This report would not have been possible without the contributions of many people. Special thanks go to the members of the committee, who dedicated extensive time, expertise, and energy to the drafting of the report. The committee also thanks the members of the staff of the National Academies for their significant contributions to the report: Jennifer Appleton Gootman, Emily Backes, Adam Jones, and Sunia Young, as well as Suzanne LeMenestrel and Marissa Glover, who both contributed to the early stages of working with the committee.
The committee is also grateful to Javed Kahn, Pamella Atayi, and Lisa Alston for their administrative and financial assistance on this project. From the Office of Reports and Communication of the Division of Behavioral and Social Sciences and Education (DBASSE), Kirsten Sampson
Snyder, Viola Horek, Douglas Sprunger, and Meredith Fender shepherded the report through the review and the production process and assisted with its communication and dissemination. Hannah Fuller and Megan Lowry, of the Office of News and Public Information and Sandra McDermin and Julie Eubank of the Office of Congressional and Government Affairs were instrumental in the release and promotion of the report. The committee also thanks Clair Woolley of the National Academies Press and Bea Porter of DBASSE for their assistance with the production of the final report; Rebecca Morgan, in the National Academies research library, for her assistance with fact checking and literature searches; consultant Erin Hammers Forstag for her writing and editing contributions; and consultants Eugenia Grohman and Allie Boman for their skillful and thoughtful editing.
Throughout the project, Natacha Blain, director of the Board on Children, Youth, and Families, Carlotta Arthur and Patti Simon, executive director and associate executive director of the Division of Behavioral and Social Sciences and Education, and Mary Ellen O’Connell and Monica Feit, the then executive director and deputy executive director of the Division of Behavioral and Social Sciences and Education, provided valuable oversight and guidance.
Many individuals volunteered significant time and effort to address and educate the committee during our information gathering sessions. Their willingness to share their perspectives, research, and personal experiences was essential to the committee’s work. We thank: David Alexander, Jenny Arwade, Raul Botello, Melissa Brymer, Emmanuel L. Chandler, Mykela Collins, Dominique Davis, Paolo DeMaria, Isra Elshafei, Mary Greiner, Jacki Haight, Leslie Helmcamp, Ebonie Hubbard, Angela Hudson, Tamara Hunter, Wendelyn Julien, Jamilah Jor’dan, Charles Macias, Eunice Minero, Gladys Moran, Micker “Mike” Richardson, Alicia Mousseau, Marquinta Thomas, Ashley Vasquez, Delia Vicente, Melissa Walls, and Keesha Woods, as well as adolescents, Jermal, Martha, Mylon, Nathaniel, Nyeja, and Zanab.
We also thank the researchers who prepared commissioned papers for the committee: Amit Cohen, Sarena Goodman, Julia Greenberg, Simona Hannon, Misty L. Heggeness, Adam Isen, Alvaro Mezza, and Timothy Thomas.
This consensus study report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.
We thank the following individuals for their review of this report:
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by Georges C. Benjamin, American Public Health Association, and Douglas S. Massey, Princeton University. They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.
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Contents
STUDY CHARGE AND COMMITTEE APPROACH
EFFECTS OF THE PANDEMIC TO DATE
ANNEX: PERSPECTIVES ON THE PANDEMIC
K–12 Educators and Administrators
Practitioners Serving Children Involved in the Child Welfare System
Practitioners Serving Children Involved in the Juvenile Justice System
2 Societal and Developmental Contexts of the Pandemic
THEORETICAL FRAMEWORKS AND PERSPECTIVES
Framework of Danger, Safety, and Protection
Pandemic “Signatures” and “Dose of Exposure” Profiles
3 Social, Emotional, and Behavioral Effects
SHORT-TERM EFFECTS AND CONSEQUENCES
Short-Term Social, Emotional, and Behavioral Consequences
Delays, Derailments, and Cascades
Social and Emotional Learning Interventions
School-Based Mental Health Supports for Youth
Parenting, Family, and Community-Based Preventive Interventions
4 Effects and Potential Interventions in Education
Initial Effects in K–12 Education
Initial Effects on Early Childhood Education
The Challenges of Reopening Child Care Facilities and K–12 Schools
PROMISING EDUCATION POLICY INTERVENTIONS
Addressing Missed Learning Opportunities
Reengaging Students and Families and Restoring Enrollment
Strengthening the Educator Workforce
Long-Term Effects of COVID-19 Illness
COVID-19 in the Prenatal and Perinatal Periods
Post-Traumatic Stress Disorder
Bereavement and Prolonged Grief Disorder
CHILD ABUSE, NEGLECT, AND VIOLENCE
PANDEMIC BARRIERS TO HEALTH AND WELL-BEING
Children with Special Health Care Needs
Strengthening the System for the Future
A Tiered Public Health Approach
6 Effects of Economic Policies
Student Loan Pandemic Relief Measures
Supplemental Nutrition Assistance Program
Pandemic Electronic Benefit Transfer
FAMILIES’ CURRENT ECONOMIC WELL-BEING
PRIORITIZE CHILDREN AND FAMILIES
ADDRESS SOCIAL, EMOTIONAL, AND EDUCATIONAL NEEDS
Academic Recovery and Achievement
Positive Social and Emotional Development
ADDRESS PHYSICAL AND MENTAL HEALTH NEEDS
Paid Family Leave and Paid Sick Leave
INVEST IN FUTURE POLICY AND RESEARCH NEEDS
APPENDIX: Biographical Sketches of Committee Members and Staff
4-2 Preschool enrollment during the pandemic, by family income
4-3 Absenteeism data from School Pulse panel
4-4 Freshman enrollment changes by type of college and student gender and age
4-5 National Assessment of Educational Progress mathematics assessment trends by state
4-6 National Assessment of Educational Progress reading assessment trends by state
TABLE
Acronyms and Abbreviations
| AIR | American Institutes for Research |
| ARP | American Rescue Plan |
| CAA | Consolidated Appropriations Act |
| CARES | the 2020 Coronavirus Aid, Relief, and Economic Security Act |
| CCDBG | the Child Care and Development Block Grant |
| CDC | Centers of Disease Control and Prevention |
| CHIP | the Children’s Health Insurance Program |
| CPRSAA | Coronavirus Preparedness and Response Supplemental Appropriations Act |
| CPSP | Center on Poverty and Social Policy |
| CRRSA | 2020 Coronavirus Response and Relief Supplemental Appropriations |
| CSRP | Chicago School Readiness Project |
| CTC | child tax credit |
| EITC | Earned Income Tax Credit |
| ESSA | Every Student Succeeds Act |
| ESSER | Elementary and Secondary School Emergency Relief Fund |
| FFCRA | Families First Coronavirus Response Act |
| GAO | Government Accountability Office |
| GDP | gross domestic product |
| HUD | U.S. Department of Housing and Urban Development |
| HVAC | heating, ventilation, and air conditioning |
| MIHOPE | Mother and Infant Home Visiting Program Evaluation |
| NCTSN | National Child Traumatic Stress Network |
| P-EBT | SNAP Pandemic EBT |
| PBIS | Positive Behavior Interventions and Supports |
| PTSD | post-traumatic stress disorder |
| SAMHSA | Substance Abuse and Mental Health Services Administration |
| SERV | Project School Emergency Response to Violence |
| SNAP | Supplemental Nutrition Assistance Program |
| SPR | Skills for Psychological Recovery |
| TANF | Temporary Assistance for Needy Families |
| VOYCE | Voices of Youth in Chicago Education |
| WIC | the Special Supplemental Nutrition Program for Women, Infants, and Children |
