Trajectories of child emotional and behavioural difficulties before and during the COVID‐19 pandemic in a longitudinal UK cohort

Abstract Background There are substantial age‐related changes in emotional and behavioural problems over childhood. In order to establish the impact of the Covid‐19 pandemic on child emotional and behavioural problems, longitudinal designs which take into account age‐related trends are needed. This study examined trajectories of children's emotional and behavioural difficulties both before and during the pandemic in a prospective birth cohort. Methods Data were from 708 children from the third generation of a birth cohort study; the Avon Longitudinal Study of Parents and Children in England. The study population comprised of 708 children (median age at COVID data collection was 2.75 years [interquartile range 0.8, 4.4]) whose parents provided pre‐pandemic surveys and a survey between 26 May and 5 July 2020. Multi‐level mixed effects models with random intercepts and slopes examined whether children's trajectories of emotional and behavioural difficulties during the pandemic differ from those expected pre‐pandemic. Results Children's emotional and behavioural difficulties trajectories pre‐pandemic increased during infancy peaking around the age of 2 and then declined throughout the rest of childhood. Pre‐pandemic, decline in difficulties scores after age 2 was 0.6 points per month; but reduced by 35% during the pandemic. This slower decline in scores translated to older children having difficulty scores higher than would be expected, during the pandemic. By age 8.5, there is a 9.5‐point difference in pre‐ and during‐pandemic scores (95% CI: 4.5–14.5). This represents an average 48% increase from scores expected at this age (pre‐pandemic mean score = 20; 95% CI: [15–25]). Results remained similar although somewhat attenuated after adjusting for parental anxiety. Conclusion The COVID‐19 pandemic may be associated with greater persistence of emotional and behavioural difficulties after the age of 2 years.