Transitions in preschool children’s internalizing and externalizing symptoms before and during the COVID-19 pandemic: The role of family disruptions in Singapore

Abstract The COVID-19 pandemic disrupted family routines, economic security, and caregiving contexts, with potential consequences for children’s mental health. However, less is known about heterogeneity in preschool children’s changes in internalizing and externalizing symptoms from before to during the pandemic and about how pandemic-related family disruptions predicted these transitions. This study examined symptom transitions among 2,601 preschool children from the Singapore Longitudinal Early Development Study, using pre-pandemic data from 2018–2019 and during-pandemic data from 2021 ( M age = 4.92 years, SD = 1.18; 50.17% girls). Latent profile analysis identified three groups at both waves: low, mild, and severe symptoms. Random intercept latent transition analysis revealed four transition patterns: stable low symptoms (63.40%), worsening symptoms (22.30%), stable mild symptoms (6.23%), and improved symptoms (7.73%). Compared with the stable low symptoms group, older children and those from families negatively impacted by the pandemic in work and family function were more likely to experience stable mild or worsening symptoms. Ethnic differences were also observed, and pandemic-related financial stress was associated with both worsening and improved symptom patterns. These findings highlight heterogeneous symptom transitions among preschool children and underscore the importance of considering demographic characteristics and family-level disruptions when supporting children’s mental health following large-scale crises.