The new crown generation: How will the epidemic affect children's brain development?

By Melinda Wenner Moyer Researchers who focus on child development wonder if the pandemic will affect the brain and behavior
.

Like other paediatricians, when Dani Dumitriu first saw Covid-19 on her ward, she was pumped up
.

To her relief, most of the newborns exposed to the new coronavirus in their hospital are fine
.

Physicians, already knowledgeable about viruses that cause birth defects, such as Zika, are extra vigilant for a variety of abnormalities
.

However, the trend seen later was very weak and hidden
.

Since late 2017, Dumitriu and her team at New York-Presbyterian Morgan Stanley Children's Hospital have collected two years of infant development data, and they've been analyzing the communication and motor skills of babies 6 months and younger
.

Dumitriu thought it would be interesting to compare babies born before the pandemic to those born during the pandemic
.

So she asked her colleague Morgan Firestein, a postdoctoral researcher at Columbia University in New York City, to see if there were any neurodevelopmental differences between the two groups of babies
.

A few days later, Firestein frantically called Dumitriu
.

Dumitriu recalled, "She said, 'Something happened, I don't know what to do, the epidemic not only had an impact, but a huge impact
.

'" She barely slept that night, turning over and over to look at the data
.

Compared with infants born before the epidemic, infants born during the epidemic had lower average scores on gross motor, fine motor and communication skills (the parents of the two groups of infants scored using ready-made questionnaires) [1]
.

This result has nothing to do with whether the biological parents have been infected with the new crown, and it seems more related to the general environment of the epidemic
.

Dumitriu was stunned
.

"Our reaction was, oh my God, we're talking about hundreds of millions of babies," she said
.

A teacher in a protective suit was teaching a little girl at her home in Cali, Colombia
.

Source: Luis Robayo/AFP/Getty While children are generally doing well after contracting the new coronavirus, preliminary research suggests that pandemic-related stress during pregnancy may have adverse effects on fetal brain development in some children
.

Not only that, but exhausted parents and caregivers change or reduce their interactions with their children, which may affect the child's physical and mental development
.

The lockdown, a crucial anti-epidemic measure, has forced many families with newborn babies into quarantine, depriving them of playtime and opportunities to interact
.

Excessive stress and distraction also prevent many caregivers from providing the one-on-one companionship that infants and toddlers so desperately need
.

"Everyone wants to know if this has an impact on child development, parent-child relationships, peer relationships," said James Griffin, director of the Division of Child Development and Behavior at the Eunice Kennedy Shriver National Institute for Child Health and Human Development in Maryland.
"Everyone is worried
.

" Several teams around the world focusing on these topics are publishing their findings, and new research projects are being launched
.

It's hard to see absolute answers right now, especially since many labs studying child development have been closed during the pandemic
.

Some babies born in the past two years may be showing signs of developmental delays; others may be fine—if their caregivers can provide them with more time at home and communicate more with older siblings
.

As with all kinds of health problems during the pandemic, socioeconomic disparities clearly determine which groups are hit the hardest
.

Early data suggests that mask use has no detrimental effects on children's emotional development, but prenatal stress may cause some changes in their brain connections
.

However, the details are unclear, and many studies are pending peer review
.

Some researchers believe that many stunted children will catch up with no long-term effects
.

"I don't think there is a generation hurt by Covid-19
,
" said Moriah Thomason, a child and adolescent psychologist at NYU Grossman School of Medicine
.

One lab that hasn't shut down amid the COVID-19 pandemic is the Advanced Baby Imaging Lab at Brown University in Rhode Island
.

Medical biophysicist Sean Deoni and colleagues here use techniques such as magnetic resonance imaging (MRI) to study how environmental factors affect infant brain development
.

While the pandemic has changed the way they do their research—fewer visitors, more cleaning—they still invite lots of babies to the lab to record their motor, visual and language abilities.
Their research is part of the National Institutes of Health.
A seven-year program by the National Institutes of Health (NIH) that focuses on early childhood development and its impact on later health
.

However, as the outbreak continued, Deoni heard concerns from colleagues
.

"Our colleagues told me privately, 'How come it took so long for these kids to pass the assessment,'" he says
.

Confused, he asked lab researchers to calculate and compare the neurodevelopmental outcomes of these babies.
Annual mean and variance
.

They found that the scores of babies born during the pandemic were significantly worse than those of babies born before the pandemic (see "Developmental slumps")
.
"It seemed like things took a nosedive from
the end of last year to the beginning of this year," he said in late 2021.
When they compared the results of the different groups, they found that babies born during the pandemic were on a series of developmental tests similar to IQ tests compared to babies born before the pandemic.
Mid-low is nearly two standard deviations .
Their findings also included that infants from low-income families suffered the greatest decline; boys were more affected than girls [2]; and gross motor skills were most affected .
Source: Reference 2 At first, Deoni thought it was a problem of selection bias: Families who had come to the laboratory for evaluation during the epidemic, despite all the difficulties, their children may have some developmental problems themselves, or have already shown corresponding signs .
But gradually, he found that selection bias could not explain the final results, because the children who came for evaluation did not differ from those who came before in terms of background, birth outcomes or socioeconomic status .
The effects may seem large, but some researchers believe they won't necessarily lead to long-term problems .
"IQ doesn't predict much for babies," says Marion van den Heuvel, a developmental neuropsychologist at Tilburg University in the Netherlands.
"It's hard to say what this will mean for their future .














She pointed to a study [3] that found that Romanian girls who were born in an orphanage but were adopted before the age of 2.
5 were less likely to develop mental problems at the age of 4.
5 than girls who had been living in an orphanage
.

Not the same thing, but it shows that infants and young children will make up for their previous difficulties when the constraints are removed
.

But what is worrying is that Deoni found that the longer the epidemic lasted, the more problems that appeared in children.
The more
.

"The extent of it is staggering
.

Deoni commented on the findings
.

The study is currently under revision in JAMA Pediatrics
.

When Deoni first published his findings on a preprint server [2], the media There was a flurry of panic and questions from peers in the research community
.

Griffin said there was a lot of concern at the time that the results were being made public without proper peer review
.

Assuming the findings hold up, during the pandemic Why are babies born with obvious cognitive impairments—especially motor impairments? Deoni believes that this is due to a lack of interpersonal communication
.

In an unpublished follow-up study, Deoni and team recorded parent-child interaction time in each family and found that In the past two years, what parents have said to their children, and what children have said to parents, has decreased compared with before the epidemic
.

He also speculates that infants and young children have not been fully exercised because they cannot play with other children as often and cannot go out.
Outdoor playground
.

"Unfortunately, these skills are the foundation of other skills," he said
.

"Other recently published research supports the idea that lack of interaction with peers can delay development in some children
.

In a study published earlier this year, British researchers surveyed 189 people aged 8 months to Parents of 3-year-olds asked if their children had attended nursery or kindergarten during the pandemic and assessed their language and executive skills
.

The authors found that children in group care during the pandemic were more capable and benefited This is especially evident among children from low-income backgrounds.
[4] The children most at risk
for
developmental delays appear to be from people of color or from low-income families
.

For example, a growing body of research shows that among school-age children, Distance learning may exacerbate already large educational and developmental disparities between wealthy and low-income families, and between white children and children of color
.

In the Netherlands, researchers found that the 2020 National Child Assessment was better than the performance of the previous three years Even less ideal, among them, children from less educated households were 60% worse off
.
[5]
In parts of sub-Saharan Africa, including Ethiopia, Kenya, Liberia, Tanzania and Uganda, studies have shown that some children lose In the United States, a report by McKinsey & Company showed that after the first lockdown, students of color who entered in the fall experienced 3 to 5 months slower learning progress ,
while
White students are only 1 to 3 months behind (go.
nature.
com/3fauntp)
.

Children who go to school or participate in other groups during the mask effect are generally interacting with people who wear masks
.

There is a problem: our faces Parts of the ministry are very important for expressing emotions and speaking, and covering our faces with masks may also affect a child's emotional and language development
.

A mother wearing a mask interacts with her daughter as she awaits the results of a nucleic acid test in Houston, Texas
.

Source: Brandon Bell/Getty Edward Tronick, a psychologist at the University of Massachusetts Boston, has been flooded with emails from parents and pediatricians concerned about the potential effects of masks on development
.

Tronick became a household name for his "Still Face" experiment in 1975, which showed that if biological parents suddenly turned faces when interacting with their infants, their children would fight for their attention at first.
, but over time will become alienated, more prone to anger, and more defensive [7]
.

Tronick decided to investigate whether wearing a mask had a similar effect
.

He and colleague Nancy Snidman, a psychologist, conducted an experiment (not yet peer-reviewed) that asked parents to use their phones to record their parent-child interactions before, while, and after wearing a mask
.

Although infants can tell that an adult is wearing a mask—these infants change their facial expressions slightly, look away, or point to the mask—they still interact with adults as before [8]
.

Masks close only one channel of communication, Tronick said.
"Parents wearing masks will still say to their babies, 'I'm still here, with you, and play with you
.

'" The impact of masks on emotional or verbal cognition It doesn't seem too big
.

A study published last May found that 2-year-olds could understand what adults were saying when wearing opaque masks [9]
.

The study's corresponding author, Leher Singh, a psychologist at the National University of Singapore, said children compensated for missing information more easily than we thought
.

Researchers in the United States found that while masks made it harder for school-aged children to detect emotional changes in adults—as difficult as facing adults wearing sunglasses—these children were still able to make good judgments in most cases [10]
.

Ashley Ruba, a postdoctoral researcher at the University of Wisconsin-Madison, said, "Children also rely on many other cues to interpret other people's feelings, such as vocal expression, body language, environment, etc.

Pregnancy
and stress Other researchers also want to understand that the epidemic Will it affect the development of children before they are born ? Psychologist Catherine Lebel, head of the Developmental Neuroimaging Laboratory at the University of Calgary in Canada, and her colleagues surveyed more than 8,000 pregnant women during the epidemic, and nearly half of the pregnant women
reported
Symptoms of anxiety, and one-third of symptoms of depression - a much higher rate than before the epidemic
.

So, does this stress affect the fetus in their womb? To find out, the research team used magnetic resonance imaging to scan 75 A 3-month-old baby
.

In a preprint paper released last October, they found that women with more prenatal stress—more anxiety or depression symptoms—had more amygdala and prefrontal cortex in their children.
The structural network is different from others
.

The amygdala is the brain area that processes emotion, while the prefrontal cortex is the area responsible for executive function [11]
.

The brain scan image above shows the pattern of connections between the baby's amygdala and other brain areas
.

During pregnancy Experiencing pandemic-related stress can weaken brain connections in some babies
.

Source: Kathryn Manning In a previous small study, Lebel and her team also found links between prenatal depression and brain connectivity differences in these areas.
association, and that these brain changes are associated with aggression and hyperactivity in preschool boys [12]
.

Other teams have also found that changes in the connectivity of these brain regions in adults are risk factors for depression and anxiety [13]
.

"These are areas of the brain involved in processing emotion and many different behaviors," Lebel said
.

Other studies have found similar associations between pandemic-related prenatal stress and child development
.

Livio Provenzi, a psychologist at the IRCCS Mondino Foundation in Italy, and colleagues found that women with more stress and anxiety during pregnancy had their 3-month-old babies better at regulating mood and attention than women with less stress and anxiety during pregnancy There are also more problems—more difficult to maintain attention to social stimuli, and more difficult to soothe [14]
.

Thomason is also conducting his own research evaluating the effects of stressors during pregnancy on children's brains and behavior
.

She points out that while many people are concerned about the impact of prenatal stress on babies born to the pandemic, this type of early research does not suggest that they will also have problems when they grow up
.

"Children are very resilient and recover easily," she said.
"
We
believe things will get better, and these children are very resilient to what has happened
.

" Indeed, previous research has shown that while stress in the womb may have a negative effect on the baby is unfavorable, but this effect is sometimes not long-lasting
.

Among those who lived through the 2011 catastrophic floods in Queensland, Australia, children born to women who were under extreme stress were more likely to have problems with problem-solving and social skills difficulties at 6 months than children born to women who were less stressed [15]
.

However, by the time they reach 30 months of age, these developmental levels are no longer related to stress, parents are more responsive to the needs of the baby after birth, and the baby grows better [16]
.

The results of vigilance and action on the outbreak of babies have been mixed, and scientists believe that it is not yet possible to draw any meaningful conclusions
.

The results of many of these early, unpublished studies may not represent reality, says Catherine Monk, a medical psychologist who worked with Dimitriu at New York-Presbyterian
.

For example, the parents who chose to participate in some of the earlier studies may not have been representative, Monk said
.

Maybe they are already worried after seeing their child's behavior
.

In addition, the results of studies like Deoni's may be affected by wearing a mask—not necessarily by a large amount, but enough to skew the results
.

Thomason's review last year in JAMA Pediatrics [17] noted that researchers have an instinct to publish interesting findings, and this instinct may have shaped these earlier studies
.

"Scientists are quick to look for harmful effects," she said.
"
These
are things that are easier to get attention and get published in high-scoring journals
.

" Researchers and funders are doing some large studies and collaborations to help get a clearer picture.
awareness
.

The National Institute on Drug Abuse has funded several studies under its Healthy Brain and Child Development Study
.

These studies will look at how stress and substance abuse during pregnancy can affect child development
.

In addition, various organizations and conferences will also bring researchers together to share the latest data
.

In March 2020, Thomason established the international "COVID Generation Research Alliance", which brings together researchers from 14 countries to study families with babies during the pandemic
.

The consortium hosts a research summit in November 2021, attracting researchers from North and South America, Europe, Australia, Asia, the Middle East and Africa
.

Even if children's brains are indeed affected by the epidemic, we still have time to correct, Dumitriu said, "the brains of 6-month-old babies are very plastic, and we can change their development direction
.

" For this, parents can play with their babies often, Talk to them and give them the opportunity to interact with others in a safe environment
.

Policy changes to support families and children may also help
.

Lebel's study [11] found that meaningful social support during pregnancy, such as support from a partner or close friend, significantly reduced prenatal stress
.

"There's a lot more that we can do in the prenatal care ecosystem," Monk said
.

The researchers also advocate for the introduction of home support measures immediately after a woman gives birth
.

Provenzi's study [14] found that people who were followed by nurses and neonatologists after delivery experienced less stress and anxiety than those who did not
.

Overall, the researchers still believe that most children will be fine, but there may be many babies who are experiencing difficulties right now
.

If we want to help those children who are developing behind, the best way is to intervene as soon as possible
.

"Children's resilience is very strong," Deoni said, "but at the same time, we also know that the 1,000 days after birth are the key to early childhood development
.

So far, the first batch of babies born in March 2020 has been At 650 days old
.

Children are a product of their surroundings, Deoni says, “What we do is give them all the stimulation, play with them, read books, and nurture them
.

"References: 1.
Shuffrey, LC et al.
JAMA Pediatr.
https://doi.
org/10.
1001/jamapediatrics.
2021.
5563 (2022).
2.
Deoni, SCL, Beauchemin, J.
, Volpe, A.
, D' Sa, V.
& the RESONANCE Consortium.
Preprint at medRxiv https://doi.
org/10.
1101/2021.
08.
10.
21261846 (2021).
3.
Zeanah, CH et al.
Am.
J.
Psychiatry 166, 777–785 (2009) .
4.
Davies, C.
et al.
Infant Child Dev.
30, e2241 (2021).
5.
Engzell, P.
, Frey, A.
& Verhagen, MD Proc.
Natl Acad.
Sci.
USA 118, e2022376118 (2021) .
6.
Angrist, N.
et al.
Int.
J.
Edu.
Dev.
84, 102397 (2021).
7.
Tronick, E.
, Als, H.
, Adamson, L.
, Wise, S.
, Brazleton, TB J.
Am.
Acad.
Child Psychiatry 17, 1–13 (1978).
8.
Tronick, E.
& Snidman, N.
Preprint at SSRN https://doi.
org/10.
2139/ssrn.
3899140 (2021).
9.
Singh, L.
, Tan, A.
& Quinn, PC Dev.
Sci.
24, e13117 (2021).
10.
Ruba, AL & Pollak, SD PLoS ONE 15,e0243708 (2020).
11.
Manning, KY et al.
Preprint at medRxiv https://doi.
org/10.
1101/2021.
10.
04.
21264536 (2021).
12.
Hay, RE et al.
J.
Neurosci.
40, 6969–6977 (2020).
13.
Holmes, AJ et al.
J.
Neurosci.
32, 18087–18100 (2012).
14.
Provenzi, L.
et al.
Dev.
Psychopathol.
https://doi.
org/10.
1017/S0954579421000766 ( 2021).
15.
Simcock, G.
et al.
Infancy 22, 282–302 (2017).
16.
Austin, M.
-P.
et al.
Infant Behav.
Dev.
49, 296–309 (2017).
17.
Thomason, ME JAMA Pediatr.
https://doi.
org/10.
1001/jamapediatrics.
2021.
5168 (2021).
Originally published in Nature on January 12, 2022 under the title The COVID generation: how is the pandemic affecting kids' brains? 》 on the news feature section © naturedoi: 10.
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