Children's socialization and returning to social norms post COVID

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There’s no question about it: The Covid-19 pandemic disrupted social interactions for children and teens.

When schools temporarily shifted to online learning, the typical child’s face-to-face social circle shrank from dozens of classmates to just the members of their immediate families.

Now, more than three years after the first wave of stay-at-home orders, data increasingly shows that children and teens are struggling — both with social skills as well as their mental health.

How severe is the problem? What specifically caused it? More importantly, what can you do to help your child make up for lost time? Below, you’ll find answers and insights from Nusheen Ameenuddin, M.D., M.P.H., a Mayo Clinic Children’s Center pediatrician.

A child’s social development

Social development starts long before a child learns to talk.

During the first year of life, for example, the social areas of the brain rapidly develop.

As caregivers rock and talk to them, babies learn how to regulate their emotions and interact with the world around them. Then, as their social circle expands beyond their primary caregivers, children learn an increasing array of social skills such as the ability to read facial expressions, share toys and how to “use your words, not your hands” to deal with conflict.

That said, children don’t necessarily need a huge social circle, says Dr. Ameenuddin.

“As long as kids have even one dedicated adult who is communicating with them, and is helping them to develop social skills, that’s okay,” she says. “That’s enough.”

Why is socialization so important for a child?

When children socialize with family and friends, they learn a wide variety of important life skills, including the ability to:

Regulate emotions and behaviors.
Understand how their behavior affects others around them.
Feel connected to others.
Get along with others.
Feel confident about their abilities.
Value the ideas and differences of other people around them.
Take turns.
Take responsibility for their actions.

What happens when a child lacks social interaction

A lot of what we know about the benefits of early life socialization comes from research done on Romanian orphans during the 1990s.

Raised in institutions, the orphans were confined to cribs, with only a minimum of human interaction. Adults fed them and changed their diapers, but they didn’t hold, rock, sing to or interact with them. When researchers first toured these facilities, they were struck by the silence. Because no one responded to their cries, the babies had stopped vocalizing.

Researchers tracked the outcomes of 136 of these children for many years. Over time, they found that the children’s brains were permanently affected by the neglect. They had less gray matter and electrical activity, which led to a lower IQ as well as increased attention deficit hyperactivity disorder (ADHD) symptoms. This was especially true for children who’d been institutionalized beyond the age of 2.[1]

In addition to the above findings, we also know that children who are frozen out of social groups tend to experience negative and lasting health effects akin to that of smoking 15 cigarettes a day.

The rise of anxiety, depression and eating disorders in children

Since the pandemic began, more and more children have struggled with their mental health. According to a Kaiser Family Foundation analysis:[5]

The percentage of teens who experienced anxiety or depression rose by one-third between 2016 and 2020[6].

Deaths due to drug overdoses almost doubled from 2019 to 2020.

Hospitalizations for eating disorders jumped by 25% between 2020 and 2021. [7]

Those statistics, however, only tell a partial story, says Dr. Ameenuddin.

“People are anchoring on the idea that the pandemic caused all of this,” she says. “But we were seeing these increases long before the pandemic hit. I will 100% agree that the pandemic exacerbated the problem, but these issues were present and on a steady upswing 10 to 15 years before the pandemic.”

So, if the pandemic isn’t 100% to blame, what is?

The effects of social media on children

The pandemic didn’t necessarily change whether kids socialized.

It changed how they socialized.

During the pandemic, children spent twice as much time online than they did before it.[8]

Several studies have now linked this increase in screen time to:

Poor sleep and reduced physical activity, which in turn worsened mental health issues like anxiety and depression. [9,10]
Increased suicidality, especially for teens with social media addiction. [11]
Higher odds of developing an eating disorder. [12]

Well before 2020, children became more comfortable talking with their thumbs than with their mouths, she says. Also, as far back as 2011, scientists and pediatricians were sounding alarm bells about children and social media.

The pandemic merely caused an existing trend to mushroom, says Dr. Ameenuddin.

How to reduce screen time

First, it’s important to note that screens offer some benefits. Digital technology can help children develop a wide range of skills, including communication skills.

Problems arise, however, when children become overly dependent, preferring social media interactions to those that take place face-to-face.

To help your child find more balance, look for ways to replace some of your child’s screen time with an in-person activity such as a sport, playdate or a club, suggests Dr. Ameenuddin. You can also:

Download the American Academy of Pediatrics family media plan. This is a mobile phone or computer app that helps guide your family through the development of a customized media plan that is personalized for each member of the family. Even if the plan isn’t followed completely, working though this app with your family can be educational and provide insights and tips for how your children interact with media.
Create screen-free zones. For example, you might designate family dinner as a device-free experience.
Reduce screen use as a family and ask your kids to hold you accountable, knowing that as a parent, you are modeling behavior for them.

Rebuilding social skills after the covid era

During the pandemic, “the parts of the brain that activate during a face-to-face interaction may have gotten a little rusty for older kids,” says Dr. Ameenuddin.

To help children develop and practice these social skills, start small, says Dr. Ameenuddin.

Create a safe, comfortable environment for children to practice new social skills.

For example, you might arrange a series of social visits with extended family — grandparents, cousins, aunts, uncles. Before each visit, talk to your kids about the skills you want them to develop. During one visit, you might have them work on asking questions, listening and repeating back what they heard. On another, they might work on sharing their toys with a cousin. On yet another, you could have them practice cooperating.

As another example, you can encourage your child to slowly get involved with activities they previously enjoyed — or currently enjoy — that involve other children. Some of these might start with an activity that involves other children they know, or families that your child is familiar with.

As their abilities improve, expand to slightly harder challenges.

If your child has severe anxiety that interferes with school and activities, bring it up with your pediatrician. Your doctor can refer you to an anxiety coach or mental health counselor.

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