COVID-19 Pandemic May Have Altered Exposures to Environmental Chemicals, ECHO Study Finds

Authors: Megan Romano, et al.

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health supported this research.

Why was this study needed?

The COVID-19 pandemic caused unprecedented disruptions in the daily lives of children and families worldwide. In the United States, recommendations to stay home and wear masks may have altered people's exposure to various potential endocrine-disrupting chemicals (EDCs). For example, changes in the use of certain consumer products, such as N-95 masks, and decreased exposure to air pollutants due to lockdown may have influenced these exposures. ECHO researchers wanted to learn whether exposures during pregnancy changed during the COVID-19 pandemic.

What were the study results?

During the COVID-19 pandemic, urinary levels of certain chemicals changed, reflecting shifts in exposure. Levels of specific polycyclic aromatic hydrocarbons (PAHs), which are air pollutants from car exhaust, fire smoke, and some grilled foods, decreased. Some synthetic phenols, used in plastics and disinfectants found in household cleaners and consumer products like mouthwashes, also showed a decline. However, levels increased of certain organophosphate esters (OPEs)—chemicals used in plastics, flame retardants, and cleaning agents, and more recently in surgical, KN95, and N95 masks. - The increase in these chemicals may be linked to the use of face masks during the pandemic. When people wore masks regularly, they may have unknowingly inhaled small amounts of these chemicals, leading to higher levels in their bodies. In contrast, urinary concentrations of chemicals commonly found in plastics, personal care products, and pesticides remained largely unchanged.

What was this study's impact?

The study highlighted how significant behavioral changes during the pandemic may have contributed to changes in exposures to harmful environmental chemicals.

Who was involved?

The study included 47 participants from three ECHO Cohort Study Sites who contributed urine samples before and during the COVID-19 pandemic.

What happened during the study?

Researchers collected urine samples from participants before (between October 2018 and February 2020) and during (between March 2020 and April 2021) the COVID-19 pandemic. They tested the samples for various chemicals.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What happens next?

Researchers could continue tracking changes in chemical exposures and their potential health effects to better understand how these environmental exposures change over time, particularly during significant societal changes like the COVID-19 pandemic.

Where can I learn more?

Access the full journal article, titled “Changes in urinary concentrations of contemporary and emerging chemicals in commerce during the COVID-19 pandemic: Insights from the Environmental influences on Child Health Outcomes (ECHO) program,” in PLoS One.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health

Published January 24, 2025

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COVID-19 Pandemic May Have Altered Exposures to Environmental Chemicals, ECHO Study Finds

Neighborhood Impact on Children’s Well-Being Shifted During COVID-19 Pandemic, ECHO Study Suggests

Posted on July 11, 2024August 27, 2025 by Jodi Snare

FOR IMMEDIATE RELEASE

The COVID-19 pandemic significantly disrupted daily life and has raised concerns about its impact on children’s well-being. A new study from the NIH Environmental influences on Child Health Outcomes Program (ECHO) sheds light on how a neighborhood’s physical and social environment influenced a child’s well-being before and during the pandemic.

According to an analysis of ECHO Cohort data, the neighborhood environment was less likely to be associated with child well-being during the pandemic than in the pre-pandemic period. The pandemic brought unprecedented social changes, altering how people and families interacted with their neighborhoods. For example, during the pandemic, neighborhood safety was less of a concern for children who spent more time indoors at home and less time outside. Likewise, the closure of parks and playgrounds limited access to green spaces and recreation, making those factors less important to a child’s well-being at that time.

The study authors point out that the new findings align with previous research showing a link between neighborhood characteristics and child well-being. For instance, previous studies indicate that living in neighborhoods with higher poverty levels, lower educational attainment, and poorer housing conditions are associated with worse child health outcomes, including physical and mental health, cognitive development, and academic achievement.

“Neighborhood characteristics were widely known to be associated with children's well-being. Until now, we hadn't looked at how the COVID-19 pandemic might change their relationships,” said Xueying Zhang, PhD, of Baylor College of Medicine. “Additionally, the impacts of the pandemic may be different among children of different races.”

The study involved 1,039 children from more than 10 ECHO Cohort Study sites across the U.S., mostly between the ages of 11 and 19. These children completed a well-being questionnaire called the Patient-Reported Outcomes Measurement Information System (PROMIS) before (2019 to March 1, 2020) and during (March 1, 2020 to August 31, 2021) the pandemic The PROMIS survey measures mental and physical health as well as peer and family relationships in children.

The researchers then matched U.S. Census tract data with a child’s residential address to examine the neighborhood characteristics. They looked at factors including race, education, occupation composition of residents, house capacities, and property features. They analyzed how these factors were associated with child well-being, considering the impacts of the pandemic and differences across child racial groups.

"Our findings highlight the significance of how child race intersects with the impact of the pandemic on child well-being,” said Dr. Zhang. “Future research could examine how people respond differently to environmental impacts during the pandemic and help to address disparities.”

Dr. Zhang led this collaborative research published in Environmental Research.

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About ECHO: Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager, rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact NIHKidsandEnvironment@od.nih.gov.

Connect With Us

Check out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth on X for the latest ECHO Program updates.

COVID-19 Pandemic Altered Relationship Between Neighborhood Environment and Child Well-Being, ECHO Study Suggests

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COVID-19 Pandemic Altered Relationship Between Neighborhood Environment and Child Well-Being, ECHO Study Suggests

Authors: Xueying Zhang, et al.

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

Why was this study needed?

Understanding how neighborhood characteristics affect child well-being is important. Prior studies have found an association between neighborhood characteristics and children’s health and development. During the COVID-19 pandemic, stay-at-home policies limited people’s interactions with their neighborhood environment. However, researchers have not considered how the pandemic might have changed these effects. ECHO researchers wanted to address this gap by exploring how the pandemic, as a natural experiment, may have changed the relationship between neighborhood characteristics and child well-being. Additionally, since COVID-19 has impacted racial and ethnic groups differently, this study examined these differences to identify potential disparities.

What were the study results?

The study found that the relationship between neighborhood characteristics and child well-being changed during the COVID-19 pandemic. It also revealed racial disparities, showing that the pandemic's impact on child well-being varied across different racial and ethnic groups.

For non-Hispanic White children, the number of people who lived in their homes and the diversity of their neighborhood were linked to lower well-being. For children of other races and ethnicities, living in areas with higher percentages of Hispanic residents and more adults working as essential workers were associated with lower well-being.

What was the study's impact?

These findings highlight how neighborhood characteristics, the pandemic, and child well-being interact, emphasizing the importance of addressing disparities during unique events like the pandemic.

Who was involved?

The study involved 1,039 children, mostly between the ages of 11 and 19, from more than 10 ECHO Cohort Study Sites across the U.S.

What happened during the study?

Researchers conducted an analysis of children who completed a well-being questionnaire called the Patient-Reported Outcomes Measurement Information System (PROMIS) before (2019 to March 1, 2020) and during (March 1, 2020 to August 31, 2021) the pandemic. The PROMIS survey measures children's mental and physical health and peer and family relationships.

The researchers then matched U.S. Census tract data with a child’s residential address to examine the neighborhood characteristics. They looked at factors including the race, education, and occupation composition of residents, as well as house capacities and property features. They analyzed how these factors were associated with child well-being, considering the impacts of the pandemic, as well as differences across child racial groups.

Note: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What happens next?

Future research could explore how specific aspects of neighborhoods affect children's well-being, especially when these factors interact.

Where can I learn more?

Access the full journal article, titled “Associations between neighborhood characteristics and child well-being before and during the COVID-19 pandemic: A repeated cross-sectional study in the Environmental influences on Child Health Outcomes (ECHO) program,” in Environmental Research.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Read the associated article.

Published July 1, 2024

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COVID-19 Pandemic Altered Relationship Between Neighborhood Environment and Child Well-Being, ECHO Study Suggests

COVID

ECHO COVID-19 Research

COVID-19

The ECHO Program, engaging more than 64,000 children and their families over an extended period, is uniquely positioned to explore research questions about the COVID-19 pandemic.

ECHO Discovery
Webinar Recordings

The Tip of the Iceberg: Understanding the Long-Term Impact of COVID-19

Resources

Visit these government sites to learn more about COVID-19.

CDC: COVID-19

NIH: COVID-19 and Mental Health

QUESTIONS

For more information, please email the NIH at NIHKidsandEnvironment@od.nih.gov.
For media inquiries or to request an interview, contact Rebekah Yeager at rebekah.yeager@nih.gov.

The COVID-19 pandemic has caused unprecedented disruptions in the daily lives of children and families worldwide. ECHO Program researchers use observation and intervention research to understand how these disruptions impact children's health and well-being.

At the onset of the pandemic in early 2020, the ECHO Cohort swiftly incorporated COVID-19-specific questions into its data collection efforts to study the real-time effects of the public health crisis on existing study participants. Additionally, the ECHO Program’s intervention research program, IDeA States Pediatric Clinical Trial Network, launched a study to explore parental attitudes about the COVID-19 vaccine and test the effectiveness of a mobile app to help parents learn more about the vaccine for their children.

What We're Learning

The ECHO Program has published more than 1,800 articles about the results of its research, including many that looked at COVID-19.

Here are some research highlights:

Measuring pandemic-related stress in ECHO Cohort participants
November 2023
ECHO investigators reported differences in pandemic-related traumatic stress among participants using a newly developed self-report survey.

A Look at Life Satisfaction in Pandemic-era Teens with Mental Health Histories
October 2023
ECHO research suggests that, during the COVID-19 pandemic, teens with a history of depression, anxiety, autism, and ADHD experienced lower life satisfaction compared to their counterparts.

Educational Background and Child Age Influenced Experiences of Caregivers During COVID 19 Pandemic
August 2023
The primary causes of stress among caregivers during the pandemic varied depending on the caregiver’s level of education and the age of their children.

NIH Study Validates New Scale for Measuring Pandemic-Related Traumatic Stress in Children and Adults

Posted on November 6, 2023August 27, 2025 by Jodi Snare

FOR IMMEDIATE RELEASE

The Pandemic-related Traumatic Stress Scale (PTSS) can be used to effectively measure stress related to the COVID-19 pandemic and identify children and adults with higher levels of stress who may need additional mental health support, according to a new study funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

The study included 17,830 children and adults from 47 ECHO Cohort study sites representing all 50 states, Washington, DC, and Puerto Rico. Researchers split the sample into four groups including 1,656 pregnant or postpartum individuals; 11,483 adult caregivers; 1,795 adolescents aged 13 to 21; and 2,896 children aged 3 to 12. Between April 2020 and August 2021, participants or their caregivers completed surveys about their pandemic-related traumatic stress, depressive symptoms, anxiety, general stress, and life satisfaction. On average, caregivers had the highest PTSS scores, followed by adolescents, pregnant or postpartum individuals, and children.

Within these groups, the researchers found additional differences related to age and gender. Adolescents, females, and caregivers of children under 5 had higher PTSS scores on average than younger children, males, and caregivers of children 5 and older, respectively. Higher levels of pandemic-related traumatic stress were associated with greater symptoms of distress and lower life satisfaction.

“The PTSS can be used beyond the immediate COVID-19 pandemic context,” said Courtney Blackwell, PhD, an ECHO Cohort Investigator at Northwestern University. “Unlike previous measures that capture traumatic stress reactions to a single event, the PTSS was developed to evaluate potential traumatic stress reactions to ongoing large-scale threats. In the future, the PTSS could be adapted to evaluate reactions to other acute onset stressors with lengthy durations.”

Dr. Blackwell led this collaborative research published in Psychological Assessment.

Blackwell, C. et al. Development and Psychometric Validation of the Pandemic-related Traumatic Stress Scale for Children and Adults. Psychological Assessment. DOI: 10.1037/pas0001211.

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About ECHO: Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager, rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact NIHKidsandEnvironment@od.nih.gov.

Connect With Us

Check out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on Twitter.

ECHO Researchers Measure Pandemic-Related Traumatic Stress in Families

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ECHO Researchers Measure Pandemic-Related Traumatic Stress in Families

Authors: Courtney K. Blackwell, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) Program, Office of The Director, National Institutes of Health with co-funding from the Office of Behavioral and Social Sciences Research.

Why was this study needed?

The COVID-19 pandemic and subsequent social distancing strategies may have ongoing negative effects on mental health. To measure this, ECHO researchers developed the Pandemic-related Traumatic Stress Scale (PTSS) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Acute Stress Disorder criteria. This study describes the development and validation of this new measurement tool and reports differences in pandemic-related traumatic stress in a large sample of children and adults.

What were the study results?

On average, caregivers had the highest levels of pandemic-related traumatic stress, followed by adolescents, pregnant/postpartum individuals, and children. Within these groups, the researchers found additional differences related to age and gender. Adolescents, females, and caregivers of children under 5 had higher PTSS scores on average than younger children, males, and caregivers of children 5 and older, respectively.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

The researchers found that PTSS is a reliable way to measure pandemic-related traumatic stress in the context of the COVID-19 pandemic. Higher levels of pandemic-related traumatic stress were associated with greater symptoms of distress and lower life satisfaction. Unlike previous measures that capture traumatic stress reactions to a single event, the PTSS was developed to evaluate potential traumatic stress reactions to ongoing large-scale threats without defined time limits. Researchers and doctors can use this scale to distinguish general stress, depression, and anxiety from traumatic stress, helping them to identify people with higher levels of traumatic stress who may need mental health support.

Who was involved?

This study included 17,830 children and adults from 47 ECHO Cohort study sites representing all 50 states, Washington, DC, and Puerto Rico. Researchers split the sample into four groups including 1,656 pregnant or postpartum individuals; 11,483 adult caregivers; 1,795 adolescents aged 13 to 21; and caregivers who reported on 2,896 children aged 3 to 12.

What happened during the study?

Between April 2020 and August 2021, caregivers reported on behaviors observed in children aged 3 to 12, and adolescents and adults completed self-reported surveys on pandemic-related traumatic stress, depressive symptoms, anxiety, general stress, and life satisfaction.

What happens next?

The PTSS can be used beyond the immediate COVID-19 pandemic context. The PTSS could be adapted to evaluate reactions to other severe stressors that last a long time.

Where can I learn more?

Access the full journal article, titled “Development and Psychometric Validation of the Pandemic-related Traumatic Stress Scale for Children and Adults,” in Psychological Assessment.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Read the associated article.

Published November 3, 2023

Download this summary

ECHO Researchers Measure Pandemic-Related Traumatic Stress in Families

ECHO Researchers Evaluate New Scale for Measuring Pandemic-related Traumatic Stress in Children and Adults

Posted on November 3, 2023April 9, 2025 by Jodi Snare

Collaborative ECHO research led by Courtney K. Blackwell, PhD of Northwestern University evaluated COVID-19 pandemic-related traumatic stress in a large sample of children and adults. In March 2020, ECHO researchers developed the Pandemic-related Traumatic Stress Scale (PTSS) to measure stress related to the COVID-19 pandemic. The PTSS can be used to identify children and adults with higher levels of traumatic stress and who may need additional mental health support. This research, titled “Development and Psychometric Validation of the Pandemic-related Traumatic Stress Scale for Children and Adults,” is published in Psychological Assessment.

The study included 17,830 children and adults from 47 ECHO Cohort study sites representing all 50 states, Washington, DC, and Puerto Rico. Researchers split the sample into four groups including 1,656 pregnant or postpartum individuals; 11,483 adult caregivers; 1,795 adolescents aged 13 to 21; and 2,896 children aged 3 to 12.

Between April 2020 and August 2021, adolescents and adult caregivers (including pregnant or postpartum individuals) completed surveys about their pandemic-related traumatic stress, depressive symptoms, anxiety, general stress, and life satisfaction. Caregivers of children aged 3-12 reported on the behaviors observed in their child.

On average, caregivers had the highest levels of pandemic-related traumatic stress, followed by adolescents, pregnant or postpartum individuals, and children. Within these groups, the researchers found additional differences. Adolescents, females, and caregivers of children under 5 had higher PTSS scores on average than younger children, males, and caregivers of children 5 and older, respectively. Higher levels of pandemic-related traumatic stress were associated with greater symptoms of distress and lower life satisfaction.

The researchers found that the PTSS is a reliable way to measure pandemic-related traumatic stress in the context of the COVID-19 pandemic. Researchers and doctors can use this scale to distinguish general stress, depression, and anxiety from traumatic stress, helping them to identify people who may need more support to improve their mental health.

“The PTSS can be used beyond the immediate COVID-19 pandemic context,” said Dr. Blackwell. “Unlike previous measures that capture traumatic stress reactions to a single event, the PTSS was developed to evaluate potential traumatic stress reactions to ongoing large-scale threats. In the future, the PTSS could be adapted to evaluate reactions to other acute onset stressors with lengthy durations.”

Read the Research Summary.

A Qualitative Exploration of COVID-19 Vaccine Hesitancy Among Parents

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A Qualitative Exploration of COVID-19 Vaccine Hesitancy Among Parents

Authors: Aubree Honcoop, James R Roberts, Boyd Davis, Charlene Pope, Erin Dawley, Russell McCulloh, Maryam Y Garza, Melody L Greer, Jessica Snowden, Linda Y Fu, Heather Young, Walter Dehority, Paul Enlow, Delma-Jean Watts, Katie Queen, Lisa Costello, Zain Alamarat, Paul M Darden

Why was this study conducted?

Research has shown that the COVID-19 vaccine is safe and effective at protecting children from severe COVID-19 disease. However, some parents have not yet vaccinated their children. Fewer children from a rural, Spanish-speaking, or Black backgrounds have received the vaccine than others.[i] We wanted to find out what parents from these groups think about the vaccine for their children. We interviewed parents about their concerns to learn how to address them and build their confidence in the vaccines.

What was done?

We selected 36 parents who lived in rural areas, spoke Spanish, and/or identified as Black. We only included parents with one or more unvaccinated children. We spoke with them about their thoughts for or against the COVID-19 vaccine.

What was found?

Many parents, whether they were for, against, or unsure about the COVID-19 vaccine, reported that they would listen to their doctor for vaccine information. Some parents wanted to know how well the vaccine protects children. Some parents also considered their child’s preferences for getting the vaccine. Others were concerned about the vaccine causing side effects or impacting health conditions such as asthma.

What do the results mean?

These results suggest what topics scientists might include in a mobile app designed to inform parents about the COVID-19 vaccine. However, this information was from a small number of parents and may not apply to people from other backgrounds.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program in the Office of the Director, National Institutes of Health (NIH).

Appreciation:

Most of all, we thank the parents who took part in the study. We also thank the site coordinators, clinic staff, and ECHO ISPCTN Data Coordinating & Operations Center staff for their support.

You may learn more about this publication here: https://pubmed.ncbi.nlm.nih.gov/37867449/

To learn more about the COVID-19 vaccine for children, visit:

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

______________________________________

[i] The National Institutes of Health (NIH) has identified individuals from rural, medically underserved, and migrant communities as high priorities for vaccination and vaccine communication efforts. This includes children living in rural areas, from Spanish-speaking households, or who identify as Black. For current data on COVID-19, including vaccination rates, please visit the CDC website.

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A Qualitative Exploration of COVID-19 Vaccine Hesitancy Among Parents

New ECHO Cohort Research Finds Some Teens with Disabilities May Have Been More Vulnerable to Social Disruptions During COVID-19 Pandemic

Posted on October 30, 2023October 30, 2023 by Jodi Snare

Collaborative ECHO Cohort research led by Phillip Sherlock, PhD; Maxwell Mansolf, PhD; and Courtney Blackwell, PhD of Northwestern University investigates the COVID-19 pandemic’s impacts on adolescents’ mental health. The findings suggest that some teens with a history of depression, anxiety, autism and ADHD experienced more severe impacts than those without. This research, titled “Life Satisfaction for Adolescents with Developmental and Behavioral Disabilities during the COVID-19 Pandemic,” is published in Pediatric Research.

Although researchers have looked at how the COVID-19 pandemic affected the mental health of children of all ages, few studies have examined the pandemic’s impact on children and teens with pre-existing mental, emotional, behavioral, and developmental (MEBD) disabilities such as depression, anxiety, ADHD, and autism spectrum disorder.

Health policies implemented to prevent the spread of COVID-19 disrupted normal activities for children and families. Schools paused in-person learning, extracurricular activities were canceled, and stay-at-home orders meant children spent more time quarantined with family members instead of engaging with friends and peers.

Adolescence is a critical period for social development. Researchers aimed to identify the groups of adolescents most affected by the pandemic to provide mental health practitioners, pediatricians, and family physicians with better information on potential intervention and prevention practices particularly vulnerable adolescents in the future.

This study included data collected from 1,084 adolescents ages 11–21 years old and their caregivers and included individuals with and without disabilities from seven ECHO observational research sites in the U.S. In addition to using existing ECHO Cohort data about adolescents and their families, researchers administered a COVID-19-specific survey to better understand the physical, mental, and social impact of the pandemic on young people and their families.

This study found that when exposed to certain stresses during the COVID-19 pandemic, adolescents with a history of depression, anxiety, autism spectrum disorder, or ADHD had lower life satisfaction compared to their peers. These stressors included social isolation, stress related to medical care access and fears about the pandemic, and living in a single-caregiver household. Additionally, 80% of adolescents, regardless of pre-existing conditions, reported decreases in social connectedness during the COVID-19 pandemic. Although the negative effects of decreased social connectedness were amplified among adolescents with MEBD disabilities, this risk factor was widespread among the majority of adolescents.

“This study allowed us to identify the groups of adolescents with disabilities who are most vulnerable and may need additional support during future emergencies,” Dr. Sherlock said. “This study also highlights the importance of interventions aimed specifically at increasing social connectedness, family engagement, and access to medical support for all adolescents, and especially for those with disabilities.”

This study revealed potential differences between adolescents with disabilities and their peers in terms of life satisfaction. Future research might include studies that focus on the vulnerable subgroups identified in this study. Future studies may also investigate the long-term effects of decreased social connectedness and other risks resulting from the COVID-19 pandemic during developmentally critical time periods.

Read the research summary.

New ECHO Cohort Research Finds Adolescents with Disabilities May Have Been More Vulnerable to Social Disruptions During COVID-19 Pandemic

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New ECHO Cohort Research Finds Adolescents with Disabilities May Have Been More Vulnerable to Social Disruptions During COVID-19 Pandemic

Authors: Phillip Sherlock, Maxwell Mansolf, Courtney Blackwell, et al.

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

Why was this study needed?

Although researchers have looked at how the COVID-19 pandemic affected the mental health of children of all ages, few studies have examined the pandemic’s impact on children and teens with pre-existing mental, emotional, behavioral, and developmental (MEBD) disabilities like depression, anxiety, attention-deficit hyperactivity disorder (ADHD), and Autism Spectrum Disorder (ASD).

Health policies that were put in place to prevent the spread of COVID-19 caused disruption of normal activities for children and families. Schools paused in-person learning, extracurricular activities were cancelled, and stay-at-home orders meant children spent more time quarantined with family members instead of engaging with friends and peers.

This study was needed to understand how the stresses of the COVID-19 pandemic impacted life satisfaction for adolescents with disabilities, as adolescence is a critical period of social development. Researchers aimed to learn which groups of adolescents were most affected by the pandemic, so that mental health practitioners, pediatricians, and family physicians might be better informed of potential intervention and prevention practices that could be implemented to help particularly vulnerable adolescents through difficult times in the future.

What were the study results?

When exposed to certain stresses during the COVID-19 pandemic, adolescents with a history of depression, anxiety, ASD, or ADHD had lower life satisfaction compared to their peers. These stresses included decreased social connectedness, decreased family engagement, stress related to medical care access, pandemic-related traumatic stress, and living in a single-caregiver household.

This study also found that 80% of adolescents, regardless of pre-existing conditions, reported decreases in social connectedness during the COVID-19 pandemic. Although the detrimental effect of decreased social connectedness was amplified among individuals with certain pre-existing MEBD conditions, this risk factor was widespread among the majority of adolescents.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This study found that adolescents with decreased social connectedness typically had lower life satisfaction across several groups with different life circumstances. However, decreased social connectedness was more harmful for individuals with disabilities. This study allowed researchers to identify the groups of adolescents with disabilities who are most vulnerable and may need additional support during future emergencies. Findings from this study also highlight the importance of interventions aimed specifically at increasing social connectedness, family engagement, and access to medical support for all adolescents, and especially for those with disabilities.

Who was involved?

This study included COVID-19 survey data collected from April 2020 to August 2021 from a sample of 1,084 adolescents ages 11–21 years old, and their caregivers. The sample included individuals with and without disabilities from seven ECHO observational research sites in the U.S.

What happened during the study?

In addition to using pre-existing ECHO Cohort data about adolescents and their families, researchers administered a COVID-19-specfic survey to better understand the physical, mental, and social impact of the pandemic on young people and their families. Data were analyzed using a machine-learning process.

What happens next?

Findings from this study showed evidence of potential differences between adolescents with disabilities and their peers in terms of life satisfaction. Future research is needed to design studies that focus on the vulnerable subgroups identified in this study. Additionally, future studies may look into the long-term effects of decreased social connections and other risks resulting from the COVID-19 pandemic during developmentally critical time periods.

Where can I learn more?

Access the full journal article, titled “Life Satisfaction for Adolescents with Developmental and Behavioral Disabilities during the COVID-19 Pandemic,” in Pediatric Research.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Read the associated article.

Published October 24, 2023

Download this summary

New ECHO Cohort Research Finds Adolescents with Disabilities May Have Been More Vulnerable to Social Disruptions During COVID-19 Pandemic