COVID-19 Pandemic Exposure and Toddler Behavioral Health in the ECHO Program

Area of Science:

• Child Psychology
• Developmental Pediatrics
• Epidemiology

Background:

• Limited evidence exists on the COVID-19 pandemic's impact on toddler behavioral and emotional well-being.
• Studies suggest potential developmental concerns for infants born during the pandemic.

Purpose of the Study:

• To investigate the association between birth timing relative to the COVID-19 pandemic and toddler internalizing and externalizing problems.
• To compare behavioral outcomes in toddlers born before, during, or assessed during the pandemic.

Main Methods:

• Retrospective cohort study using Environmental Influences on Child Health Outcomes (ECHO) data (2009-2023).
• Categorized 3438 children into prepandemic, pandemic-assessed, and pandemic-born groups.
• Assessed internalizing and externalizing symptoms using parent-reported Preschool Child Behavior Checklist (CBCL 1½-5) at 18-39 months.

Main Results:

• Toddlers exposed to the pandemic (pandemic-assessed and pandemic-born groups) showed significantly lower levels of both internalizing and externalizing problems compared to the prepandemic group.
• Adjusted analyses confirmed these findings, indicating a protective effect associated with pandemic exposure.

Conclusions:

• Toddlers with prenatal and/or postnatal exposure to the COVID-19 pandemic exhibited fewer behavioral problems than those born and assessed pre-pandemic.
• Further research is needed to identify protective factors that may mitigate the pandemic's effects on child behavior.