Psychological IMPACT of Remote Learning in Children and Adolescents With Mental Health Disorders in the Community New York City Area

ABSTRACT

Objectives: The global crisis of COVID-19 demanded that schools adapt to online education at an unprecedented pace. Remote learning has followed social distancing protocols and helped in continuation of education. However, in children with mental health disorders (C-MHD), the outcomes of online learning are not similar to normal individuals. The primary objective of this study is to determine the prevalence of psychological distress of transitioning to remote learning in C-MHD. The secondary objective is to provide directions to increase student satisfaction for online education. Methods: An IRB-approved cross-sectional analysis was done on children aged 5 to 17 years (N = 172), including 87 boys (50.6%) and 85 girls (49.4%), from January to May 2021, at South Bronx Community Hospital, NY. A total of 111 children were Hispanic (65%) and 53 were African American (31%). Structured questionnaires were used by residents/fellows to determine effects of remote learning on children. A χ2 test was used to analyze the data, and p values were calculated across the variables of remote learning and psychiatric diagnosis of MDD, ADHD, and generalized anxiety disorder (GAD). Results: Our analysis showed that 105 (61%) of C-MHD students struggled to learn remotely compared to in-person learning (more children with MDD [20.35%, p < 0.05] as compared to GAD and ADHD). Due to long screen hours, more felt distracted (37%) than tired (14.5%). More felt sad (17%) than happy (0.06%), and 21.5% felt anxious. More children with GAD (42% vs 27%) as compared to MDD (35% vs 24%), rated e-learning as good. More children with ADHD (35% vs 30.6%) did not like e-learning. More children with MDD (26%, p < 0.05) reported feeling safe from COVID-19 in e-learning than did children with GAD (23%) and ADHD (17%). Conclusions: During the pandemic, C-MHD patients presenting to the emergency department with anxiety, aggression, and irritability have increased dramatically, where one of the main precipitating stressors was the inability to transition to remote learning. Online education during the pandemic has caused severe psychological and behavioral impacts on children. Student satisfaction will increase if streamlined digital processes and personalized support systems are fully integrated. SC, SAC, COMP