Thursday, March 26, 2026

Study shows COVID-19 pandemic’s disrupted young children’s executive function development





Society for Research in Child Development





How did the COVID-19 pandemic impact young children’s executive function skills? 

Executive function skills are a set of inter-related processes that support attention, self-control, and goal-directed behavior. Executive function has been linked to positive outcomes across multiple domains of development. The skills associated with executive function develop rapidly during childhood and promote longer-term health, academic success, and wellbeing. Researchers from Harvard University were eager to learn how the pandemic affected children's developing executive function skills across time.

Using data gathered from 2018 to 2023 as part of the Early Learning Study at Harvard (ELS@H), a longitudinal, population-based and representative study of children’s development conducted in Massachusetts, the researchers analyzed a sample of over 3,100 children from age 3 to 11. Half of the sample were girls; the children were mostly white (74.6%), while 18.3% were Hispanic, 11.8% were Black, and 10.7% were Asian. Nearly half of all parents reported incomes between $75,000 - $125,000 or between $125,000 - $200,000 per year with around 20% reporting more than $200,000 and about 30% reporting less than $75,000.

Children were administered the Minnesota Executive Function Scale (MEFS), a tablet-based assessment used to measure executive function. Researchers used the data to track the development of executive function skills over six years, before, during, and after the pandemic’s onset. 

The researchers found the average rate at which executive function grew following the pandemic’s onset was lower than is developmentally typical based on previous national norms and existing research; this pattern held across all socioeconomic subgroups. The authors suggest that this finding may help explain the systemic academic and behavioral challenges facing children since the pandemic, and they emphasize that to mitigate the pandemic’s ongoing effects, these students may need more support to develop and expand their executive function skills. 

The study is featured in a new Child Development article, “The Impact of the COVID-19 Pandemic on Young Children’s Executive Function: A Longitudinal, Population-based Study,” by Stephanie M. Jones, Caitlin M. Dermody, Jen Acosta, and Nonie K. Lesaux of Harvard University and Alan F. Mozaffari of the University of California, Berkeley. The Society for Research in Child Development (SRCD) had the opportunity to speak with the author team to learn more about the research.

SRCD: Did anything in the results surprise you? 

Author team: Executive function is an essential cognitive capacity that develops rapidly during early childhood and is shaped by early experiences. Therefore, we were not surprised that an extreme disruption like the pandemic affected the development of children’s executive function skills. That being said, the magnitude of our findings was surprising. Children’s scores in our sample were significantly below the nationally normed average scores of age-matched children measured before the pandemic, even though the children met or even exceeded age-matched scores before the pandemic’s onset. The starkness of this finding sheds light on the systemic scope of the pandemic’s effects on child well-being and the importance of traditional education and care experiences for all children’s development. Specifically, we know that prior research has identified many of the significant and sustained challenges that children and families experienced following the pandemic’s onset (e.g., parental stress, economic instability, illness, social isolation, and other disruptions to education and care) as factors that can disrupt executive function. It may well be that these pandemic-related experiences, alone or in concert, place substantial burdens on families and the broader systems that sustain and support family and child wellbeing, resulting in the pattern of findings we observed for children’s executive function. 

SRCD: Can you explain how this research might help families, teachers, school administrators, policymakers and researchers?

Author team: Right now, those who care for, work with, or think about today’s youth continue to hear and share stories of children’s struggles post-pandemic. Uniting the growing body of research on executive function with the wealth of existing information on the pandemic’s impacts offers a path toward recovery. Specifically, we need more efforts to strengthen children’s executive function skills and more systemic strategies to improve the environments that support them. It is well documented that early disparities in executive function predict later challenges in health, academics, and behavior, so efforts to support children’s skills today are an essential step forward. For families and educators, our findings highlight the power of environmental influences and the importance of attending to executive function as a key facet of child development. For policymakers and administrators, our research suggests that supporting executive function may be a key recommendation for pandemic recovery efforts, investments, and resources. For researchers, our study calls for further investigation into the role of executive function as an explanatory mechanism driving challenges to children’s academic and behavioral struggles post-pandemicWe plan to continue to explore the mechanisms driving our findings in our upcoming work, and current research in our lab provides insights into the long-term challenges facing students (e.g., Fritz et al., 2026). Most importantly, our research joins others in recognizing that the systemic challenges of the pandemic require systemic solutions. 

SRCD: How did family/parental income intersect with the pandemic’s effects on the sample of developing children you examined?

Author team: Past research demonstrates that executive function is linked to socioeconomic status. Prior to the pandemic, the well-documented pattern of variation in executive function by income was present in our sample; however, once the pandemic began, income-based gaps appeared to narrow. The patterns in our findings held on average across all socioeconomic sub-groups, demonstrating the systemic scope of the pandemic’s effects on all children’s well-being and the importance of supportive experiences and environments for all children’s development. 

SRCD: What are some of the research’s limitations? 

Author team: As in many longitudinal studies, pandemic disruptions resulted in changes in the frequency and methodology of our data collection in the Early Learning Study at Harvard (ELS@H). Once the pandemic began, we were unable to directly assess the children until two years following our last pre-pandemic data collection. While this pacing could result in some missed nuances, it did allow us to examine our data in a unique time-stamped way pre- and post-pandemic. The pandemic also altered our method of data collection: the MEFS assessments were administered in person for the first three waves and virtually for the fourth and fifth waves. Although some studies have found that virtual assessments of executive function can be as reliable as in-person assessments (Ernst et al., 2024; Perry et al., 2023), it is possible this change affected our data. That being said, multiple pilots and robustness checks suggested no differences, making us confident that our data represent children’s executive function skills accurately. Other limitations include that our findings are specific to our population-based sample in Massachusetts and may not be applicable nationally. In the future, research comparing these findings to those of other longitudinal studies in different populations would be beneficial. Although we cannot make strong causal claims here about the impact of the pandemic and its related events on children’s executive function, the longitudinal nature of the design, the population sample, and the external nature of the pandemic “shock” lends strong credibility to the directionality and pattern of our findings.

SRCD: How should future research further investigate the role of executive function among children who continue to struggle academically and behaviorally in a post-pandemic society?

Author team: Theory and empirical evidence show how executive function skills are related to multiple domains of development. For example, these skills are positively associated with peer acceptance, adaptive classroom behavior, and social competence, and negatively associated with internalizing and externalizing problems, as well as inattention and hyperactivity, both concurrently and longitudinally (e.g., Stuke & Doebel, 2024). Therefore, to best support children, further research will need to continue to unpack those relationships between executive function and the post-pandemic challenges related to behavior, academics, or absenteeism. In so doing, such research will be able to provide continued insight into the mechanisms that drive executive function development across time as children face new and diverse environmental experiences. Researchers will thus be able to provide evidence on policy and pedagogical solutions that best serve students’ needs (e.g., support for executive function skills). Our upcoming work with the ELS@H data plans to do just that, embracing an ecological perspective as we study our population-based sample in a longitudinal way. Most importantly, we hope that researchers remain interested in learning more about the importance of executive function skills for children, as well as the impact of environmental experiences on their development. 

This research was funded by the Saul Zaentz Charitable Foundation.

Summarized from an article in Child Development, “The Impact of the COVID-19 Pandemic on Young Children’s Executive Function: A Longitudinal, Population-based Study,” by Jones, S.M., Dermody, C.M., Acosta, J. Lesaux, N.K. (Harvard University) and Mozaffari, A. F. (University of California, Berkeley). Copyright 2026 The Society for Research in Child Development. All rights reserved.

 

ER triage for children’s behavioral health too often wrong, shows bias


Parents advised to tell the nurse immediately if they are worried their child is at risk for harming themselves or others while waiting




Ann & Robert H. Lurie Children's Hospital of Chicago





In emergency medicine, triage differentiates patients who require immediate attention from those who can safely wait for care. When it comes to children’s mental or behavioral health, however, triage scores were found to be inaccurate in two-thirds of the cases when compared to the level of care the child actually received during their emergency visit, according to a new study published in JAMA Network Open. Under-triage, or assignment of a lower severity score than the level of care that was needed, was more likely for children who were Black, Hispanic, and those who preferred Spanish compared to English.

“Our study was the first to examine rates of mis-triage in pediatric emergency departments when children present for mental or behavioral health concerns,” said lead author Jennifer Hoffmann, MD, MS, emergency medicine physician and researcher at Ann & Robert H. Lurie Children’s Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “When triage determination is wrong, there might be a risk to patient and staff safety, or resources might be diverted from kids in greater need. Especially with the ongoing youth mental health crisis, and as we continue to see more and more children with these issues in the emergency department, our ability to accurately distinguish levels of urgency upon arrival becomes even more critical. We need to refine triage tools to be more accurate and equitable so that they will work for all children who walk through our doors seeking care.”

Dr. Hoffmann and colleagues analyzed 74,564 visits for mental or behavioral health complaints among children 5-17 years of age presenting to one of 15 U.S. emergency departments participating in the Pediatric Emergency Care Applied Research Network (PECARN) Registry. The study focused on the Emergency Severity Index (ESI), the triage system used in over 90% of U.S. emergency departments.

The most frequently presenting primary mental health diagnosis groups were depressive disorders (25% of visits) and suicide or self-injury (23% of visits). Aggressive behavior occurred in 24% of the visits.

Over-triage, which involves assigning a higher severity triage score than the level of care the child received throughout their emergency visit, was found in more than half (57%) of visits, while under-triage occurred in approximately 1 in 12 visits (8%). Over-triage was more likely during visits by younger patients and Black patients compared to White patients. Under-triage was more likely among visits by Black and Hispanic patients compared to White patients, as well as in visits with a language preference of Spanish relative to English.

“The main message for parents is to advocate for your child. If you are worried that your child is at risk of harming themselves or others while they are waiting, tell the nurse immediately,” Dr. Hoffmann advised.

“Underlying drivers for inequities in triage may include implicit bias, which refers to unconscious stereotypes or attitudes,” said Dr. Hoffmann. “Clinicians need education on recognizing their own biases, in order to avoid undue influence on the care they provide. Using automated tools or artificial intelligence (AI) to augment the nurse’s assignment of triage scores might help achieve a more objective assessment, although these strategies require further testing. We also need to make interpretation services in the emergency department more readily accessible to families who prefer a language other than English. Ultimately, accurate and equitable triage systems are needed to match children with the right care at the right time, particularly during times of resource strain.”

In addition to Dr. Hoffmann, authors from Lurie Children’s include Christina R. Rojas, MDAron C. Janssen, MD, and Elizabeth R. Alpern, MD, MSCE.

Ann & Robert H. Lurie Children’s Hospital of Chicago is a nonprofit organization committed to providing access to exceptional care for every child. It is the only independent, research-driven children’s hospital in Illinois and one of less than 35 nationally. This is where the top doctors go to train, practice pediatric medicine, teach, advocate, research and stay up to date on the latest treatments. Exclusively focused on children, all Lurie Children’s resources are devoted to serving their needs. Research at Lurie Children’s is conducted through Stanley Manne Children’s Research Institute, which is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is the pediatric training ground for Northwestern University Feinberg School of Medicine. It is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. Emergency medicine-focused research at Lurie Children’s is conducted through the Grainger Research Program in Pediatric Emergency Medicine.

 

Kindergarten screening for early (grade 1) and late-emerging (grade 4) dyslexia risk



JAMA Network Open



About The Study: 

In this cohort study of 515 children followed from kindergarten through grades 1 and 4, distinct patterns of cognitive-linguistic deficits in kindergarten were associated with 2- to 5-fold increased risk for early- and late-emerging dyslexia. These findings provide a foundational evidence base to support the integration of developmentally sensitive screening into pediatric surveillance frameworks, facilitating early identification and a shift from reactive to preventive care, including for children at risk of late-emerging dyslexia.



Corresponding Authors: To contact the corresponding authors, email Avi Karni, MD, PhD, (avi.karni@yahoo.com) and Rotem Yinon, PhD, (rotemwr82@gmail.com).

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamanetworkopen.2026.3036)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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