605 - Look Who’s Not Talking: The [Silent] Effects of a Global Pandemic on Young Children

Poster Number: 605
Publication Number: 605.310

Elizabeth M. Chawla, Georgetown University School of Medicine, Washington, DC, United States; Ann Marie Martin, Georgetown University School of Medicine, Arlington, VA, United States

Background: The COVID-19 pandemic has had significant impact on children despite low rates of infection during the first waves. Data emerging shows impacts on mental health and education, especially for school-aged youth, but few studies have examined impacts on young children. Globally, studies show increased screen time for children of all ages during quarantine, even under 5. The existing literature suggests excessive screen time can contribute to developmental delay, especially in language, and lack of adequate interaction with caregivers can have long-term impacts on the mental/behavioral health of children including development.

Objective: To study the effects of an extended quarantine on young children, we examined rates of developmental delay and referral to specialized therapists in our health system during the first year of the COVID-19 pandemic.

Design/Methods: We utilized retrospective chart review for children under 6 years seen in primary care in the Medstar Georgetown Health System during the first year of the COVID-19 pandemic (study period) compared to an equivalent one-year period before the pandemic (control period). We reviewed ICD-10 diagnosis codes for developmental delay, as well as referrals to outpatient specialty therapists. Statistical analysis was completed using the chi square, with sub-analysis for all visit types vs well child checks (WCC) for both study questions.

Results: Total office visits reduced by 10% during the study period [96,744 to 86,692], but well visits remained stable [13,998 to 13,106]. Language delay [P=.036] and motor delay [P < .001] were diagnosed more frequently during the study period for all visit types; language delay was diagnosed more frequently during WCC as well [P=.038]. Overall, referral to outpatient therapists increased during the study period [P=.002], as well as referral to speech therapy specifically [P < .001]. The majority of referrals came from non-WCC visits for both time periods.Conclusion(s): Although sick visits reduced during the first year of COVID-19, significantly more children were diagnosed with speech delay and motor delay. The increase in speech delay was consistent across all visit types and in referrals to pediatric speech therapy. As previous studies suggest, increases in screen time and decreases in social interaction for young children during quarantine could be contributing. Further studies are needed to explore these trends in other populations, and to explore if prolonged social isolation and quarantine during early developmental stages has a meaningful impact over time on our youngest patients.