The month of March brings with it the third anniversary of the COVID-19 shutdowns beginning in the United States. The year 2020 became synonymous with change and fear, as major sporting events were cancelled, thousands contracted and died from the new virus, and work and school went online for millions. The world has changed forever – especially for children.
In a parent survey conducted in the fall of 2022 by the Pew Research Center, 48 percent of parents with children in grades K-12 said the first year of the pandemic had a very or somewhat negative impact on their children’s emotional well-being. Additionally, a 2022 review of research by the National Institutes of Health (NIH) found that “the impact of the COVID-19 pandemic on child and adolescent mental health is multifaceted and substantial” and urged more well-designed studies examining its effects pandemic in mental health.
(Related: Vaccines against COVID-19 are still necessary to prevent death in children and adolescents.)
Now, a team of researchers in Sweden is turning to children’s drawings and their own explanation of what they drew to get a better sense of their feelings, beliefs and ideas about COVID-19. A small study published March 2 in the journal Acta Paediatrica found that common themes were detailed images of canceled activities, illness, and death, and children had sufficient knowledge about illness.
The team collected 91 drawings by children between the ages of four and six submitted to the Swedish Children’s Drawings Archive between April 2020 and February 2021. The project was part of research into children’s voices in public space during the pandemic.
“It was a very fun study. I was actually quite unsure whether a medical journal would publish the article, but they did, children’s drawings included and all,” co-author Anna Sarkadi said in a statement. Sarkadi is a doctor specializing in child health and social medicine from Uppsala University in Sweden
They analyzed the drawings using a type of visual analysis called semiotic visual analysis, which looks at image symbolism (what the images represent and how) and meaning (the associated meaning). The analysis also looked at the child’s own explanations accompanying the drawings.
The findings revealed that even the youngest children were strongly affected by the pandemic. In addition to canceled plans and images showing the sick and dying, fear, worry and missing grandparents were common themes among them. The coronavirus is often described as a monster, while other children described how to protect themselves from the virus. One drawing even showed two children in a sword fight against a giant virus.
(Related: It is more difficult for children with food allergies to get COVID.)
“The drawings were often covered in a lot of mucus. In one drawing, a child wrote, ‘You vomit, then you cough, then you feel better or you die,’ in extremely clear illustrations,” explained Maria Thell, co-author and doctoral student at Uppsala University, in a statement.
The study found that children also know quite a bit about the virus, including how it spreads and its symptoms. Of the 91 drawings, 14 showed hand washing, 17 showed symptoms such as coughing, and 44 depicted the virus itself.
“As a researcher with a background in child and youth science, I would love to develop this method further,” Thell said.
This group’s research will continue, and drawings by seven to 11-year-olds will then be studied.
“By encouraging young children to draw using open-ended prompts, such as what an illness feels like, looks like, or what is different now, it is possible to understand their interpretations of a situation and associated emotions,” the authors write in the study.
Additionally, they write, pediatricians can use children’s drawings to gauge emotional response to COVID-19 in addition to other health issues and get a unique glimpse into their world. This can help adults get a better idea of what children do or don’t understand and identify any ‘unhelpful imaginings’ they may have concocted.
A survey of children in the UK found that children aged seven to 11 were very aware of social distancing, illness and death caused by the virus, and similar reviews of children’s drawings have been carried out in Spain and Greece.