Better or Worse? Real-time impact of COVID-19 re-opening among children with and without mental health and neurodevelopmental disorders over time.

The overall aim of this project is to understand the real-time impact of the COVID-19 public health emergency measures on children's mental health (MH) as our society re-opens, and possibly closes again, over the coming year. In our large sample of children and families with and without pre-COVID mental health and neurodevelopmental problems, we have previously shown that the majority of children experienced a significant negative impact to their MH during the pandemic. However, up to 30% of children reported no MH concerns, or even improvement of their MH during school and recreation closures. From self- and parent-online report of MH symptoms, and using the infrastructure that we have successfully established, we will now determine whether these MH impacts are long-lasting. This study will examine the roles of sociodemographic factors (e.g. household income, race/ethnicity), COVID-19 factors (e.g. vaccination status), child and family-level factors to understand what places a child at increased or decreased risk of MH problems during societal re-opening. Lastly, we want to understand whether children whose MH initially improved, during societal closures, experience increased MH problems as society re-opens. The results of this study are essential for identifying children at risk for poor MH and improving their outcomes. Our experienced team and established partnerships will ensure that study data are used to advocate for children's needs and to inform public health decisions about the societal re-opening process over the coming year and into a post-pandemic period.