Understanding Child Development in the Assessment of Stress in Children Amidst the COVID-19 Pandemic

Clare Cardo McKegney, DNP, APN, CPNP


Pediatr Nurs. 2021;47(1):48-51. 

In This Article

Abstract and Introduction


On March 11, 2020, the World Health Organization (WHO) declared the rate of infection of COVID-19 virus around the world as a pandemic. At the time, most practitioners concerned themselves with the actual disease process with a focus on contagion, management, and treatment. As pediatric providers, we were also immediately charged with the care and management of children in the office for well surveillance and acute care, while maintaining appropriate infection control measures for the safety of patients and staff. With school closures and social distancing, infants, children, and adolescent were asked to isolate in their homes. Pediatric providers immediately recognized that COVID-19 could have potential devastating effects on the psychological wellbeing of our patient population. As the summer neared an end, the American Academy of Pediatrics (AAP) (2020) and the Centers for Disease Control and Prevention (CDC) (2020) encouraged schools across the country to allow children to be with their peers in some capacity (even if limited) in the classroom.

Efforts, such as mask wearing, social distancing, and reduction of face-to-face time with peers, decreased the number of cases throughout the summer. However, as the general population attempts to seek a normal work and academic life, the cases are on the rise again in Europe, as well as in many states in the United States (WHO, 2020). The country is fatigued with anxiety regarding the disease; families and caregivers have concerns about work security, food security, potential infections, and the grave reality of losing a loved one. In addition, our country is faced with a polarized political climate and anti-racism movement that we have not seen in our children's lifetime.

In an effort to recognize the manifestations of stress in children, it is vital that the pediatric providers apply the emotional and psychosocial developmental stage of each child into their plan of care. It is the responsibility of the provider to then educate families of the essential role they take in assessing for the stress response in children. This article will use the teachings of Erik Erickson to provide a framework for organizing the assessment of each stage of development.