Is COVID-19 the only impact on health we need to worry about for our children?

IS COVID-19 THE ONLY IMPACT ON HEALTH WE NEED TO WORRY ABOUT FOR OUR CHILDREN? March 2021

Is COVID-19 the only impact on health we need to worry about?

By the end of March 2021 many children will have spent ten months out of the twelve away from schools, classrooms and playgrounds. For many children access to school-based outdoor space is the only opportunity they have to run, jump, climb and learn outdoors.

The press has been full of stories about the impact on children of playground closures outside of school, as well as the role schools play in delivering learning and supporting wellbeing, but what about the impact the removal of outdoor learning and play time has had on children? Has this had an impact on obesity and fitness levels? Has it made a difference to the many other areas of development we know that it supports, such as social skills, mental health and general learning?

What provision is being made for the absence of outdoor learning and play when children return to school? Does the impact of COVID-19 go beyond the classroom?

In January and February 2021 - at the height of the lockdown - we talked to a number of school teachers about the impact that COVID-19 has had on their children in terms of fitness, wellbeing and learning, specifically looking at the role of outdoor play and learning.

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Let’s set the scene In January 2021 Sport England published its latest Active Lives Children and Young People Survey. It showed that, across the UK, the number of children and young people who were physically active fell during the 2019/20 academic year in England, as first storms and then the coronavirus (Covid-19) pandemic restricted the type of activities available. According to the survey only 44.9% of children and young people (3.2 million) met the Chief Medical Officer guidelines of taking part in sport and physical activity for an average of 60 minutes or more a day.

It’s also unclear how the isolation and physical distancing may influence the development of socioemotional skills, like regulating your feelings, exercising self-control and managing conflicts with your peers. It’s now known that time in education is essential for helping children to mature – particularly if their parents aren’t modelling those skills at home – and the time out may delay their progress.

Is COVID-19 the only impact on health we need to worry about for our children?

44.9%

25%

48%

of children met guidelines of taking part in sport & physical activity for an average of 60 minutes or more a day in 2019/20 academic year.

of what a child has learned in a school year, is lost over the summer holidays.

of schools said improving facilities had increased physical activity levels.

81% of children claimed to have spent less time outdoors in natural spaces with friends since the national lockdown in March 2020.

Is COVID-19 the only impact on health we need to worry about for our children?

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It’s not just the missed opportunities for learning and development that need to be considered during the current crisis, however.

The more serious concern is that, when schools are closed for long periods, many children will begin to forget what they already know – a regression that will be much harder to remedy. Studies suggest that, on average, children lose around 25% of what they’ve learned in a school year, over the summer holidays. If that eight-week break is extended to more than forty weeks, it seems reasonable to expect a significant element of regression, not just in terms of learning but also personal development skills.

Similarly, there are obvious physical health concerns. A recent report from the USA looked at the long-term impact of the loss of access to play and active, outdoor learning. It said: US COVID-19 restrictions such as the closure of schools and parks, and the cancellation of youth sports and activity classes around the United States may prevent children from achieving recommended levels of physical activity… Short-term changes in Physical Activity and Sedentary Behaviour in reaction to COVID-19 may become permanently entrenched, leading to increased risk of obesity, diabetes, and cardiovascular disease in children. Programmatic and policy strategies should be geared towards promoting PA and reducing SB over the next 12 months.

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A similar one from Canada noted: ...evidence of immediate collateral consequences of the COVID-19 outbreak, demonstrating an adverse impact on the movement and play behaviours of Canadian children and youth.

Importantly, this impact isn’t universal across the different areas of the UK. In May 2020 the Institute for Fiscal Studies reported that children from richer families are spending about 30% more time on home learning than those from poorer families. Not only this but the study also found that those from poorer communities were less inclined to send children back to school and, once there, children had access to less outdoor space and learning opportunities. This was backed up by Ofsted’s findings during their Autumn 2020 research, which showed that time away from school was having a general, negative impact on children, in particular the most vulnerable.

As far back as June 2020 the Children’s Commissioner said, about the pandemic and its effect on children: “The UN Convention on the Rights of the Child recognises that schools provide much more than formal learning. Article 29 of the UNCRC mandates that “Education should help develop every child’s personality, talents and mental and physical abilities to the full”. This supplements Article 31 which recognises that “Every child has the right to relax, play and take part in cultural and artistic activities”.

These are not things which come from an online tutorial but are nurtured in the classroom and developed in the playground.”

Is COVID-19 the only impact on health we need to worry about for our children?

Of course the restriction of playground time during the COVID-19 lockdowns isn’t limited to schools.

Many local authorities have shut public playgrounds because of hygiene and maintenance issues, during the lockdown periods, with Government support for this move.

A National England report commissioned by the Government showed that 81% of children claimed to have spent less time outdoors in natural spaces with friends since the national lockdown in March 2020. The vast majority (83%) felt being in nature made them very happy. Just 3% reported being unhappy outdoors. 70% expressed the intention of spending more time outdoors when Covid restrictions allow.

Despite this, in January 2021 Stevenage council closed 54 playgrounds after a rise in cases of COVID-19 in the area, including among children and young people. In Colchester, the council shut one of its largest playgrounds, saying that marshals had noted more than 100 people in the space at once. It added that others could also be closed. In Brighton, council leader Phélim Mac Cafferty said: “We really don’t want to close our playgrounds, but our concern is that as the new strain of the virus is spreading at a worrying speed, they’re becoming unsafe. This is because too many people of all ages are using them to congregate and socialise.”

In response, in a letter from Play England to all local authorities in England, several experts who work with children said that playgrounds should stay open “to reduce the catastrophic impact of Covid and lockdown on children’s physical and mental health and wellbeing”.

a role in their children’s problems and 90% of parents without a local playground said that having access would make their child play outside more.

“Covid-19 has provided an opportunity to press pause and re-evaluate.

Before the crisis, childhood obesity and growing mental health problems were areas of concern and yet, public playgrounds were being closed at an alarming rate due to lack of government investment.

“The vast majority of children in the UK live in urban areas and so playgrounds are an essential public service. For millions of children, free-to-access public playgrounds are their only chance to play outdoors.”

In many cases parents are left trying to weigh pros and cons of what’s worse: putting your child at risk for COVID-19 or at risk for severe social and educational hindrance. As a result of this uproar No 10 was forced, eventually, to confirm that all children could use playgrounds, not just those without gardens. Yet, doctors and public health experts have continued to urge the government to relax the restrictions on play, warning that children are failing to “thrive and grow” without social interaction.

“Children need children...” said Sunil Bhopal, a paediatrician and lecturer in child health in Newcastle.

“Is stopping them playing together really necessary to control this pandemic? We are seeing sadness and distress. If we want children to grow, develop and thrive they have to be able to play and … interact with each other.”

Anita Grant is chair of Play England said: “This is an unprecedented time of restriction and control, and we know this will adversely affect children. Playing outside in playgrounds may not be risk-free but the much greater risk is the impact of isolation, lack of exercise, loss of socialisation and connection with the external world that could result from the lockdown.

“Children and families already in deprived circumstances will be most impacted if they close.”

She said that while parks offered open space, children benefited specifically from playgrounds.

“Children in spaces free from adult restrictions are able to try things out, have a sense of agency and work things out for themselves.

The rules say that children’s playgrounds are allowed – we should Mark Hardy, chair of the Association of Play Industries said: “In an API survey of 1,100 parents through Mumsnet we showed that 72% of parents of children with health issues such as obesity said that the lack of outdoor play facilities in their area has played Is COVID-19 the only impact on health we need to worry about for our children?

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The evidence supporting the role of outdoor play and learning, in schools, is clear.

A number of studies have been published in journals that demonstrate the role a playground development can have in engaging children, combating inactivity and obesity and enriching the learning experience.

At Playforce our own impact evidence, conducted over two years, surveyed schools that had in some way developed or grown their outdoor space to include equipment linked to learning and health objectives. In more than 51% of cases tackling physical inactivity was the main objective for this development. 85% wanted to use the new installations for play and 71% for outdoor learning. 43% of respondents reported significantly better behaviour as a result of the installation, 36% noted an improvement in positive attitudes to learning, 48% said improving facilities had increased physical activity levels, 54% noted an improvement in happiness and 42% an improvement in general well being. It therefore stands to reason that the removal of access to this equipment will have an impact on children and young people.

In July 2020 (and who knew that, at this point we’d be heading for a further two lockdowns and counting) Marguerite Hunter Blair and Anita Grant, Chief Executive or Play Scotland and Chair of Trustees for Play England, respectively, wrote: “...helping children and young people to connect with nature, be more active and have fun together will promote and create the conditions for optimal learning. Key to building this play-led outdoor learning paradigm is communication with the school community about the benefits of the approach. It is right that parents should be keen that children ‘catch up’, but moving children physically back into school needs to be managed, with play and socialisation as priorities.’”

They went on to say that: “Child Poverty Action Group Scotland’s Cost of the School Day report found that children were “desperate” to return to school because it was their main opportunity to socialise with friends.” and: “Following this extended period of restriction and isolation, children’s play and learning will need to involve some degree of agency that will enable them to take on an active role and ownership of their experiences. Playing freely with friends and peers enables them to process their experiences and develop resilience.

Outdoor play is particularly beneficial during times of anxiety, stress, and adversity: it provides a sense of control and independence; it helps children make sense of things they find hard to understand; it supports their coping and resilience.”

“An increase in play-led outdoor learning in schools can pave the way to better outcomes for children at school and in the

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community, now and for the rest of their lives. And it will support physical distancing for adults in these settings too.”

Similarly, the British Journal of Sports Medicine supported this approach stating that: Physical activity (performed regularly as well as just a single bout) can help young people’s cognitive function and their attention…

Combining physical activity with learning has cognitive benefits and is fun, especially with younger children.

In short, you don’t have to look far to find a number of reports, like our impact analysis, that demonstrate the direct connection between outdoor activity and play and academic performance improvement, as well as physical health and mental wellbeing.

It’s widely accepted that outdoor play and learning is an important area for our children’s health, wellbeing and learning.

But what impact has the COVID-19 pandemic had on this at a practical level?

To find out more we spoke to three schools and asked them to share their experiences of lockdown and, more importantly, the return to school process.

Our Focus Groups and interviews are always conducted confidentially, to encourage open discussion and comment.

School #1 is a vibrant, multicultural primary school in the North East.

RD is a class teacher and PE lead.

School #2 is a large primary school in Bedfordshire.

NM is a class teacher.

School #3 is a large infant and nursery school in the North East.

MT is EYFS lead and Outdoor Coordinator.

Have you noticed an increase, decrease or no change in the number of children that you’d class as overweight or obese on returning to school after lockdown?

RD: When we came back in September the children went into new classes so it wasn’t easy, at first, to see what changes had taken place. But eventually we could see that a shocking number had put on a significant amount of weight in a relatively short time.

Is COVID-19 the only impact on health we need to worry about for our children?

MT: Yes, absolutely. We’ve noticed many, throughout the school, that have gained a lot of weight since the lockdown started.

NM: Although we’ve seen the same what has been clear is that those that had a problem before lockdown are struggling even more now. They’ve done nothing active for the whole time! But those that were active before continued that way and in many cases are doing even more activity each day.

Have you noticed an increase, decrease or no change in children’s overall fitness over 2020?

RD: Definitely. It’s not just a case of weight and obesity. General, overall fitness has dropped. So much so that we decided to top up the fitness requirements we already had in place to try to tackle this. For example, we now require all of our children to do the daily mile and have made a really big thing of it. It was shocking how many children could barely do a lap without complaining about being tired or having to walk, in the early days of their having returned to school.

MT: Yes, absolutely. But we haven’t been able to do very much about this because we can’t do PE in the school as it is needed for socially distanced eating and teaching. It’s too cold outside at the moment and the grassroots football and other hobbies that we used to support outside aren’t going ahead because of the weather and hygiene issues. It’s had a knock on effect for all children, particularly those that wouldn’t have been active outside of school time.

What about the non-fitness benefits of play and activity. Have you noticed an increase, decrease or no change in the number of cases of bullying or inappropriate behaviour over 2020?

lockdown period? Do you think time spent on active play (indoor or outdoor) increased, decreased or stayed the same when at home, during the first lockdown period?

NM: It’s been a really mixed bag. Some children spent more time outside during the lockdown because it was good weather and parents could shove them out. But I’m not convinced it was outdoor learning so much as play… and I’m not sure how good quality (in terms of learning) the play actually was.

The first lockdown was much harder than subsequent lockdowns as we didn’t really know what we were dealing with - and neither did parents and children. We had to work out how to deliver teaching and learning. As a result most of it was indoors. However this has got more creative as subsequent lockdowns have gone on. We’re now encouraging parents to do things with their children during normal tasks like baking and board games. Quality family time also teaches social elements. In fact, we’re now thinking that we could be looking at a generation of children that are more socially able because they’ve spent an extended amount of time in the family, developing social skills.

RD: They both vastly decreased. As a school we provided online learning but this limited children’s outdoor time. They were asked to fill in a PE diary and we encouraged this but only about 30% actually did it. Weekly calls backed this up. The children just weren’t doing the activity like they were in school. In some cases, for the weekly calls, we could tell that the children were being woken up just for the call and it could have been lunchtime or even later.

RD: Actually we’ve been pleasantly surprised. Everything is pretty good and we’re pleased that we haven’t seen any increased bullying about fitness or weight, either.

NM: When we came back in September we tried to tackle this head on and did a heavy PSHE programme. We were aware this was likely to be an issue. Actually, we discovered that the children were just pleased to see each other and things that might have triggered incidents before haven’t happened. Generally the children have been better and more sensitive. That said, we have often had to treat topics like this as the children all starting school again and helping them to learn this again from scratch.

MT: We’ve seen a slight increase in cases. Behaviour and attention spans have definitely decreased since the lockdown, which can sometimes impact on how the children respect each other.

NM: Actually, that’s true. We have had more cases of shouting out and not having courtesy. The children have had to learn again about inclusion and interaction. Instilling a team ethos and school community has been something important we’ve had to work at.

Do you think time spent on children’s outdoor learning increased, decreased or stayed the same when at home, during the first Is COVID-19 the only impact on health we need to worry about for our children?

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MT: In our case I think outdoor active play probably increased slightly but this was balanced with massively greater technology use… so I’d have to question the benefit!

When children returned to school after lockdown do you think time spent on children’s outdoor learning and play increased, decreased or stayed the same as it had been before the lockdown?

MT: In our case both of them decreased. In our case it has just been impossible to balance the hygiene and social distancing requirements with the need for outdoor time and space.

NM: It has been a really mixed situation. In terms of lesson time, broadly speaking, it has stayed the same - but only just.

We’ve had restrictions on outdoor space use and a lot of curriculum to catch up on that made us feel children needed to be in a classroom doing that. That said, outdoor PE did feel safer and was prioritised over indoors, but the weather has made this harder. Also the need to quarantine and wipe down equipment has made this harder. It meant that routine took precedence and only stuff that could be wiped down ended up being used.

Outside of PE lessons, though, there has been a reduction. When you add it up the children are probably only getting 15-20 minutes outside as opposed to the 40 minutes they were getting. Now they have limited playground zones that they can use and we have to manage the time we give them to run around so everyone gets some outside time.

RD: We’ve had the same experience. We had so much curriculum to catch up on that we’ve had to prioritise that - often at the expense of outdoor learning. We’ve tried to balance this with increased play opportunities (such as bouncy hoppers, pogo sticks, outdoor bowling, hoola hoops and so on), to encourage them to be as active as possible when they are outside, but it’s not the same as structured outdoor learning.

Have you found that children’s attitude to being active (sport and active play) has improved, worsened or stayed the same over 2020? What do you put this down to?

RD: When we first came back it was considerably worse because the children were out of the habit and daily routine. The children were a lot less willing to get involved. There have been improvements but as teachers we’ve had to work a lot harder to be creative and promote a culture of activity and being positive.

We introduced a ‘Laps to Lapland’ scheme before Christmas where they had to tot up miles to get a reindeer back to Lapland.

We noticed that the children were far more willing to take part when they had a goal to work towards.

NM: We’ve had a slightly different response. On the whole the children have been keen and their attitude has improved. I think this is because they really love being back at school and together.

Activities - such as Playforce’s Drop Spots - have been particularly

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popular at lunchtimes. They’ve enjoyed having a variety of things to do. That said there is a whole load of learning to be done about engagement with groups and teams that they haven’t done and particularly the smaller ones haven’t ever experienced.

Have you noticed changes in children’s interaction and communication over 2020, as they have gone through periods at home and returning to school?

NM: Playing was an issue in general. The children haven’t really been interacting with other children at home and it made it difficult for them when they returned - particularly the littlest ones. But this has improved now.

MT: Absolutely. We noticed a real change in the way children played together at the start - lower ability levels, bad manners, poor listening skills as well as really struggling to know how to play with other children.

RD: The other thing we’ve noticed is lower energy levels as well as a general overwhelm, particularly for the little ones.

Have you found that it is more or less challenging to prepare outdoor learning and play activities in a COVID-19 environment, or about the same as normal?

RD: Probably more challenging, but we just get on with it. We were very uncertain at the start in terms of what we were and weren’t allowed to do but we eventually took the view that if the children are allowed back, we have to make it work safely. We’ve got used to it.

NM: It’s not something we’ve thought too hard about. We’ve just got on with it. We had planned to do more because of the topics we were covering but had to adjust because of what we were actually allowed to do outside.

That said, it definitely now requires more thought and planning.

And, if we were to increase the amount we were doing outside it would take a considerable amount more time, which we don’t have at the moment.

What do you consider to be the most challenging considerations now?

MT: Balancing cleaning and risk assessment with the children’s natural instinct to explore and interact.

NM: Definitely the restrictions as a result of zoning. The children have an 8m x 3m space in which to play - the playground is divided into six sections. It’s not a great space, particularly for older children but they can’t use the field because it’s wet and muddy. It restricts what they can do and the amount of running around… as well as the things we can plan.

RD: Yes, definitely zoning. All of our PE classes had to be outside because we didn’t have available indoor space but the zones for

Is COVID-19 the only impact on health we need to worry about for our children?

bubbles didn’t give us much space to work with. Bad weather, too, has impacted. We’ve had to balance sticking with curriculum with keeping them warm in bad weather.

What’s happened to your existing playground equipment? Have you been able to maintain equipment in a good state of repair over 2020? Is it being used at all?

RD: We were lucky that most of our equipment was quite new so it has stayed well maintained, even if it isn’t being used at the moment. Each bubble is allocated a zone so one year group uses the fitness park and so on. We can’t have more than one bubble on the equipment, though, and this is a real shame as it sort of taunts the children that don’t have access to it.

NM: Yes, ours is all coned off and isn’t being used at all. We can’t manage the hygiene and germs on it without this. We’ve also had to restrict toys at lunchtime.

MT: We’ve kept some in use but restricted the majority.

Depending on their bubbles some groups get to use it but it’s limited to them. We’ve had to work hard to keep things wellmaintained, however, because our caretaker is shielding. It hasn’t been easy!

What predictions do you have for 2021 in terms of outdoor learning and play? Do you think certain equipment will become more/less important or popular? What are your greatest concerns about outdoor play and learning for 2021?

RD: We’re always looking for good ways to improve general wellbeing through fitness and activities. It worries me that PE and general fitness isn’t going to be able to continue in the fun, game-based way it did, because there is uncertainty about the rules and guidelines.

discover. There isn’t any sense of flexibility or the unknown.

They’ve lost a huge amount of time (potentially almost a year) and there will be a lot to catch up. Once you start introducing PE and team events and playing with equipment at lunch, it’ll all be brand new. Tolerance of winning and losing will need to be taught again.

As will discovery and testing boundaries of risk and activities. Some have never experienced these things.

MT: Yes, at the moment with the various other things we have to catch up on spending money and time on developing outdoor spaces to include more equipment isn’t a priority. But as time goes on - and the issues that a lack of outdoor play is causing become more evident (and problematic) schools are going to have to think more about how they use their outdoor space and the equipment they have.

We’d like to hear your thoughts and views on the many themes raised in this, the first of our Focus Group and Discussion sessions.

How are you tackling these issues in your school? What would you like to see us doing to better support you with this?

Play England has produced an excellent guide called Play After Lockdown that provides a framework for addressing the issues arising from the impact on play of COVID-19. It offers simple guidelines designed to make provision possible (and safe) whilst at the same time, not suffocating the very processes play is intended to help.

Our next topic will be discussed on 20th April 2021. If you’d like to take part you can contact us on marketing@playforce.co.uk.

I also worry about what children do and don’t do at home. Even if it’s just going for a walk I think more parents need to be encouraged to see activity as an essential part of their child’s day.

Otherwise we’re looking at being back to square one in terms of fitness, when they return after even the short holidays.

I also think that encouraging children to take ownership of their own fitness and wellbeing will become increasingly important - perhaps because of my last point. I think we’ll do more and more in schools in terms of helping them to see the connection between activity and wellbeing, health and feeling better.

Hopefully by offering them lots of options in schools - in particular with smaller equipment such as hoola hoops - we can demonstrate ways in which they can do it for themselves.

NM: Equipment is going to be important because we’re going to have to teach children how to play again, once this is over. At the moment they’re limited to a small amount of concrete and imagination. And they don’t have team play at all. On the one hand this has been good because it has developed their appreciation of the little things but they’ve lost the opportunity to explore and Is COVID-19 the only impact on health we need to worry about for our children?

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