Vulnerability and resilience in children during the COVID-19 pandemic

Winnie W.Y. Tso, Rosa S. Wong, Keith T.S. Tung, Nirmala Rao, King Wa Fu, Jason C.S. Yam, Gilbert T. Chua, Eric Y.H. Chen, Tatia M.C. Lee, Sherry K.W. Chan, Wilfred H.S. Wong, Xiaoli Xiong, Celine S. Chui, Xue Li, Kirstie Wong, Cynthia Leung, Sandra K.M. Tsang, Godfrey C.F. Chan, Paul K.H. Tam, Ko Ling ChanMike Y.W. Kwan, Marco H.K. Ho, Chun Bong Chow, Ian C.K. Wong, Patrick lp

Research output: Journal article publicationJournal articleAcademic researchpeer-review

148 Citations (Scopus)


Background: The coronavirus disease 2019 (COVID-19) pandemic is having a profound impact on the health and development of children worldwide. There is limited evidence on the impact of COVID-19 and its related school closures and disease-containment measures on the psychosocial wellbeing of children; little research has been done on the characteristics of vulnerable groups and factors that promote resilience. Methods: We conducted a large-scale cross-sectional population study of Hong Kong families with children aged 2–12 years. Parents completed an online survey on family demographics, child psychosocial wellbeing, functioning and lifestyle habits, parent–child interactions, and parental stress during school closures due to COVID-19. We used simple and multiple linear regression analyses to explore factors associated with child psychosocial problems and parental stress during the pandemic. Results: The study included 29,202 individual families; of which 12,163 had children aged 2–5 years and 17,029 had children aged 6–12 years. The risk of child psychosocial problems was higher in children with special educational needs, and/or acute or chronic disease, mothers with mental illness, single-parent families, and low-income families. Delayed bedtime and/or inadequate sleep or exercise duration, extended use of electronic devices were associated with significantly higher parental stress and more psychosocial problems among pre-schoolers. Conclusions: This study identifies vulnerable groups of children and highlights the importance of strengthening family coherence, adequate sleep and exercise, and responsible use of electronic devices in promoting psychosocial wellbeing during the COVID-19 pandemic.

Original languageEnglish
JournalEuropean Child and Adolescent Psychiatry
Publication statusPublished - 17 Nov 2020


  • Child psychosocial problems
  • Coronavirus
  • COVID-19
  • Home confinement
  • School closure

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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