From the WebMD Archives

July 15, 2020 -- A 4-year-old who was potty-trained starts having accidents multiple times a day, and a 5-year-old suddenly starts baby-talking and sucking their thumb; habits they gave up years ago.

An 8-year-old that used to sit, read, and do Legos throughout the day now seems hyperactive and unable to sit still. The speech gains made in a 15-year-old with autism seem to have wasted away, and a 16-year-old who used to be fairly easygoing now has eruptions and angry outbursts over seemingly tiny things.

What do these things all have in common?

They all are signs of regression -- the term to describe when children step back, or regress, in a skill they've developed or behavior they've mastered. Regression is a normal part of childhood development, but in the age of COVID-19, experts say it’s happening in a vast and more widespread way than normal.

“What I'm seeing and what I'm hearing about is regression in everything from potty training and baby talk, to refusals to do schoolwork and other responsibilities, an upsurge in tantrums, aggressive and out-of-control behavior, and an upsurge in anxiety and difficulty around eating, sleeping, and managing one's impulses,” says Nancy Close, PhD, an assistant professor at the Child Study Center at the Yale School of Medicine, who has written about regression as it relates to the pandemic.

“The level of stress has gone up to an enormously high level in this pandemic, and many children are struggling,” says Close, who is also clinical director of the Parent and Family Development Program. “So all of a sudden, you might see difficulties with sleeping because the idea of moving away from a secure caregiver can at times feel really overwhelming to a little one.

“They might be waking up more at night, or they might be whinier or clingy.”

Regression takes a variety of forms, depending on the child, their age, and their circumstances. Here’s a closer look at some of the ways it happens and what parents and caregivers can do about it.

Developmental and Behavioral Regression

Children are generally highly motivated to move forward in their development and delight when they master a new skill or accomplish something new. Close says they’re almost hard-wired with energy and motivation to reach out, explore, manipulate, and master their bodies and environment. But doing so, she says, is also hard work for them.

So it’s not uncommon that children sometimes regress and backslide after they learn skills or behaviors. Experts say when it happens, it’s most likely a signal that kids are struggling to manage strong emotions and don’t know how to cope with the stress, worry, or frustration they are feeling. In other words, it’s how children subconsciously communicate that they need more support.

“Behavior is communication, and it's their way of showing us -- usually not consciously or intentionally -- that their brain is trying to handle a lot and they can't cope with all of it as well as normal,” says Rebecca Schrag Hershberg, PhD, a clinical psychologist and the founder of Little House Calls Psychological Services. “More often than not, regression happens when something is stressing a child's system and their brain is on overload.”

The global pandemic clearly falls into that category and is triggering regression in many children who suddenly ask for help with tasks they’ve done by themselves, backtrack on developmental milestones they’ve hit, and suddenly have a hard time regulating emotions in a way they haven’t before.

“Children’s brains are working overtime to just adjust to this new reality, so when you then ask them to do something seemingly simple -- like put away the tablet -- and they respond with a high degree of irritability or even defiance, it’s not that they just became a bigger jerk overnight. They’re just being asked to handle more than they can in this moment,” says Hershberg, the author of The Tantrum Survival Guide.

While regression is a normal part of childhood development, it often startles parents, who worry and wonder about what is happening and why. It can also frustrate parents when their child stops a behavior or skill they’d mastered. But experts say it’s not generally a cause for major concern.

“It’s important for us to talk about this so [parents] can recognize and identify it when it’s happening and appreciate that it's normal and natural, as long as it doesn't last for an extended period of time, and as long as that child is not continuing to lose skills over the long term that they have already developed,” Close says.

Hershberg says when a child regresses, it doesn’t mean you should take away the rules -- just approach the situation from a place of compassion and support rather than in a punitive way. She says this will be very important as we move toward fall, reintroduce a very different type of pandemic-era school, and increase children’s daily stressors and demands.

Close agrees. “For older children, help them to anticipate exactly what's going to be happening as much as you can, and problem-solve difficult moments and situations they might encounter in advance.”

Here are some other ways to address behavioral regression in your child:

  • Follow a schedule as much as you can. “In general, predictability and consistency make children feel safe,” Close says. “I think the trap some fall into is setting a schedule that's so rigid that it overwhelms everybody. So just be cognizant of not overdoing it.”
  • Acknowledge that this is hard. Children often feel better if their own feelings are simply validated and they are assured that it’s normal and OK to be stressed and feel uncertainty.
  • Offer more comfort. Since regression is a sign that children are struggling to cope, offering more snuggles, hugs, and other compassionate physical touches throughout the day can help calm and soothe them.
  • Give children something to control. “When children don’t feel like they have control over anything in their life, that is a recipe for regression,” Close says. “It’s important for their normal development to be in control of their world.” Typically, children get that control by knowing what the rules and expectations are in their home and in their relationships, and having a routine for their days and their weeks. You can also add it in by building choice into their day -- for things as simple as snacks and outfit choice, to TV shows, books, toys, or activities.
  • Help them make connections between what’s happening in their life and the world so they better understand what they’re feeling. “Children may not be able to articulate how much they miss their friends or teachers or what they’re worried about without parents helping them figure out what is driving the behavior and what can be done to make them feel better,” Close says.
  • Stay positive. Experts say offering positive reinforcement can help turn things around.
  • Assess your own stress. Finally, make sure your own stress and anxiety are in check, because your children will absorb that.

If a child does regress, it’s not easy to say how long it will take to resolve. Each child will respond differently. In general, experts say most behaviors resolve in a matter of weeks. But if it lasts longer or you’re especially concerned, reach out to their pediatrician. Close says patience is important, too, and she tells parents to remember that progress is likely just around the corner.

“Regression can easily happen before there's a big movement forward, so it’s kind of like seeking extra comfort as they get ready for taking that next big step,” Close says.

Academic Regression

The COVID-19 pandemic is also triggering large-scale academic regression. Megan Kuhfeld, PhD, who studies student academic growth, and her colleagues at NWEA -- a research-based, educationally focused nonprofit organization -- has sought to find out how much of an impact it has. She published a study, along with researchers from Brown University and the University of Virginia, that projects COVID-19-related learning loss based on the fact that the pandemic interrupted schooling for 55 million students in the U.S.

Kuhfeld says academic regression isn’t universal. Her team’s data suggests the top third of students could make gains in reading. On average, students over the summer tend to forget, or unlearn, a portion of what they learned the previous school year. But under her team’s projections, most students will likely return to school this fall having retained only 63%-68% of the learning gains in reading and as little as 37%-50% of the learning gains in math from the previous school year.

“It does start to get pretty alarming,” she says. “I would say this was somewhat higher than I expected it to be, but we are talking about 3 months out of a 9-month school year where kids were not in classrooms and didn't get the exposure to academic content they would have gotten.”

Harvard University’s Opportunity Insights Economic Tracker has more data on the learning loss. It says as of June 21 in the United States, total student participation in online math coursework decreased by 93.1%, compared to January.

Data also shows the pandemic could widen racial disparities. An analysis from McKinsey & Company says the learning loss could widen an already sizeable opportunity gap. The paper suggests Black students could fall behind by 10 months and Hispanic students by 9 months.

“This is really important, and it shines a light on the inequalities that we already know exist and gives us an opportunity to really rethink in some ways how we deliver instruction and how we can turn around and make a difference for the students that are most at risk,” Kuhfeld says. “This could be a time that we can really invest in education and try to catch up kids who are chronically behind to help them improve.”

The Annenberg Institute at Brown suggests this will require good assessments of where students are at, use of things like extended learning time, and increased tutoring when possible. As for parents, William Lane, EdD, a special education expert in Delaware, suggests you do as much as you can to boost your child’s skills. He says this has educational benefits, and limiting academic regression can help with behavioral regression, too. So he says for little children, count cars if you are commuting or birds while walking. Practice math throughout the day while shopping or cooking. And for all children, make sure they are reading and you are reading to them.

“Reading is so important,” Lane says. “In terms of time, I recommend their age, plus 5 minutes at a minimum. Have the child read the book to you if they can, or have the parent read it and while you do that, work on sounding out words, identifying colors, anticipating what will happen, and those kinds of things.”

Lane says if your time is tight, ask a relative or friend if they’ll help you by hopping on a video chat and working remotely with your child -- even for just a few minutes a day, doing anything from coloring to playing a game, doing math problems, or reading.

“Not only do these things help the student in terms of academic regression, but these are also the kind of things that helps everyone relax. It can make students feel less distressed and more prepared, and it helps parents relax a bit, too. Knowing you are working on something and helping them, even in a small way, can make everyone feel better,” Lane says.

Social skills regression

Regression as it relates to school is likely to also involve a backsliding in social and emotional skills, experts say. “I think it's really important that we focus not just on math and reading but how we can support children more broadly,” Kuhfeld says. “There are lots of other important aspects about school.”

While this type of regression impacts all children it is most deeply felt by families whose children have special needs, including autism. Increased stress, uncertainty and unstructured time and a decrease in connections with school, teachers and others is upending life for many children and families who rely on these people, settings and social interactions for their development.

“There's regression across the board but disabled children, like those who have severe autism, have regressed even more during this pandemic,” says Feda Almaliti, vice president of the National Council on Severe Autism, and the mother of a teenager with severe autism. “It’s really devastating to watch all this progress that our children have made and that we’ve worked so hard to advocate for through an appropriate education just slip away.

“Children like my son will never be neurotypical. But as parents we just want to close the gap as much as possible so they can be as independent as possible and it’s impossible to do without school for them.”

Almaliti says school districts need to focus on solutions for special needs children and she doesn’t think they’re doing that enough. As for what’s possible to do at home? Solutions there aren’t guaranteed either, but the University of Michigan says structure and visuals can help guide students through uncertainty, and seeking out social support is important.

Autism Speaks has several behavioral, educational and mental health resources for children with autism and their parents and Lane, thespecial education expert in Delaware. has written extensively on the subject since the pandemic started. He’s also compiling a daily-updated Resource Directory on his website.

He says when it comes to social skills practice, parents can work with children on proper body language and conversation at any time. He recommends focusing on one element at a time – such as proximity to the speaker, eye contact, body positioning, gestures, active listening, not interrupting, asking open-ended questions and taking turns. Children can practice these skills in your home, neighborhood, on errands or over video chat with others.

He says you can watch movies, online videos or television and analyze how others are interacting and conversing. If they are able, he says children can also put social skills into practice by writing letters to friends or family members. While it’s not the same as getting these interactions with others – he says do the best you can, where you are.

“I think we need to highlight these issues for parents and keep talking about this to remind parents how they can keep working on all these issues with their children,” Lane says. “But we also all need to recognize the hard truth, which is we’re facing stark regressions across the board and it’s going to take considerable time to catch up.”

Show Sources

Nancy Close, PhD, Yale School of Medicine, New Haven, CT.

Rebecca Schrag Hershberg, PhD, Little House Calls Psychological Services, New York City.

Megan Kuhfeld, PhD, researcher, NWEA, Portland, OR.

William Lane, EdD, special education expert, Lewes, DE.

Autism Speaks, COVID-19 information and resources for families.

Annenberg Institute at Brown, EDResearch for Recovery: “School Practices to Address Student Learning Loss.”

Harvard University, Opportunity Insights Economic Tracker, Education, Online Math Participation.

McKinsey & Company: “COVID-19 and student learning in the United States: The hurt could last a lifetime.”

Michigan Health: “6 Ways to Support Children with Autism During the Pandemic.”

University of Washington Center for Reinventing Public Education: “Using Assessments Wisely This Year.” “How to prevent your neurodivergent students’ social skills regression this summer.”

Yale School of Medicine: “Handling Regression During COVID-19.”

Psychology Today: “Regression in the Time of Coronavirus.”

M. Kuhfeld and B. Tarasawa, Collaborative for Student Growth. “What summer learning loss can tell us about the potential impact of school closures on student academic achievement,” April 2020.

M. Kuhfeld, Ed Working Papers, Annenberg, Brown University. “Projecting the potential impacts of COVID-19 school closures on academic achievement,” May 2020. “Regressive Behavior: Signs of Child Regression & What to Do.”

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