Children learning remotely or in a hybrid setting are more likely to experience worse emotional and mental health, as well as less movement, time spent with friends, and being outside than children who go to school, according to a recent study by the Centers for Disease Control and Prevention (CDC).

“Virtual instruction might present more risks than does in-person instruction related to child and parental mental and emotional health and some health-supporting behaviors,” the researchers said, adding that children “might need additional support to mitigate pandemic effects.”

Prior to the pandemic, over 8 million children between the ages of three and 17 suffered from a behavioral or mental health condition, according to the National Survey of Children’s Health (pdf). Anxiety, behavior disorder, and depression were the most common conditions.

The findings of the CDC study were based on a survey of 1,290 parents of children aged five to 12 who received either in-person instruction, online learning, or a combination of online and in-person instruction, and was conducted between Oct. 8 to Nov. 13, 2020.

Parents of children learning remotely were more likely to report worsening emotional or mental well-being of their kids (24.9 percent) than parents whose children received in-person learning at school (15.9 percent). But reports of anxiety and depression were similar in children in all three learning models, highlighting the importance that schools play in providing mental health services for children.

Researchers of a different study published in the Journal of School Health found that 35 percent of adolescents accessed mental health services “only in an educational setting,” based on data from a 2012 to 2015 National Survey on Drug Use and Health.

“Common reasons for accessing services in educational settings included problems with schools, friends, and family members,” the researchers said.

As for how much physical activity kids were getting, about 62 percent of the parents of remote learners said their children were less active than parents of children attending school every day (30.3 percent). In addition, parents of virtual learners told the CDC that their kids spent less time outside (58 percent) compared to 27.4 percent of kids receiving in-person instruction.

Parents also reported on their mental and emotional well-being, including concerns over difficulties in child care arrangements and job stability.

The researchers said that parents of online learners “more frequently reported their own emotional distress, difficulty sleeping, loss of work, concern about job stability, child care challenges, and conflict between working and providing child care than did parents whose children were receiving in-person instruction.”

In addition, parents of children receiving hybrid learning also “reported conflict between working and providing child care and loss of work more often than did parents of children receiving in-person instruction.”

Some of the limitations of the findings include the small sample size and response rate possibly impacting how applicable it is to the population as a whole, and the results not representing all children aged five to 12.

More schools across the country are having students return to five days a week of in-person learning, while still offering virtual learning for students who wish to continue with that model.