Occupational disruption in childhood during the pandemic: reflections on the return to in-person activities

Abstract

The isolation caused by the COVID-19 pandemic led to major changes in the daily lives of children due to social distancing and the increased burden on their caregivers. This event is identified as an occupational disruption that interrupts the occupational patterns and roles of children and their families. This reflective essay aims to analyze the consequences of isolation during the pandemic period on the socio-emotional development and participation of children once they return to in-person settings. Among the main reflections that emerge are the stress experienced at the family level, changes in daily routines, and the social, emotional, and sensory consequences. With the return to in-person environments, children are once again exposed to less controlled settings in terms of stimuli, academic demands, and routines they had grown unaccustomed to, which significantly affects social interaction. The essay emphasizes the role of occupational therapy in addressing the developmental challenges children face following an occupational disruption.

Keywords:
Controlled Confinement; Child Development; Social Participation; Family

Resumen

El aislamiento producto de la pandemia por COVID-19 provocó grandes cambios en la vida diaria de niños y niñas debido al aislamiento social y a la sobrecarga de sus cuidadores. Este evento se identifica como una disrupción ocupacional que irrumpe con los patrones y roles ocupacionales de los niños y sus familias. Este ensayo reflexivo tiene por objetivo analizar las consecuencias del aislamiento durante el periodo de pandemia en el desarrollo socio emocional y la participación de niños y niñas una vez que retornan a la presencialidad. Entre las principales reflexiones que emergen se encuentran el estrés generado a nivel familiar, los cambios en las rutinas y las consecuencias a nivel social, emocional y sensorial. Con el retorno a la presencialidad, vuelven a ambientes menos controlados en términos de los estímulos, a las exigencias académicas y a las rutinas a las que estaban desacostumbrados, por lo que se ve afectada notablemente la interacción social. Se enfatiza en el rol de la terapia ocupacional para afrontar los desafíos en el desarrollo infantil posterior a una disrupción ocupacional.

Palabras clave:
Confinamiento Controlado; Desarrollo Infantil; Participación Social; Familia

Resumo

O isolamento provocado pela pandemia de COVID-19 causou grandes mudanças na vida cotidiana de crianças devido ao distanciamento social e à sobrecarga de seus cuidadores. Este evento é identificado como uma interrupção ocupacional nos padrões e papéis ocupacionais das crianças e de suas famílias. Este ensaio reflexivo tem como objetivo analisar as consequências do isolamento durante o período da pandemia no desenvolvimento socioemocional e na participação de crianças ao retornarem à presencialidade. Entre as principais reflexões que emergem estão o estresse gerado no contexto familiar, as mudanças nas rotinas e as consequências nos âmbitos social, emocional e sensorial. Com o retorno à presencialidade, as crianças voltam a ambientes menos controlados em termos de estímulos, às exigências acadêmicas e às rotinas das quais estavam desacostumadas, o que afeta significativamente a interação social. Enfatiza-se o papel da terapia ocupacional para enfrentar os desafios no desenvolvimento infantil após uma interrupção ocupacional.

Palavras-chave:
Confinamento Controlado; Desenvolvimento Infantil; Participação Social; Família

Introduction

The coronavirus (COVID-19) pandemic revealed a phenomenon that had already been raising public concern: the increasing incidence of mental health problems in children. In 2020, the virus spread rapidly, prompting the implementation of various health measures, including confinement and physical/social distancing. These measures had wide-ranging consequences, such as the reduction or restriction of family resources, shifts in household dynamics, disruptions in family life and routines, and a decrease in physical, emotional, and social stimulation (Galiano Ramírez et al., 2020). As a result, primary caregivers experienced high levels of stress and increased strain (Escobar et al., 2023).

In Chile, after the lockdown was declared, everyone's daily life was affected by a range changes, many of them associated with stress among adults due to fear of contagion, distancing from family and friends due to health controls, grief over the loss of loved ones, financial difficulties, and overlapping roles within the home, among other factors (Palacio-Ortiz et al., 2020). A significant number of families faced challenges in providing adequate care and coverage for the needs of their children and adolescents (Mangué Pérez et al., 2020), leading to an increase in symptoms of mental health problems in this population (Indart De Arza, 2023).

Additionally, daily life was impacted by the closure of schools and kindergartens, a measure supported by families, teachers, and the government in Chile, who believed that the negative consequences of closure would be less severe than keeping schools open (Díaz & Donoso, 2022). However, this decision interrupted and altered significant occupations, routines, and sources of social support, leading to increased family burden and consequently affecting the socio-emotional development of children, adolescents, and their families (Abufhele & Jeanneret, 2020; Valderrama Núñez & Ojeda Águila, 2024).

This new reality affected the entire population. However, based on social constructs, children are expected to adapt and withstand the effects of confinement, including those related to adults' mental health (Carmenate Rodríguez & Rodríguez Cordero, 2020; Pérez et al., 2020; Romero-González et al., 2021). This is despite the fact that, on the one hand, children's reactions to disasters depend on their age and developmental level (Larraguibel et al., 2021). Furthermore, adaptation and coping with the situation will be largely mediated by parents and other socialization agents (Espada et al., 2020). This meant that children had greater challenges in social interaction, managing frustration, performing daily tasks, expressing themselves, and using language (Escobar Gimpel & Squicciarini Toro, 2022).

Therefore, the thesis of this essay suggests that physical and social isolation during the pandemic influenced children's socio-emotional development, effects that became evident after their return to in-person learning.

Routines in Confinement and New Forms of Organization

According to Galiano Ramírez et al. (2020), one of the main disruptions for children worldwide was confinement and school closures. This situation caused: 1) the interruption of schedules for activities outside the home, such as work and school; 2) disruptions in the daily routines of household members who had to work or study from home; and 3) the emergence or increase of stress related to limited participation in rewarding activities, such as visiting family and friends, shopping, dining out, and attending cultural and sporting events. For children and adolescents, these changes affected “their hours and type of play and spaces for social participation” (Vásquez Oyarzún et al., 2022, p. 94), as the focus shifted primarily to continuing their studies from an academic perspective, often disregarding the consequences that the interruption of their daily routines and activities caused (Retamal Parra, 2022).

The shift in the school system’s modality had significant consequences for the socio-emotional development of children, primarily due to restrictions on seeing friends and participating in personally meaningful activities. This limited their usual outlets for releasing tension and energy (Abufhele & Jeanneret, 2020). The emergence of new routines within the home led to changes in previously established habits—some routines were modified, disrupted, or eliminated entirely, while new ones developed over the course of just a few months (Molina et al., 2020). In many cases, unhealthy lifestyle patterns appeared, including increased sedentary behavior and disruptions to the sleep–wake cycle (Galiano Ramírez et al., 2020). In response, health institutions began promoting physical exercise, recreational activities, and age-appropriate entertainment tailored to the available living space (Manso-Refoyo et al., 2021). However, these recommendations often revealed or deepened inequalities among families due to the wide diversity of living conditions and contexts in which they live.

With the limited range of activities due to the cessation of in-person classes, the lack of outdoor time and peer interaction, children are inclined to spend more time in front of screens, shifting their activities to a virtual space. This increases the influence of screens on social, cognitive, and emotional development, which implies a detrimental impact on social interaction through words and contact with others (García & Dias de Carvalho, 2022; Pedevilla, 2023). Because childhood is a particularly sensitive stage of development, children appear to be more vulnerable to the potential negative repercussions of screen misuse (Pons et al., 2022; Retamal Parra, 2022).

In addition, overexposure to screens, stress, lack of outdoor activities, and low exposure to sunlight can have negative implications for sleep quality in both parents and their children (Escobar et al., 2023; Pedevilla, 2023), disrupting families' emotional stability and negatively impacting occupational performance, diminishing quality of life.

All of the aforementioned changes have disrupted individuals’ habits and routines, making it difficult to engage in meaningful occupations and limiting the environments in which these activities typically take place (Valderrama Núñez & Ojeda Águila, 2024). These disruptions have generated stress and tension within families, and in some cases, have contributed to the emergence of violence in parenting and family dynamics. This may be attributed to increased psychosocial stress among caregivers, reduced supervision, or a rise in unsupervised screen time (Galiano Ramírez et al., 2020).

Changes in the Family: Adapting to New Parenting Challenges

During confinement, the family system underwent a process of learning and adaptation, posing a particular challenge for families caring for young children (Pérez et al., 2020). Caregivers had to take responsibility for organizing and managing their children’s emotional experiences, which created difficulties in adult self-regulation, disrupted co-regulation processes, and negatively affected children’s socio-emotional development (Olhaberry & Sieverson, 2022), largely due to the emotional instability caregivers experienced in facing such an uncertain context (Vásquez Oyarzún et al., 2022).

Family dynamics were strained by difficulties in providing adequate emotional care to children, challenges in adapting to telework—especially when family or domestic organization did not support it (e.g., large families)—and ongoing concerns fueled by uncertainty, such as the lack of a clear socio-labor outlook or limited access to social support and resources (Mangué Pérez et al., 2020; Retamal Parra, 2022; De Armas-Mesa et al., 2023). These factors contributed to increased family conflict, irritability, hyperactivity, impulsivity, and anxiety, and also triggered accidents as well as impulsive and violent responses (Abufhele & Jeanneret, 2020; Retamal Parra, 2022).

In this context, neglectful attitudes and a decline in caregiving were also observed, resulting from school and childcare closures, the personal and work-related demands placed on caregivers, or their illness, quarantine, or isolation (Galiano Ramírez et al., 2020). Prolonged confinement and unemployment increased the risk among parents of alcohol and substance abuse, intimate partner violence, family conflict, child abuse, and sexual abuse (Palacio-Ortiz et al., 2020). These adverse experiences—related to maltreatment and neglect—exposed children and adolescents to a greater likelihood of developing mental health disorders, with potential cumulative and long-lasting consequences for their socio-emotional development (Indart De Arza, 2023).

In some cases, caregivers were affected to such an extent that their ability to provide a safe, stable, and nurturing environment for children was compromised (Galiano Ramírez et al., 2020). Furthermore, they often developed attitudes and behaviors inconsistent with the values they intended to instill through parenting—an important consideration, since children primarily learn through the example set by their caregivers. As a result, they became more sensitive to adult stress and worry, which in turn increased their own negative emotions (Galiano Ramírez et al., 2020; Pedevilla, 2023).

It is not only about adapting to new routines within the home, sharing daily life full-time, but also accompanying children in distance education, adding the role of teacher to parenting can also influence family dynamics, which generates frustration for parents and children and, eventually, conflicts (Muñoz, 2021). Along the same lines, Vásquez Oyarzún et al. (2022, p. 94) explain that, by establishing the interruption of school attendance, limiting their social participation, the caregivers in charge face the “challenge of contributing to the development of girls and boys from home” without greater skills and with the tools they had at their disposal. Therefore, the great effort made by caregivers in this area highlights the importance of collaboration between educational institutions and families (Abufhele & Jeanneret, 2020), which is key because both institutions “are the two most influential social environments in the lives” (Vásquez Oyarzún et al., 2022, p. 94) of children and adolescents.

The entire scenario described has an impact on the organization of daily household life, revealing difficulties in guiding children, especially if they become rebellious and defiant, difficulties in offering appropriate and engaging activities, and in balancing childcare with household chores, especially among mothers who feel overburdened (Galiano Ramírez et al., 2020) and are in charge of single-parent households. This gender gap significantly affects family dynamics and the mothers' health.

However, although physical and social isolation during the pandemic had negative effects on the socio-emotional development of many children, several protective factors within the family system have also been identified as mitigating these difficulties. Among these are the presence of responsible and emotionally stable adults who provided consistent support, established healthy routines and habits, created a stimulating environment—sensory, cognitive, and emotional—and actively promoted resilience (Galiano Ramírez et al., 2020; Indart De Arza, 2023).

Return to In-person Schooling: Children’s Social Participation

Various studies highlight that an environment rich in opportunities supports more optimal child development. When such an environment fails to provide meaningful experiences that encourage exploration, these opportunities are lost, limiting the resources a child can acquire and hindering the development of essential life skills (Galiano Ramírez et al., 2020; Palacio-Ortiz et al., 2020; Förster & López, 2022; Maciel et al., 2021; Olhaberry & Sieverson, 2022). An enriching environment, therefore, is one that offers a wide range of opportunities within a safe setting, fostering the acquisition of emotional regulation strategies and social skills (Coelho-Medeiros et al., 2022).

During the pandemic, environments rich in experiences were drastically reduced, which meant that children—who are in a critical phase of acquiring and developing skills—were affected by impoverished, low-stimulation contexts. This had a significant impact on their neurodevelopment (Förster & López, 2022).

These challenges experienced during confinement had a major impact when children returned to in-person schooling. Those who had been growing up in under-stimulating environments suddenly had to readjust to the school setting, where the number of stimuli and environmental demands was much higher (Coelho-Medeiros et al., 2022). These demands included following a fixed schedule, interacting with peers, dealing with sensory stimuli, and adapting to new rules—elements that were either unfamiliar or had fallen out of practice (Fernandes et al., 2022).

The pandemic had a significant impact on the mental health of students from pre-kindergarten to fourth grade, with increases in internalizing, externalizing, and somatic symptoms (Larraguibel et al., 2021; Ochoa-Fuentes et al., 2022). Internalizing symptoms were generally associated with anxiety or depressive manifestations, while externalizing symptoms were often expressions of unpleasant emotions, particularly among younger children (Escobar et al., 2023).

Therefore, with the return to in-person schooling, the changes experienced by children in public spaces became more evident. Sleep disturbances, symptoms of anxiety and depression, post-traumatic stress, irritability and challenging behaviors, agitation, inattention, and attachment-related problems have been observed (Escobar et al., 2023).

With the return to school, greater problems with emotional regulation have been observed, with a significant increase in self- and hetero-aggression (Coelho-Medeiros et al., 2022). The lack of experiences and stimuli means that upon returning to school, children have difficulty concentrating or interacting with others, which reduces academic performance, causes problems with peers and teachers, and, in turn, generates a negative self-perception (Mangué Pérez et al., 2020).

It is worth noting that these studies also highlight that, in some cases—particularly where families faced fewer difficulties and were not exposed to violent environments—children benefited from spending more time at home. These more controlled interaction settings allowed for the development of language and communication skills, as well as an increase in children’s sense of responsibility and attentiveness within the home (Coelho-Medeiros et al., 2022; Costa et al., 2022).

Final Reflections

The pandemic, like other circumstances within the environments where children grow up, can lead to occupational disruptions. These disruptions interrupt the activities children typically engage in, as well as their patterns of participation in roles and occupations. As a result, they are required to adapt and find new ways to organize and engage in their daily routines.

The lack of stimulation and of experience-rich environments reduces the quality of children’s sensory processing and socio-emotional skills. This is especially critical because it is during childhood—a key stage in the life cycle—that healthy experiences promote neurodevelopment and the acquisition of essential skills for navigating daily life. Without such experiences in early life, acquiring these abilities becomes more difficult, thereby limiting children’s participation across various life contexts.

In addition, it is important to highlight that strengthening any individual's pre-existing abilities requires practice and exposure to diverse and enriching environments—conditions that were largely absent during confinement. This led to both an interruption and, in some cases, regression in the development of social skills and the ability to interact with peers, whether in structured or spontaneous environments. The increased use of screens further contributed to difficulties in interpersonal interactions, such as trouble making eye contact, limited vocabulary, and low frustration tolerance in peer relationships.

Based on these reflections, it is also possible to identify that, during confinement, access to sensory stimuli was controlled and limited, with each person defining the intensity of the stimulus. For example, in online classes, closing the door to manage household noise, lowering the volume on electronic equipment, silencing the computer, regulating odors in the room, and controlling proprioceptive information when deciding how and where to sit. Furthermore, since social interaction during this period was primarily conducted through social media, this contact was limited both in terms of stimuli and in terms of socialization, where people could choose who to see on the screen, who to call, or who to answer.

This confinement situation also meant a greater presence of parents, which, in some cases, allowed for greater interaction with their children, encouraging language acquisition. However, in most homes, this increased parental presence meant daily overload, requiring them to help with schoolwork, provide support, and continue with their own work demands. This undoubtedly affects the bonding patterns established within the home, even leading to violet environments and/or neglect that have affected children.

Considering the above, it is necessary for occupational therapy to integrate a comprehensive approach to development, considering sensory processing as the basis for the different dimensions of development and placing special emphasis on socio-emotional aspects in all areas of professional work with children and adolescents.

Regarding socio-emotional skills, the common approach tends to rely on direct instruction. However, the discipline equips professionals with the competencies to integrate these skills through participation in the daily occupations in which children are involved. In this way, they can play a crucial role in enhancing these abilities through both individual and group interventions. Moreover, occupational therapists have the capacity to prescribe occupations that are embedded in the context of the family and enriched with the types of stimuli necessary for development. It is important to note that in order for this to be effective, the intensity and characteristics of these stimuli must be carefully considered to avoid reductionist approaches—for instance, prescribing noise-canceling headphones in response to any report of auditory discomfort without a comprehensive assessment.

Undoubtedly, this health emergency has significantly impacted the lives of individuals and communities at both local and global levels. In response, the discipline of occupational therapy has had to diversify and expand its scope of practice, particularly in collaboration with families and schools. Post-pandemic interventions must go beyond facilitating satisfactory engagement in the occupations characteristic of this period. They must also support the adaptation of routines, help individuals cope with new life scenarios, and foster an understanding of emerging forms of participation among children. Additionally, occupational therapy should create opportunities to strengthen the skills necessary for healthy and holistic development, all within an interdisciplinary framework.

• How to cite:
  Poblete-Almendras, M. J., Lagos-Fuenzalida, C., & Robinson-Aldunate, S. (2025). Occupational disruption in childhood during the pandemic: reflections on the return to in-person activities. Cadernos Brasileiros de Terapia Ocupacional, 33, e3916. https://doi.org/10.1590/2526-8910.ctoARF401639162
• Data Availability
  The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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Edited by

• Section editor
  Prof. Dr. Vagner dos Santos

Data availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

Publication Dates

• Publication in this collection
  17 Oct 2025
• Date of issue
  2025

History

• Received
  19 Apr 2024
• Reviewed
  04 Sept 2024
• Reviewed
  17 Apr 2025
• Accepted
  23 May 2025