Developmental Challenges for Children in the Pandemic – Things to Consider

Children with heart disease are at risk for developmental differences.  It’s important that families monitor, support, and advocate for their unique needs!  Our providers have been following these kids through the Cardiac Neurodevelopmental Program for a decade.  Over the last couple of years, the pandemic has created some new developmental challenges.  Here are some things to consider:


Infants and Toddlers

  • Some infants and toddlers with developmental delays are not getting the services they need due to the pandemic
  • For infants and toddlers getting only virtual or online therapies, there are concerns that these therapies may not be as effective
  • Be sure to resume therapies when you feel it is safe for your infant or toddler

Preschool and Early School-Readiness

  • Some children are delayed or not enrolling in Pre-Kindergarten due to the pandemic; research shows that Pre-Kindergarten is very important for building school readiness skills. It’s ideal not to skip Pre-Kindergarten.
  • Some children who participated in virtual or online instruction during the early years of elementary school are showing delays in early reading and math.  Talk to your school team if you have concerns.
  • For many children receiving IEP services, speech, or occupational therapy services during the pandemic, their services were reduced, disrupted, or they occurred online only. If you have concerns, call a new IEP meeting at any time to talk through your concerns and get updates to your child’s program as needed.


  • Most parents were not able to connect with teachers and staff during the pandemic because they could not enter the classroom or school.  As the new year approaches, take time to contact your child’s teacher and explain on concerns or considerations you may have.
  • Some IEP services were disrupted or reduced during the pandemic. Monitor your child’s goals and progress with the IEP team. Remember that you can call an IEP team meeting any time. Similarly, if your child has a 504 Plan, you can also meet with the school team as needed.
  • Social, behavioral, and emotional symptoms are higher in some children as they were unable to do age typical things, such as their spending time with friends, and participating in hobbies and extracurricular activities.  When you feel it is safe, help your child resume these activities.
  • State-wide standardized testing in some regions shows that math and reading scores are delayed following disruptions during the pandemic. Children who experienced lengthy virtual or online learning may be at highest risk.  Contact your school team with concerns, especially if your child scored low on testing and does not receive adequate services.


  • Social isolation and reduced activities affected emotional adjusting in some teens, with higher symptoms of anxiety and depression. Reach out to your pediatrician to find local counselors if needed.
  • Reduced community involvement has impacted normal milestones during this time, including learning to drive, dating, community volunteer or work opportunities, sports and hobbies, and others. When possible, help your teen resume the milestones needed to ease the later transition to adulthood.


Summary of what you can do:

  • If you have concerns about development and your child is less than 3 years old, talk to your cardiologist or pediatrician about getting services started, such as speech, occupational, or physical therapies
  • If your child is enrolled in school, be sure to initiate and maintain communication with the teacher or school team so you are informed about any concerns or needs.
  • If your child has an IEP or 504 Plan and you have concerns, call a meeting with your team. You do not need to wait until the annual meeting date.
  • If your teen is showing emotional symptoms of concern, reach out to your pediatrician for counseling referrals in your community


If your child has not been followed by the Cardiac Neurodevelopmental Program at CHOA, talk to your cardiologist to gain a referral and visit the website to learn more:


Authored by:

Dawn Ilardi, PhD, ABPP-CN
Pediatric Neuropsychologist
Cardiac Neurodevelopmental Program
Department of Neuropsychology
Children’s Healthcare of Atlanta

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