TOPLINE

Among children born during the first COVID lockdown in England, caregiver-reported executive function at the age of 4 years emerged as the notable area of concern, despite language, motor skills, and non-verbal reasoning generally meeting or exceeding age-based expectations. Compared with non-verbal reasoning ability, expressive language, executive function, and motor skills remained relatively weaker.

METHODOLOGY

• Researchers conducted a cross-sectional observational study to evaluate language, executive function, motor skills, and non-verbal reasoning in 4-year-old children born during the initial COVID lockdown in England (March 23, 2020, to June 23, 2020).
• The study included 205 children (58.5% boys) who underwent standardised assessments between May 2024 and June 2025; of these, 180 were assessed remotely and 25 were assessed in person using identical protocols.
• Direct assessments measured expressive and receptive language, expressive and receptive vocabulary, and non-verbal reasoning, and caregivers completed validated questionnaires assessing executive function and motor skills of children.
• The researchers compared developmental outcomes with pre-pandemic norms and evaluated whether language, executive function, and motor skills were developing in line with children's non-verbal reasoning ability to identify areas of relative strength and concern.

TAKEAWAY

• At the age of 4 years, sentence structure, expressive and receptive vocabulary, and non-verbal reasoning scores exceeded pre-pandemic norms (P < .001 for all), whereas word structure and motor skills were consistent with age-based expectations.
• Caregivers reported that the overall executive function and independent problem-solving were significantly lower than expected.
• Compared with non-verbal reasoning ability, executive function, expressive language including word structure and expressive vocabulary, and motor skills were significantly lower than expected (P < .05 for all), whereas sentence structure and receptive vocabulary were not significantly different.
• Executive function emerged as the most notable area of concern, with more children than expected showing low executive function scores (18.0% vs 14.0% expected in the below-average range; 15.2% vs 2.0% expected in the very low range). Very low word structure scores were also more common than expected (5.4% vs 2.0%).

IN PRACTICE

"The present results imply the need for additional classroom scaffolding for behavioural regulation, EF [executive function]-focused approaches and more explicit strategies for expressive language, rather than individual screening or specialist support," the authors wrote.

"Our findings may also inform support for other young children already born when lockdowns began, those outside of the UK who experienced similar restrictions and the next wave of children born after lockdowns had ended," they added.

SOURCE

The study was led by Nicola Botting, School of Health and Medical Sciences, City St George's, University of London, London, England. It was published online on July 14, 2026, in Archives of Disease in Childhood.

LIMITATIONS

The study compared outcomes with pre-pandemic norms rather than a matched comparison group. Executive function and motor skills were assessed through caregiver reports rather than direct assessment. The cohort included a higher proportion of highly educated families than the general population, potentially limiting the generalisability of the findings.

DISCLOSURES

This study received funding from the UK Research and Innovation-Economic and Social Research Council. The authors did not declare competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.