It’s probably not a big shock to learn that less screen time and more physical activity for children leads to better mental health. A recent University of Washington pediatric study backs up that theory with new details on kids’ increased problems during the pandemic.

The study, published last month in JAMA Network Open, takes a snapshot of the daily activities of children ranging from ages 6 to 17 between Oct. 22 and Nov. 2, 2020, when a third wave of new COVID-19 cases in the United States began taking shape.

Of the 1,000 children surveyed, 22.2% were attending school in person, 50.6% were attending classes virtually and 27.2% were in a hybrid arrangement, the study said. Surveyed families reported a daily average of 4.4 hours in recreational screen time for their children — a figure the study notes is in line with most pre-pandemic estimates.

The mental health of the children in the study was assessed using the Strengths and Difficulties Questionnaire. Among them, 143 were either diagnosed with or undergoing evaluation for anxiety, 110 for depression, 160 for attention deficit hyperactivity disorder (ADHD) and 116 for a behavioral problem.

The Strengths and Difficulties Questionnaire scores in the UW survey showed 11.9% had difficulties, higher than the 7.1% documented in previously published studies of U.S. norms.

“As expected, children whose families experienced the most pandemic-related stressors exhibited the most mental health and behavioral problems,” the researchers wrote. “Notably, this association persisted when controlling for demographic characteristics previously associated with health disparities and disproportionate COVID-19 impact, such as race and ethnicity, and parental educational attainment.”

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According to the study, only 195 of the surveyed children reported getting 60 minutes of daily physical activity a day, and the less physical activity and more screen time they had, the more pronounced the difficulties were across all age groups.

Dr. Pooja Tandon, an associate professor of pediatrics at the UW School of Medicine and the study’s lead author, said the study showed children most affected by pandemic-related stressors, such as food insecurity, loss of income, loss of health insurance and exposure to COVID-19, engaged less in physical activity and had more screen time than their peers.

Tandon said the unique circumstances of the pandemic meant much of that screen time was unavoidable, both for school and for socialization.

But it’s important to take time from the screen to get outside, play, interact with other humans and loved ones, even sleep.

“I recognize that this is an incredibly challenging time for parents,” said Tandon, “and I think there are opportunities as families for us to just prioritize these health behaviors, knowing that it’s important for both physical health and mental health.”