Results

Four themes were generated after the data analysis through the Narrative Thematic Analysis regarding the perceived psychological distress and other life outcomes of the children during the lockdown and quarantine. The results have presented with representative excerpts.

Theme 1: Children showed poor emotional and social responses during the lockdown.

Majority of the mothers reported poor emotional responses of their children. One mother shared her experiences of her son:
Initially, my son was very happy to hear a long holiday... After two weeks, he expressed fear and apprehension about his studies. He does not look happy… He does not talk properly… (M_9)
Another mother reflected similarly:
My daughter was worried about the longer school closure… she is annoyed due to restrictions to meet and play with her friends… bored, and quarrels with her siblings… shows more stress and aggression… She is upset about her changed routine… does not complete her work timely… spends maximum time on mobile… she is stressed about the burden of the homework. (F_10)
A mother reported unusualness in her daughter’s behaviours:
After two weeks of lockdown, she is spending her most of the time in watching television… her social interaction has deteriorated…she has become less talkative… She misses her friends and school… she shows boredom and sadness. (F_10)             

Theme 2: A decreased interest in studies and other creative activities of children were reported.

The mothers reported that the cognitive abilities, interest, language abilities, creative activities, likings, and reading abilities of their children got seriously affected due to the lockdown. One mother reported some negative effects of restrictions:
In the beginning, it was almost right but after 10-12 days of lockdown, her learning and understanding got badly affected… her self-motivation was sudden reduced and her studies were put on the lowest priority… She reported reduced stimulation and boredom. (F_11)
Another mother shared her similar observations for her daughter:
My daughter was happy that there is a long holiday but when she came to know that she cannot meet anyone outside and she may not be allowed to play and visit her friends… She became sad, irritated and felt down… We tried to make her understand but she did not hear us… She was very good in drawing and painting and used to make paintings on inner walls of house… but she lost her interest in all these… It may be due to the restrictions on her play, interaction and freedom after lockdown… It seemed that her abilities went down… She showed ill-health symptoms and reduced performance in all activities. (F_10)
Another mother reported similarly:
I am observing reduced interest in studies, play and other activities of my daughter… It is surely due to restrictions on her autonomy to have social interactions with other people especially her friends… She almost lost her interest in all creative and constructive activities… She moves aimlessly here and there… Her physical activities have gone down… She looks sad and demotivated… Her interest in studies has gone down after lockdown. (F_11)    

Theme 3: Children showed unusual symptoms of psychological distress due to the restrictions.

Many psychological distress symptoms in their children were also reported by mothers. One mother reflected as:
Initially, my daughter was unable to understand the meaning of lockdown... After a few days of lockdown, she started showing anxiety, resistance, anger, irritation, frustration… I have tried hard to explain the present ongoing scenario, on which she expresses resistance… She expresses fear of the disease…  She puts illogical arguments… She has become apprehensive… She becomes easily irritated, restless and angry… Her emotional expressions have become negative and incongruent. (F_11)
Similar experiences were shared by another other:
It is quite a difficult time for us and it has become very difficult to keep children inside homes, especially during their playing hours… She has now become irresistible… It is very challenging for us to handle her anxiety…  She shows lethargic attitude and depressive symptoms… She frequently reports boredom, isolation, decreased stimulation and lowered taste in food… She misses school… She feels down, apprehensive, tired and hopeless… She also shows irritation and frustration… She shows more frequent anxiety, irritation, anger, hopeless and restlessness… She shows concerns about restrictions and getting infected. (F_9)

Theme 4: Many negative physical health symptoms were observed in the children after the lockdown.

The lockdown has also catalyzed many ill-health symptoms which were generally absent before the restrictions imposed after the outbreak of COVID-19. For example, one mother shared her experiences of her son:
After two weeks of lockdown, I have seen many health issues with my son… He hardly takes food properly… His routine of sleep, wake and play have gone seriously disturbed… Nowadays, he does not enjoy a sound and complete sleep… He also goes to his bed very late… His movement and enthusiasm have become absent…He frequently complains indigestion, lowered activity and multiple complaints of body ache. (M_11)
Another mother reported similar symptoms in her daughter:
 After a few days of lockdown, my daughter started showing a decrease in the level of hunger… She has now developed sleep disturbance… She reports an incomplete or disturbed sleep every morning… She has become unorganized and lazy… She is also losing interest in play as there are no friends available to play with her. (F_9.5)
Similarly, another mother showed concerns for her daughter’s poor health:
With the start of lockdown, she has been active and had a good appetite but after two weeks of lockdown, her food intake is decreasing day-by-day… She has become stubborn now… She frequently complaints stomach aches… She also frequently reports poor and disturbed sleep… She becomes easily annoyed with poor taste in food. (F_10)

Discussion

The findings showed that the restrictions of lockdown, social distancing and quarantine negatively affected the life outcomes of children. The children showed decreased emotional and social responses due to extreme restraints due to lockdown (Theme 1). Social interaction, play behaviours, expression of positive emotions, approaching behaviours were replaced with poor interaction, sadness, quarrelling behaviours, aggression, withdrawal, disturbed routine and boredom.
Majority of the children exhibited a decreased interest in studies and other creative activities (Theme 2). This may be due to school closure, and lack of proper stimulation and social reference. It has been argued that motor activities and social interaction of children have a close connection with the proper functioning of their cognitive abilities and health outcomes (Evans, 2003; Fedewa et al., 2018). The company of likeable persons and friends help people to learn face success and failures in their life and these influences are more important for children (Spence, 2006). It has also been suggested that the negative consequences for children may have become serious during longer restrictions due to the lack of a regular and substitute structure of learning because explicit rules, schedules, expectations facilitate self-discipline, impulse control and a sense of control essential for the social, emotional and psychological development as well engagement in creative works of children (Healio Psychiatry, 2020).
Majority of the mothers reported their children to exhibit a variety of psychological distress symptoms due to the lockdown (Theme 3). Major distress symptoms were anxiety, resistance, anger, irritation, stubborn, frustration, fear of the disease, apprehension, negative emotions, hopelessness, irresistibility, lethargic attitude, depressive symptoms, isolation, decreased stimulation, frustration and restlessness. It was also reported that the children develop many new negative physical health symptoms due to the restrictions during the lockdown (Theme 4). Sleep disturbance, poor appetite, disinterest in play activities, slow movement, reduced enthusiasm, indigestion, body ache and reduced taste in food were chief ill-health symptoms reported by the mothers for their children.
The current epidemic was unparalleled severe and pervasive in its effects for children. Children are very sensitive to the severe changes in the environment. Restrictions on social connection, forced isolation, decreased activity and disengagement from meaningful activities like schooling, play and relationships have been suggested to lower psychological and health outcomes (Paules et al., 2020). Previous studies have also suggested that connectedness has positive links with adjustment, achievements, health and productivity and negative association with negative psychological and health outcomes of children (Foster et al., 2017). According to the Attachment Theory (Bowlby, 1958) and the Buffering Hypothesis (Cohen & Wills, 1985), social and peer relationship are unavoidable sources of affiliation, love, positive emotions, satisfaction, positive stimulation, meaningfulness, tangible resources, pro-social behaviours, positive engagement and opportunities of learning which work in all conditions for all age groups of people. In essence, reduced freedom and enhanced restrictions (movement, activity, play etc.), reduced social interactions (friends, peers, neighbours etc.), a negative emotional environment in the family and community, uncertainty and percolations of negativity of family members may be working behind the positive life outcomes of children during the lockdown due to COVID-19. The findings may carry significant policy, practice and research implications. The interventions involving media, family and community may protect the health and well-being of children and help them to deal effectively with their cognitive, emotional and behavioural issues more effectively. Proper care of sleep, food, leisure and creative activities of children to help them to achieve their full productivity and remain healthy and well-functioning are recommended. A positive outcome of the joint family was surfaced where children may feel more protected and may find an opportunity to remain positively engaged. 

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