{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T22:22:39Z","timestamp":1773872559360,"version":"3.50.1"},"reference-count":34,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T00:00:00Z","timestamp":1734652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"SABIC Psychological Health Research and Applications Chair, Department of Psychiatry, College of Medicine, Deanship of Postgraduate Teaching, King Saud University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: The COVID-19 pandemic triggered a global transition to distance learning, which significantly impacted children\u2019s mental health. In Saudi Arabia, remote education began on 8 March 2020, lasting between 1.5 to 2.5 years. This study aims to explore the psychological effects of distance learning on children and adolescents, with a focus on mental health challenges and coping mechanisms. Methods: A cross-sectional study was conducted using an online survey distributed to parents of children aged 6 to 18 in the major metropolitan areas of Jeddah and Riyadh. The survey included demographic questions and the Arabic version of the Vanderbilt ADHD Diagnostic Rating Scale, a tool for assessing behavioral challenges, anxiety, and symptoms of attention deficit hyperactivity disorder (ADHD). Results: A total of 71.6% of families reported a positive experience with distance learning. A significant correlation was found between parents\u2019 marital status and children\u2019s ability to cope with remote education. Interestingly, children without ADHD symptoms experienced three times more negative outcomes than those with ADHD symptoms. However, despite reporting fewer negative experiences, children with ADHD exhibited increased symptom severity and academic difficulties. Of the students, 5.4% were diagnosed with predominantly inattentive ADHD, 1.8% with predominantly hyperactive\/impulsive ADHD, and 3.9% with combined ADHD. Additionally, 7.2% of students screened positive for oppositional defiant disorder, 1.5% for conduct disorder, and 6.6% for anxiety or depression. Children from separated or divorced families were more likely to exhibit ADHD symptoms (p = 0.002). Children with ADHD symptoms reported a more positive experience with distance learning (p &lt; 0.05). Conclusion: This study represents the first comprehensive, multi-city investigation in Saudi Arabia examining the relationship between distance learning, sociodemographic factors, and mental health symptoms in children. The findings highlight the psychological challenges faced by children during the pandemic and emphasize the need for targeted interventions to support both mental health and academic outcomes. These results offer valuable insights for future research and inform strategies to address children\u2019s well-being in scenarios involving distance learning.<\/jats:p>","DOI":"10.3390\/children11121551","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T06:44:33Z","timestamp":1734677073000},"page":"1551","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Psychological Impact of Distance Learning on Children and Adolescents in Saudi Arabia: A Multi-City Analysis of Behavioral and Mental Health Outcomes During the COVID-19 Pandemic"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2556-9052","authenticated-orcid":false,"given":"Samah H.","family":"Alkhawashki","sequence":"first","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11472, Saudi Arabia"},{"name":"SABIC Psychological Health Research and Applications Chair (SPHRAC), Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maram H.","family":"AlTuwairqi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11472, Saudi Arabia"},{"name":"SABIC Psychological Health Research and Applications Chair (SPHRAC), Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4490-3220","authenticated-orcid":false,"given":"Ahmad H.","family":"Almadani","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11472, Saudi Arabia"},{"name":"SABIC Psychological Health Research and Applications Chair (SPHRAC), Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afnan A.","family":"Almarshedi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahaf","family":"Alasiri","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia"},{"name":"College of Medicine, King Saudi bin Abdulaziz University for Health Sciences, Jeddah 21498, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noha A.","family":"Mobeireek","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mishaal R.","family":"Alrashoud","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Dammam Medical Complex, Dammam 32253, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1951-8323","authenticated-orcid":false,"given":"Noura A.","family":"Abouammoh","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4646-7488","authenticated-orcid":false,"given":"Fatimah S.","family":"Alshahrani","sequence":"additional","affiliation":[{"name":"Department of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9459-9936","authenticated-orcid":false,"given":"Areej A.","family":"AlFattani","sequence":"additional","affiliation":[{"name":"Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7049-0960","authenticated-orcid":false,"given":"Shuliweeh","family":"Alenezi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11472, Saudi Arabia"},{"name":"SABIC Psychological Health Research and Applications Chair (SPHRAC), Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s10389-020-01321-z","article-title":"COVID-19 and Social Distancing","volume":"30","author":"Qian","year":"2022","journal-title":"Z. Gesundheitswissenschaften J. Public Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1136\/bmjebm-2022-112085","article-title":"School closures during COVID-19: An overview of systematic reviews","volume":"28","author":"Hume","year":"2023","journal-title":"BMJ Evid. Based Med."},{"key":"ref_3","unstructured":"(2023, November 20). The Saudi MOE Leading Efforts to Combat Coronavirus Pandemic (COVID-19). Available online: https:\/\/planipolis.iiep.unesco.org\/en\/2020\/saudi-moe-leading-efforts-combat-coronavirus-pandemic-covid-19-7148."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1001\/jamapediatrics.2021.5840","article-title":"School Closures during Social Lockdown and Mental Health, Health Behaviors, and Well-Being among Children and Adolescents during the First COVID-19 Wave: A Systematic Review","volume":"176","author":"Viner","year":"2022","journal-title":"JAMA Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"101656","DOI":"10.1016\/j.copsyc.2023.101656","article-title":"Youth psychosocial resilience during the COVID-19 pandemic","volume":"53","author":"Doom","year":"2023","journal-title":"Curr. Opin. Psychol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1080\/13548506.2021.1891266","article-title":"Resilience and Psychological Impact on Italian University Students during COVID-19 Pandemic. Distance Learning and Health","volume":"27","author":"Quintiliani","year":"2022","journal-title":"Psychol. Health Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Fruehwirth, J.C., Biswas, S., and Perreira, K.M. (2021). The COVID-19 pandemic and mental health of first-year college students: Examining the effect of COVID-19 stressors using longitudinal data. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0247999"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"112934","DOI":"10.1016\/j.psychres.2020.112934","article-title":"The psychological impact of the COVID-19 epidemic on college students in China","volume":"287","author":"Cao","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Giusti, L., Mammarella, S., Salza, A., Del Vecchio, S., Ussorio, D., Casacchia, M., and Roncone, R. (2021). Predictors of Academic Performance during the COVID-19 Outbreak: Impact of Distance Education on Mental Health, Social Cognition and Memory Abilities in an Italian University Student Sample. BMC Psychol., 9.","DOI":"10.1186\/s40359-021-00649-9"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"D\u00e4ndliker, L., Br\u00fcnecke, I., Citterio, P., Lochmatter, F., Buchmann, M., and Gr\u00fctter, J. (2022). Educational Concerns, Health Concerns and Mental Health During Early COVID-19 School Closures: The Role of Perceived Support by Teachers, Family, and Friends. Front. Psychol., 12.","DOI":"10.3389\/fpsyg.2021.733683"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"00368504211029812","DOI":"10.1177\/00368504211029812","article-title":"Perception towards E-learning and COVID-19 on the mental health status of university students in Malaysia","volume":"104","author":"Moy","year":"2021","journal-title":"Sci. Prog."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e2124092","DOI":"10.1001\/jamanetworkopen.2021.24092","article-title":"The Association Between School Closures and Child Mental Health During COVID-19","volume":"4","author":"Hawrilenko","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_13","first-page":"216","article-title":"How the COVID-19 Contingency Affects Children","volume":"78","year":"2021","journal-title":"Bol. Med. Hosp. Infant. Mex."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Garrote, A., Niederbacher, E., Hofmann, J., R\u00f6sti, I., and Neuenschwander, M.P. (2021). Teacher Expectations and Parental Stress During Emergency Distance Learning and Their Relationship to Students\u2019 Perception. Front. Psychol., 12.","DOI":"10.3389\/fpsyg.2021.712447"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1007\/s00787-021-01856-w","article-title":"The impact of COVID-19 lockdown on child and adolescent mental health: Systematic review","volume":"32","author":"Panchal","year":"2021","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Levante, A., Martis, C., Bianco, F., Castelli, I., Petrocchi, S., and Lecciso, F. (2023). Internalizing and externalizing symptoms in children during the COVID-19 pandemic: A systematic mixed studies review. Front. Psychol., 14.","DOI":"10.3389\/fpsyg.2023.1182309"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1111\/camh.12501","article-title":"Review: Mental health impacts of the COVID-19 pandemic on children and youth\u2014A systematic review","volume":"27","author":"Samji","year":"2022","journal-title":"Child Adolesc. Ment. Health"},{"key":"ref_18","unstructured":"Varnham, J. (2014, November 05). \u201cClinical Tools\u201d. Saudi ADHD Society. Available online: https:\/\/adhd.org.sa\/en\/adhd\/resources\/diagnosing-adhd\/clinical-tools\/."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1093\/jpepsy\/jsg046","article-title":"Psychometric Properties of the Vanderbilt ADHD Diagnostic Parent Rating Scale in a Referred Population","volume":"28","author":"Wolraich","year":"2003","journal-title":"J. Pediatr. Psychol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1177\/10870547211027640","article-title":"Distance Learning in Children with and without ADHD: A Case-control Study during the COVID-19 Pandemic","volume":"26","author":"Tessarollo","year":"2021","journal-title":"J. Atten. Disord."},{"key":"ref_21","first-page":"00469580211049065","article-title":"Online Learning Performances of Children and Adolescents with Attention Deficit Hyperactivity Disorder During the COVID-19 Pandemic","volume":"58","author":"He","year":"2021","journal-title":"Inq. J. Health Care Organ. Provis. Financ."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S85","DOI":"10.1016\/j.encep.2020.05.011","article-title":"Comment les enfants et adolescents avec le trouble d\u00e9ficit d\u2019attention\/hyperactivit\u00e9 (TDAH) vivent-ils le confinement durant la pand\u00e9mie COVID-19? How do children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) experience lockdown during the COVID-19 outbreak?","volume":"46","author":"Bobo","year":"2020","journal-title":"L\u2019Encephale"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Pan, P.-Y., and B\u00f6lte, S. (2020). The association between ADHD and physical health: A co-twin control study. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-78627-1"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1542\/peds.2013-3686","article-title":"Anxiety in Children with Attention-Deficit\/Hyperactivity Disorder","volume":"133","author":"Sciberras","year":"2014","journal-title":"Pediatrics"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1037\/a0012719","article-title":"Rate and Pre-dictors of Divorce Among Parents of Youths With ADHD","volume":"76","author":"Wymbs","year":"2008","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1023\/A:1017592030434","article-title":"Families of Children with Attention-Deficit\/Hyperactivity Disorder: Review and Recommendations for Future Research","volume":"4","author":"Johnston","year":"2001","journal-title":"Clin. Child Fam. Psychol. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1776","DOI":"10.1016\/j.sbspro.2013.07.031","article-title":"Relationship Between Marital Conflict and Child Affective-Behavioral Psychopathological Symptoms","volume":"84","author":"Arfaie","year":"2013","journal-title":"Procedia Soc. Behav. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Spinelli, M., Lionetti, F., Pastore, M., and Fasolo, M. (2020). Parents\u2019 Stress and Children\u2019s Psychological Problems in Families Facing the COVID-19 Outbreak in Italy. Front. Psychol., 11.","DOI":"10.3389\/fpsyg.2020.01713"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1515\/edu-2020-0122","article-title":"Energetic Students, Stressed Parents, and Nervous Teachers: A Comprehensive Exploration of Inclusive Homeschooling During the COVID-19 Crisis","volume":"2","author":"Letzel","year":"2020","journal-title":"Open Educ. Stud."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Carri\u00f3n-Mart\u00ednez, J.J., Pinel-Mart\u00ednez, C., P\u00e9rez-Esteban, M.D., and Rom\u00e1n-S\u00e1nchez, I.M. (2021). Family and School Relationship during COVID-19 Pandemic: A Systematic Review. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182111710"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1017\/dmp.2013.22","article-title":"Posttraumatic Stress Disorder in Parents and Youth after Health-Related Disasters","volume":"7","author":"Sprang","year":"2013","journal-title":"Disaster Med. Public Health Prep."},{"key":"ref_32","first-page":"133","article-title":"COVID-19 and Parent-Child Interactions: Children\u2019s Educational Opportunities and Parental Challenges During the COVID-19 Pandemic","volume":"34","author":"Shahali","year":"2023","journal-title":"Soa Chongsonyon Chongsin Uihak J. Child Adolesc. Psychiatry"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1007\/s00787-020-01706-1","article-title":"Parental experiences of homeschooling during the COVID-19 pandemic: Differences between seven European countries and between children with and without mental health conditions","volume":"31","author":"Thorell","year":"2021","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1037\/amp0000660","article-title":"Risk and resilience in family well-being during the COVID-19 pandemic","volume":"75","author":"Prime","year":"2020","journal-title":"Am. Psychol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/12\/1551\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:56:19Z","timestamp":1760115379000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/12\/1551"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,20]]},"references-count":34,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["children11121551"],"URL":"https:\/\/doi.org\/10.3390\/children11121551","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,20]]}}}