A video of a toddler born in the year 2020 pressing inanimate objects in the hope of dispensing hand sanitizer recently went viral. Although bizarre, this is emblematic of the current hyper-precautionary health climate that Generation Alpha will be growing up in. The WHO's hygiene campaign, 'Save Lives: Clean your Hands' to reduce COVID-19 infections has galvanised even the youngest in our populations to be mindful of self-hygiene.

Despite children being somewhat sheltered by the ravaging physical effects of the pandemic, (the Paediatric Intensive Care Audit Network (PICANet) found that out of the 71 under-18s who have needed intensive care, most have survived), we can't help but ask, will any of this have detrimental psychological effects in the long-term? Children are growing up in the cautionary age of the pandemic but also in the promising era of pioneering technology developments readily available at their fingertips. MobiHealthNews unpacks the efficacy of children's apps currently on the market. 

Schooling and educational apps

Through the Get Help with Technology scheme, the UK government has delivered 876,013 laptops and tablets as part of its bid to get more than a million devices to schools and colleges during the pandemic. Although devices are being made available to disadvantaged children who are either clinically vulnerable or whose face-to-face education is disrupted, according to Ofcom, between 1.1 million and 1.8 million children still do not have access to a laptop, desktop or tablet at home, potentially leaving many children behind, creating frustration and anxiety.

In an Office of National Statistics (ONS) report on Coronavirus and homeschooling in Great Britain: April to June 2020, of parents who were homeschooling, one in three women (34%) agreed that it was negatively affecting their well-being compared with one in five men (20%), while 43% of homeschooling parents agreed that it was negatively affecting the well-being of their children. In light of this report, Layla Moran, UK politician, Liberal Democrat education spokesperson said: "Moreover, the Government must address the mental health impact of the pandemic by signposting the appropriate support services to every household, and properly funding the charities that provide those services.”

Creating optimum user experience 

Conversely, apps and technology have also been hailed as helping young people come to terms with illness and to help them navigate everyday life. After his shock by the lack of information for children diagnosed with cancer, Dom Raban, CEO for Xploro spoke to MobiHealthNews about coming up with the idea for Xploro, a health information platform that uses games, augmented reality and AI to reduce stress and anxiety about medical procedures. Involving children in the process of developing the platform was vital to ensure it met their needs and the firm consulted Year 10 children about the best format to deliver health information. This strategy was also echoed at the HIMSS & Health Kids 2.0 session where health psychologist and serious games specialist, Pamela Kato highlighted that when creating games to improve health outcomes for young people, it is important to speak their language.

As CEO of non-profit organisation HopeLab, Kato led the research and development for Re-Mission – a game to help young people with cancer adhere to their treatment. More recently, Kato was involved in the creation of the game Plan+it Commander which aims to improve organisational and social skills of young people with ADHD. A randomised trial in the Netherlands carried out over 20 weeks showed that the intervention had a positive effect on behaviour reported by parents and teachers.

Also corroborating the positive influence of digital platforms, patient speaker, Monica Evason has highlighted the importance of bringing awareness to digital tools that are tailored to the specific needs of individuals post-cure and how they can make a significant difference to navigating everyday tasks. Jason Monero is one of the many young people that Monica Evason works with to improve quality of life post-cure. As a visually impaired teenager he has a complex medical condition and yet the support he looks for from the digital world isn’t for the medical issues, it’s for managing life. He has written a list entitled, ‘being able to see with the help of digital tools’, which details the digital apps and tools that help him complete a range of tasks through each day.

Using VR as treatment

Virtual reality is also showing promising developments in the child health space. Digital medicine company, Akili recently announced that it has received approval from the Conformité Européenne (CE) to market EndeavorRx as a prescription-only digital therapeutic software intended for the treatment of attention deficit hyperactivity disorder (ADHD). The CE Mark follows the US Food and Drug Administration (FDA) decision, which made EndeavorRx the first FDA-cleared prescription treatment delivered through a video game. Dr Anil Jina, managing director, chief medical officer of Akili said: “This approval provides a path for the future expansion into Europe and will allow us to offer a new non-drug treatment option to families of children living with ADHD.”

Striking a healthy balance

It is likely that awareness and lobbying around the use of children's mental health apps may continue to grow as gamification used in education and awareness of illnesses has gained praise for its value. Moreover, a survey of NHS Child and Adolescent Mental Health Services (CAMHS) in England has highlighted the ways digital literacy is impacting the adoption of digital interventions to support child mental health during the pandemic.

The survey showed that, almost 4 out of 10 (36%) of CAMHS have not adopted any new digital mental health tools to support children in need of mental health support since the onset of COVID-19. The majority (64%) of NHS CAMHS are signposting children and young people to an online resource - rather than a proven digital intervention. Forty-five percent of NHS CAMHS believe digital therapeutics have a role to play in early intervention support. A limited knowledge of available digital interventions, cost, and a lack of clinical evidence were cited as the top three barriers for integrating new digital therapeutics.

As we continue to see the expansion of the digital revolution age, experts will continue to disagree on the effects of technology. Based on this ongoing debate, researchers will proceed to warn parents to make informed decisions when it comes to moderation in app usage, and appropriate education around emerging technologies, something considered critical in striking a healthy balance.