Arisa Yamaguchi

Objective: To examine the association between children’s quality of life (QOL) and their experience of being heard by family and/or teachers during the COVID-19 pandemic.Design: A cross-sectional study.Settings: A randomly sampled postal survey of fifth or eighth grade children conducted in December 2020 in Japan.Participants: Responses from child/caregiver dyads (n=700) were adjusted for complex sampling to ensure the sample’s national representativeness, incorporating all regions.Interventions: Based on the survey results, children were categorised as ‘being heard’ if they reported being frequently asked about their thoughts regarding the pandemic and having their thoughts and feelings considered by family, teachers or both.Main outcome measures: Overall QOL and six QOL subscales measured through the Kid-KINDL Questionnaire (KINDL Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents).Results: About half (52.9%) of children were heard by both family and teachers, with higher rates in fifth grade (59.9%) than in eighth grade (45.1%). The adjusted prevalence ratio for above median QOL was 4.40-fold (95% CI: 2.80 to 6.94) higher in children heard by both family and teachers than in unheard children. Associations remained significant but were lower in children heard only by family or teachers. QOL subscales showed similar associations, with family, self-esteem and friends being the strongest. Children asked for their thoughts or feelings without adult consideration did not exhibit higher QOL.Conclusions: ‘Being heard’ during the pandemic was positively associated with higher QOL. Recognising children’s right to be heard and promoting environments where they are heard at home and school may improve their well-being.

Background: Few studies have used direct reports by children to assess how the rights documented in the United Nations Convention on the Rights of the Child (CRC) have been affected during the pandemic of coronavirus disease 2019 (COVID‐19). Methods: Data were obtained from the CORONA‐CODOMO Survey, a web‐based survey conducted from April to May 2020 in Japan, targeting children aged 7–17 and parents/guardians of children aged 0–17. We focused on self‐reports from children, including two open‐ended questions asking their needs and opinions. The results were analyzed according to the five categories of rights defined by the CRC: education, health, safety, play, and participation. Results: Among the 2,591 children who participated in the survey, 1,292 children (49.9%) answered at least one of the two open‐ended questions. The most frequent concern was COVID‐19 infecting members of their families (78.2%), followed by the inability to see their friends (74.3%). There were 1,523 direct comments from children. The comments covered a wide range of the rights in the CRC, including reopening of schools, disparities in education, access to health information, alternatives for playing and seeing friends, and needs for participation and being heard. Few comments were related to safety whereas a certain proportion of children were victimized within households. Conclusions: Our results suggest that the rights outlined in the CRC have been restricted during the COVID‐19 pandemic. Health and educational professionals working with children and policymakers should introduce the rights‐based approach to protect the best interests of children during and after the pandemic.