By: Amarica Rafanelli on January 19, 2020
While Covid-19 is typically benign in children, the pandemic could have long-lasting impacts on society’s youngest members. With childcare programs closed and social distancing measures in place, many children are missing out on opportunities for development.
“Children are not getting the cognitive and social stimulation that they would normally get outside their home,” said Dr. Michelle Aguilar, the head of pediatrics at Venice Family Clinic in Los Angeles, California. Providers have noted delays in speech and language as well as trouble sharing and being in groups.
But for children, a delay in social skills may not be the only consequence of the pandemic. With many parents undergoing financial stress, children face higher rates of housing and food insecurity. And others are subject to rising rates of neglect and household dysfunction – all of which can affect a child’s trajectory into adulthood.
“Numerous studies have shown that early life experience and adverse life events have had a negative impact on the health and development of children,” said Aguilar.
In this episode of the podcast, we explore the full scope of consequences for children growing up in the Covid-19 pandemic, from the short term effects to long-term implications. We speak with experts in the field and health providers, including Venice Family Clinic’s Dr. Michelle Aguilar and early head start director, Stacey Scarborough.
Since 2008, Direct Relief has supported Venice Family Clinic with financial assistance and medical aid, including prescription medications for chronic disease care, disaster response supplies, and most recently, PPE, such as N-95 masks, protective gowns, and face shields.
COVID-19 is typically benign in children, usually presenting as a mild flu or nothing at all. But for society’s youngest members, the effects of the pandemic go beyond the disease itself.
From the moment a child is born socializing plays an important role in their development, from learning to share to honing their language skills. But with social distancing measures in place, many kids are missing out on opportunities to play. So how is that affecting their development?
I spoke with Stacey Scarborough, the head of Venice Family Clinic’s early head start program in Los Angeles, California.
RAFANELLI: “Tell me a little bit about the clinic’s head start program.”
SCARBOROUGH: “Sure. So we are an early head start program, so we provide services to families with young children, birth to age three and pregnant women. And we do home visits with families and we offer them play groups. And we have a center-based program where children come to the center each day for their educational component and nutritional component.”
Teachers lead children through group lesson plan designed to promote basic developmental growth from speech to fine motor skills. A typical day might include counting cheerios, scribbling with crayons and crawling through obstacle courses. While Scarborough says most children are hitting their developmental milestones, they have exhibited abnormal behavior.
SCARBOROUGH: “We do see such a heightened awareness of everything. Like they’re constantly telling on their peers: ‘They touched this and didn’t wash their hands,’ ‘My mom didn’t brush my teeth.’ So they are telling everything because they have such a heightened awareness and they’re really into wrong and right at this age. So our providers have been very cautious, like, ‘What’s happening with this generation?’ They’re constantly telling on each other. So there’s a lot of mental health to help kids relax and play and not be so concerned about everything, which they are.”
RAFANELLI: “Do you think the lack of social interaction has affected kids in any way?”
SCARBOROUGH: “Yeah. I don’t know if I can come up with a very specific story, but they’re very aware that they need to stand apart, they’re very aware that they shouldn’t touch another item that somebody has. And that’s hard for sharing. This is an age where you learn how to share and we’re kind of encouraging no sharing. And that’s a big skill that you need as an adult to bring into the workplace. This is the age where you work on developing those skills and we’re kind of saying, ‘You can’t do that.’ So, this is the window of opportunity. You know, they’ll learn it later, but it’s a harder thing to learn when you’ve learned not to share under trauma and then we’re going to say later in life, “You have to share. You’re not a good human being if you don’t know how to share.’ So those soft skills are tough right now to be learning when they’re supposed to be learning them.”
But interpersonal skills like sharing or learning how to work in a group are not the only areas of concern. Stacey and other providers at the clinic have noted delays in speech and language
AGUILAR: “They’re lacking from those social interactions that they would have normally gotten from people outside their homes. They’re lacking that play time with other children.”
Dr. Michelle Aguilar is the head of pediatrics at Venice Family Clinic. She sees patients from birth up to 18 years of age. She says during the pandemic, many kids are receiving less attention.
AGUILAR: “Many of our caregivers are now under a lot of stress and having to divide their attention to other children who are older and would have normally been at school. So the parent used to have time and attention to give to the younger child.”
For many parents, money has become a major source of stress. With millions of Americans out of work, the pandemic’s financial fallout has been significant. And for those struggling to pay rent or put food on the table, providing for their children’s basic needs can be difficult. During the pandemic, housing and food insecurity have skyrocketed, at the same time as rates of domestic abuse and neglect have increased. These kinds of stressful events, referred to as adverse childhood experiences, can have long-term consequences.
AGUILAR: “So studies have demonstrated that adverse childhood experiences have detrimental effects on brain development and overall health. So we see long-term effects: learning disabilities, depression, obesity, heart conditions. So, it does have a huge impact.”
RAFANELLI: “Have you had any patients that have experienced what you would consider an adverse childhood experience because of the pandemic?”
AGUILAR: “I would say yes. Families have had to separate when a caregiver or a family member becomes ill. They’ve had to separate for some time to stay with other family members, so they do not get exposed. Housing insecurity: having to move into multi-generational homes that are now crowded. So, yes there have been ongoing adverse childhood experience due to the pandemic leading to toxic stress.”
The pandemic’s effects on children are not only catching the attention of parents and pediatricians. A handful of researchers are looking closely at the issue, including Dr. Rashmita Mistry.
MISTRY: “My name is Rashmita Mistry. I am a professor in the department of education at the University of California at Los Angeles.”
Dr. Mistry is interested in how major historical events affect the children who live through them. She’s the author of a recent study on how the pandemic is likely to affect children’s health and wellbeing.
RAFANELLI: “So what are the long-term implications of experiencing a pandemic at a young age?”
MISTRY: “So let’s take the example of children’s cognitive development and academic achievement. So there’s really strong, compelling evidence that, especially for children from lower income households and backgrounds, that access to high quality early childcare programming really helps lessen some of the achievement gaps that have been documented for children from wealthier families and households as compared to lower income households. So if the pandemic hits, and a parent loses their job and their child care provider is shut down because of concerns around the spread of the virus or their provider shut down because they can no longer afford to stay open or because the parent can’t afford to send their child to that program because they can’t afford it, then the child has lost access to critical resources that are likely to help support not only their cognitive development, but also their mastery of basic foundational academic skills, as well as key social emotional learning that we know happens in early childcare programs and spaces. And that’s not to say that parents can’t and don’t do a lot of that support at home, but for lower income children, we know access to high quality early childcare programs are also really, really important and instrumental.”
These kinds of disruptions, don’t just cause temporary setbacks. Dr. Mistry says they can have consequences that continue throughout the long-term.
MISTRY: “So we’re now moving beyond the pandemic, the child is a four or five-year-old enrolled in school and they’re going to maybe start a little bit further behind in terms of that key foundational academic knowledge or those kind of social, emotional skills. So they’re going to have more catch up to do. But the child, let’s say for example, is attending a neighborhood school in a lower-income community that maybe doesn’t have the same level of resources or the same level of teacher qualifications or is just under-resourced in ways that better funded public schools might not be. So that child’s educational experience is further compromised in that circumstance. Had that child been able to attend a higher quality school maybe that catch-up would have happened and would have been sufficient, but if that child then continues to attend an under-resourced school that is struggling in its own ways due to a lack of public funding and support, then that child’s cognitive and academic and social, emotional development is going to continue to be compromised in ways that are important. And we know that the third grade is this critical transition point. It’s not super fatalistic. But we know that if you haven’t really mastered those foundational skills by then, then those disparities just continue to widen, so kids continue to fall back or move forward based on these early educational opportunities and skills. So it’s really this like cascading effect. And again, if there aren’t points in the system to catch it and correct it, then what’s likely to happen is that there’s just going to be this accumulation of shocks and disruptions and disadvantages that are going to continue to play out.”
RAFANELLI: “So it seems like you’re saying that economic resources–child’s socioeconomic status–plays a major role in their healthy development. But can you talk more about how the pandemic, specifically, plays into this?”
MISTRY: “The pandemic in some ways is making a lot of this a lot more visible. It’s been there for a while, at least speaking within a U.S. context. Issues around childhood poverty have existed. We have almost one in four children pre-pandemic that were living in families that were officially designated as poor. And so poverty is not new in the pandemic. It’s been elevated.
There are more families that are struggling and more children that are being placed at greater risk for experiencing poverty and then experiencing all of the net negative repercussions of that. And again, like I said, we already know that young children are particularly vulnerable to the long-term adverse consequences of experiencing poverty compared to older children, so it’s not that any of this is new to us. In fact, it raises the alarm for being even more concerned about how the pandemic is likely to affect children’s short-term and long-term developmental outcomes, especially for kids who were already vulnerable prior to the pandemic.”
This transcript has been edited for clarity and length.