Community News
Developmental Disturbance – Kids’ brains were truly affected by the pandemic, but there is still time to steer them back on course
BY SIMONE J. SMITH
“We’re in a crisis, I don’t know what to do, because we not only have an effect of a pandemic, but it’s a significant one.” Morgan Firestein, a Postdoctoral Researcher at Columbia University
The start of a new school year. It’s a time filled with excitement, hope, and the promise of new beginnings. You watch your child, with their backpack slung over their shoulder, shoes laced up, ready to take on the world. For them, it’s just the start of a big adventure—their first day of kindergarten.
As you stand there, beaming with pride, there’s something lingering in the back of your mind, something you can’t shake. You see, your child was born during the pandemic—when the world was quieter, slower, and uncertain, and now, as they step into this new world of school, you can’t help but notice… something’s not quite right
They are bright. They are curious. They are more resilient than you could ever have imagined, but there are moments—small things—that you see. The way they struggle with words that seem to come easily to others. The way certain sounds, or textures upset them in ways you can’t understand. You don’t know what it is, but you can tell that things aren’t unfolding the way you expected, and that’s hard. It’s hard because you don’t have answers. It’s hard because no one seems to have answers.
Babies born in 2020 started life in the strange world of lockdowns amongst people with faces hidden behind masks. Social experiences, such as seeing extended family, trips to the playground, or mother and baby groups, could not happen. Although children have generally fared well with the pandemic, there is preliminary research suggesting that pandemic-related stress during pregnancy could be negatively affecting fetal brain development in some children.
Unfortunately, parents and carers were interacting differently, or less with their young children in ways that have affected their child’s physical and mental abilities. Lockdowns isolated many young families, robbing them of playtime and social interactions, and there are hints of a more subtle and insidious trend followed close behind.
Dani Dumitriu and her team at the New York Presbyterian Morgan Stanley Children’s Hospital in New York City had over two years of data on infant development starting in late 2017. They had been analyzing the communication and motor skills of babies up to six months old. Dumitriu thought it would be interesting to compare the results from babies born before and during the pandemic. She asked her colleague Morgan Firestein, a postdoctoral researcher at Columbia University in New York City, to assess whether there were neurodevelopmental differences between the two groups.
A few days later, Morgan called Dani in a panic and with some very disturbing news. “We’re in a crisis, I don’t know what to do, because we not only have an effect of a pandemic, but it’s a significant one,” She had been up most of that night, pouring over the data. The infants born during the pandemic scored lower, on average, on tests of gross motor, fine motor and communication skills compared with those born before it (both groups were assessed by their parents using an established questionnaire). There seemed to be something about the environment of the pandemic itself.
Until now, research assessing the impact of COVID-19 school closures on young children’s development has been limited by the lack of detailed, individual-level data. The prenatal and postnatal growth epochs are critical periods for infant and child development to the extent that: adverse, traumatic, and stressful experiences during these periods produce programming effects on brain, development, and psychopathological risk.
Studies tracking individuals conceived, in utero, infancy and early childhood during pandemics, natural disasters, and famines (e.g., the 1918/19 influenza pandemic, the 1959-61 Chinese famine) demonstrate that those exposed can suffer life-long negative consequences. In the early years, when children’s developing brains are more sensitive to a lack of responsive environments the immediate negative impacts of closing programs that provide some early simulations (such as childcare) were further amplified by diminished future learning which also leads to more pronounced inequalities later on.
Research teams looking into these issues around the world are starting to publish their findings. Firm answers are hard to come by, not least because many child-development research laboratories shut down during the pandemic.
There is recent research that supports the idea that lack of peer interactions could possibly be holding some kids back. In a study published earlier this year, researchers in the United Kingdom surveyed 189 parents of children between the ages of eight months and three years, asking whether their children received daycare, or attended preschool during the pandemic, and assessing language and executive functioning skills. The authors found that the children’s skills were stronger if they had received group care during the pandemic, and that these benefits were more pronounced among children from lower-income backgrounds.
Those most at risk seem to be children of colour, or those from low-income families. For instance, a growing body of research suggests that among school-aged children, remote learning might be widening the already-large learning and development gaps between children from affluent and low-income backgrounds and between White kids and children of colour.
In parts of sub-Saharan Africa including Ethiopia, Kenya, Liberia, Tanzania and Uganda research suggests that some children have lost as much as a full year of learning. In the United States, after the first lockdown, a report by the consultancy firm McKinsey suggested that students of colour began school in autumn three to five months behind in learning, whereas White students were only one to three months behind.
I want to note at this point in the article that research to date has been mixed regarding the effects of the pandemic on early language development. Indeed, one can imagine various plausible mechanisms by which the pandemic may have facilitated, or limited language development.
Research findings provide initial estimates of the short-term effects. More specifically, they report developmental losses in children assessed at the end of 2020 relative to children assessed with the same instruments and identical procedures in 2017. The areas of child development evaluated included: general development, language, social-emotional behavior, and executive function. The results indicate that the boys and girls assessed in 2020 earned lower average scores than their 2017 counterparts in three of these areas. Social isolation, mask wearing, job loss, and other ecological shifts that occurred during the pandemic may have changed the home language environment in important ways with potential implications for infant language development.
Mask‐wearing and social isolation may have hampered the extent to which children could pick up on language inputs in their environment, and pandemic‐related stress may have reduced the quantity, and quality of parent‐child interactions. As a parent, you know how stressful that time was, and increased perceived stress has been linked with the provision of less sensitive parent‐child interaction. Greater parenting stress, perceived stress, and psychological appraisals of stress have each been associated with lower scores on measures of early language development. Some other studies, however, have found no relation between perceived stress and language development.
Some empirical work has found support for the cumulative exposure theory. One cross‐sectional survey suggested that experiencing a single stressful life event due to the pandemic was a risk factor for poorer mental health. Another study of low‐income families found that caregivers who experienced both pandemic‐related job and income loss reported significantly higher depressive symptoms and life stress. This aligns with pre‐pandemic research reporting that negative life events predict higher levels of maternal depression and anxiety.
While declines in maternal mental health are concerning in their own right, an abundance of research has also linked maternal mental health with infant language and behavior. Specifically: maternal depression, anxiety, and perceived stress have each been associated with poorer socioemotional and language outcomes in the first years of life.
Maternal mental health and perceived stress symptoms may shape infant development through impacts on the home language environment and parent‐child interaction, critical factors for scaffolding infant language, and socioemotional development. For example, depressed mothers tend to use less infant‐directed speech and engage in fewer conversational turns with infants, which in turn are associated with a smaller vocabulary size at 18 months. Depressed mothers also tend to demonstrate more withdrawn and intrusive parenting behaviors, which are associated with: greater behavior problems, lower social competence, and lower language skills in offspring.
“Even if kids’ brains are truly being affected by the pandemic, there is still time to steer them back on course,” Dani Dumitriu notes. “We can totally get ahead of this becoming a public-health emergency,” she says. “The brains of six-month-olds are very plastic, and we can get in there, and we can change their trajectory.”
Parents can make headway by playing and talking with their young children regularly and giving them opportunities to play with others in safe settings. Policy changes aimed at supporting families and children could make a difference, too. Overall, researchers maintain that most children will probably be OK — but more than usual might currently be struggling.
If we want to support those who are falling behind, we should ideally intervene soon. Children are certainly very resilient, but at the same time, we also recognize the importance of the first 1,000 days of a child’s life as being the crucial early foundations. The more that we can stimulate them and play with them and read to them and love them — that’s what it’s going to take.
REFERENCES:
https://www.econstor.eu/bitstream/10419/263395/1/dp15179.pdf
https://www.mondino.it/wp-content/uploads/2022/01/20220113_NATURE_p180-183-1-1.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9874599/