COVID-19, lockdowns and our little ones

After experiencing three months of lockdown in Auckland, we have had many parents ask us about the impact of isolation on the little ones in their lives. How will their development be affected? What does being exposed to people wearing masks do?  How can parents or caregivers counteract the impacts of this? We have asked our expert Dr. Annette Henderson to investigate global research with answers to these key questions.

Is the pandemic affecting infants’ cognitive development?

There are only a few published studies on the impact of the pandemic on infant development and the findings are mixed. The key difference seems to be the level of interaction between babies and toddlers and their parents or primary caregivers. If you are ensuing you have high-quality stimulation with your little one throughout the day, and expose them to as much language as possible during their active-alert phases of the day, the potential impacts of the pandemic and lockdowns will be minimised.

(Deoni et al., 2021) compared cognitive development scores of infants born in Rhode Island, USA in 2021 compared to a comparison group of infants born between 2011 – 2019. The findings of this study suggest a reduction in cognitive development scores across verbal and non-verbal domains in infants born during the pandemic compared to infants born before the pandemic, with males being at particular risk and higher levels of maternal education protecting infants from the adverse impacts of the pandemic. Interestingly, these findings were consistent even when controlling for perceived maternal stress (suggesting that the effects are not simply due to mothers feeling more stressed during the pandemic). Thus, these findings suggest that infants born during the pandemic are at risk of poorer cognitive outcomes, although longitudinal data is needed to understand whether these poor outcomes are stable across time.

In contrast, a yet-to-be published study conducted by (Kartushina et al., 2021) analysing data from 1,742 caregivers of 8 – 36 month old children across 13 countries provided some evidence that language development progressed across their lockdown better than expected based on prior norms. This study also reported two other findings to note: infants who showed larger gains in vocabulary development across the lockdown spent less time passively viewing screens and more time engaged in reading activities with their caregivers.

What can be done to curb potential adverse impacts of the pandemic on early cognitive development?

  • Ensure that you and your little one engage in high-quality interactions several times throughout the day.  For example, face-to-face with lots of smiles, positive vocal tone and being responsive to your little one’s actions; 
  • Use high quality, age-specific play items to keep you little one interested for longer and therefore maximising the quality of engagement you have with them during awake times;
  • Create opportunities to engage in at least 15-30 minutes of shared book reading with your little one per day;
  • Minimise the amount of time that your little one engages in passive viewing of screens;
  • Expose your little one to as much language as possible, describe play items, take them on house tours, garden tours, describe what you’re doing, what they’re doing. The more language they are exposed to the better their development outcome across the first 2-3 years of life. 

How does being exposed to people wearing masks affect infants? 

Although there are many infants being raised in households in which face coverings are common, there are also many infants who would otherwise not have regular exposure to their social world wearing face coverings if it were not for the COVID-19 pandemic. Compared to infants being raised in New Zealand years ago, infants being raised here now will be exposed to individuals wearing masks on a regular basis for the foreseeable future. This fact or “new normal” across the globe has raised questions about how masks may influence infants’ development (for example, see Green et al., 2021; Lachman, 2020).  This is because faces carry important information that has been linked to early language, social and cognitive development. Thus, it is reasonable that people are concerned about the impact of masks on infant development since masks cover a minimum of ½ of a person’s face and may distort the sound qualities of a person’s speech.

Before covering the research (of which there is not yet much) on masks and infant development, keep in mind that most of infants’ everyday interactions in their homes will occur without masks, which means that there are likely significant periods of time during which infants are getting typical no-mask face-to-face interactions with a primary caregiver.

However, interactions outside of their home, including at their childcare centres (when relevant), will likely include masks of some form. Thus, understanding more about how masks may impact development is an important area for study. To date, the number of studies that have examined the effects of masks on early social, cognitive and language development are few and so, the evidence is not clear as to whether or not mask use is in fact as detrimental to development as many have hypothesised.

In one recent study, the researchers were interested in whether, or not, masks interfered with infants’ ability to recognise familiar words (Singh et al., 2021). In this study 22 month-olds were shown a picture of two objects and then a person asked the infant to look at one of the objects (e.g., “Can you show me a … ?”). Infants were randomly assigned to one of three conditions: 1) the person was not wearing a face covering, 2) the person was wearing an opaque mask (e.g., surgical mask), and 3) the person was wearing a clear visor. The findings revealed that infants looked at the correct object just as fast in the no mask and opaque mask groups, but the infants in the clear visor group were slower to look at the correct object. Thus, these findings suggest that the visual distortion that may happen with clear visors may be more detrimental to word recognition than not being able to see the person’s mouth as happens when people wear opaque masks.

Here are some things to consider when interacting with young infants through masks (adapted from Green et al., 2021):

  • Talk to your little one just as you typically would, for example, keep using infant directed speech;
  • Wear masks, but only when required to do so legally or for safety reasons;
  • Counter the mask-wearing time with plenty of non-mask, face-to-face interactions with your bubble or virtually with friends and family outside of your bubble;
  • Create other opportunities for effective communication and bonding when needing to wear a mask, such as trying not to cover up your eyes as well so that infants can access important cues of communication and emotion through the eyes;
  • Create opportunities for your baby to become more familiar with what smiles and other emotions look like in the eyes by playing peek-a-boo with the mask on and then keep smiling (or making other emotions) with the mask off;
  • Emphasise expressiveness with eyes, eyebrows and vocal affect so that infants can still learn about emotional expressions, what they mean and how they are expressed. 

Parenting during a pandemic

Studies investigating mental health of mothers with infants suggest that the pandemic is having some adverse impacts on maternal mental health.  

Mothers who have given birth during the pandemic are at risk of experiencing greater stress and mental health challenges due to the fact that they are needing to cope with all the typical pressures that occur when you have a new baby, but doing so during a pandemic increases stress, worry, concerns about accessing support, and so forth. Some evidence that, compared to reports of new mums prior to the pandemic, mothers who gave birth during COVID-19 pandemic in the USA were more likely to report experiencing a more stressful childbirth (Mayopoulos et al., 2021). Further, increased levels of childbirth stress were associated with greater problems bonding with breastfeeding and bonding with their newborn. Other evidence of impact of maternal depressive symptoms and mother-infant boding comes from a study conducted by (Liu et al., 2021).

In another study, that looked at mothers’ responses across two national lockdowns in the UK revealed that a greater proportion of mothers with infants and young children reported higher levels of depressive symptoms as the pandemic continued, from March 2020 to November 2020, (Fisk et al., 2021).  Further, mothers with infants with certain temperamental traits such as higher negative affect and lower effortful control may be particularly more likely to experience depressive symptoms across the pandemic, but this may not be specifically pandemic related due to aspects of the study design (Fisk et al., 2021). Interestingly this study did not find too much evidence of increases in mental health problems of mothers, which might be due to the age of the children in the sample (less difficulties than if they were pregnant or new mums or compared to having older children where there are struggles with balancing work, caregiving, and home schooling).

Stress of the pandemic may impact parents’ ability to be attentive, responsive parents. We know that responsive parenting is critical for promoting positive child outcomes across a variety of domains.

Stress can also influence parents’ ability to regulate their own emotions and engage in positive parenting outcomes. In a recent study found by our group, we found that relative to pre-pandemic assessments, parents are reporting that they are engaging in more harsh parenting practices, are less responsive, and have poorer relationship quality with their children during the first lockdown in NZ in 2020 (McCrae et al., in press).  However, the extent to which that parents engaged in cooperative coparenting (i.e., able to work together to parent their children) reduced the extent to which the pandemic impacted positive parenting practice.

Overall, raising little ones during a global pandemic is not without its challenges. There are clear ways we can counteract the potential adverse impacts as outlined above. We hope these ideas help to put your mind at ease during this difficult time as after all quality time with your precious little one(s) is the key to their development.   

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COVID-19 and Infancy References

Deoni, S. C., Beauchemin, J., Volpe, A., Dâ Sa, V., & RESONANCE Consortium. (2021). Impact of the COVID-19 Pandemic on Early Child Cognitive Development: Initial Findings in a Longitudinal Observational Study of Child Health. MedRxiv : The Preprint Server for Health Sciences. https://doi.org/10.1101/2021.08.10.21261846

Fiske, A., Scerif, G., & Holmboe, K. (2021, July 2). Maternal depressive symptoms and early childhood temperament before and during the COVID-19 pandemic in the United Kingdom. https://doi.org/10.31234/osf.io/quket

Green, J., Staff, L., Bromley, P., Jones, L., & Petty, J. (2021). The implications of face masks for babies and families during the COVID-19 pandemic: A discussion paper. Journal of Neonatal Nursing, 27(1), 21–25. https://doi.org/10.1016/j.jnn.2020.10.005

Kartushina, N., Mani, N., Aktan Erciyes, A., Alaslani, K., Aldrich, N., Almohammadi, A., Alroqi, H., Anderson, L., Andonova, E., Aussems, S., Babineau, M., Barokova, M., Bergmann, C., & Ca, J. (2021). COVID-19 first lockdown as a unique windo into language acquisition: What you do (with your child) matters. https://doi.org/10.35516/0103-046-988-034

Lachman, A. (2020). Shared Pleasure in the Time of COVID 19 : The Importance of the Shared Smile for Babies in a World of Masked Faces. Perspectives in Infant Mental Health, 28(3), 1–7.

Liu, C. H., Hyun, S., Mittal, L., & Erdei, C. (2021). Psychological risks to mother–infant bonding during the COVID-19 pandemic. Pediatric Research, March, 1–9. https://doi.org/10.1038/s41390-021-01751-9

Mayopoulos, G. A., Ein-Dor, T., Dishy, G. A., Nandru, R., Chan, S. J., Hanley, L. E., Kaimal, A. J., & Dekel, S. (2021). COVID-19 is associated with traumatic childbirth and subsequent mother-infant bonding problems. Journal of Affective Disorders, 282(November 2020), 122–125. https://doi.org/10.1016/j.jad.2020.12.101

Provenzi, L., Grumi, S., Altieri, L., Bensi, G., Bertazzoli, E., Biasucci, G., . . . Borgatti, R. (2021). Prenatal maternal stress during the COVID-19 pandemic and infant regulatory capacity at 3 months: A longitudinal study. Development and Psychopathology, 1-9. doi:10.1017/S0954579421000766

Singh, L., Tan, A., & Quinn, P. C. (2021). Infants recognize words spoken through opaque masks but not through clear masks. Developmental Science, 24(6), 1–11. https://doi.org/10.1111/desc.13117

 

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