CASTLE POINT, Mo. 鈥 Lucretia Wilks, who runs a small day care out of her home in north St. Louis County, is used to watching young children embrace, hold hands and play together in close quarters.
But the covid-19 pandemic made such normal toddler behavior potentially unsafe.
鈥淚t鈥檚 weird that they now live in a time where they鈥檙e expected to not hug and touch,鈥 said Wilks, founder of , which cares for about a dozen children ranging from infants to 7 years old. 鈥淭hey鈥檙e making bonds, friendships, and that鈥檚 how they show affection.鈥
Day care and other child care providers said they are relieved to see covid cases drop as vaccines roll out across the United States. But even as the nation reopens, mental health and child development experts wonder about what, if any, long-term mental health and development consequences young children may face.
In the short term, medical and child development experts said the pandemic has harmed even young children鈥檚 mental health and caused them to miss important parts of typical social and emotional development. Besides not being able to get as close to other people as usual, many young children have seen their routines interrupted or experienced family stress when parents have lost jobs or gotten sick. The pandemic and its economic fallout have also forced many families to change caregiving arrangements.
鈥淐oronavirus is impacting children and families in many ways mentally. The biggest and most obvious way is in the children鈥檚 structure and routine,鈥 said Dr. , an associate professor of psychiatry at the Washington University School of Medicine in St. Louis. 鈥淵oung kids thrive in structure and routine, so when you disrupt that, things go awry pretty quickly in their day-to-day lives.鈥
Tandon, who has spoken frequently with parents and caregivers since the pandemic began, said she and her peers have seen more severe anxiety and high levels of stress in young children than in the past.
Child behavior experts pointed to a number of problems exacerbated by the pandemic in a last year, including separation anxiety and clinginess, sleep issues and challenges learning new information. Children have also shown regressive behaviors 鈥 wetting the bed even though they鈥檝e been potty-trained, for example.
For young children, changes in caregiving arrangements can be a huge source of stress. And the financial strain of the pandemic forced many families to rethink how they cared for their youngest children.
The average monthly child care cost in Missouri, for example, is $584 for 4-year-olds and $837 for infants, according to , which works with over 30,000 programs for children. That has been too high for some parents who lost their jobs in the pandemic. President Joe Biden鈥檚 covid relief plan signed into law in March gives monthly payments of up to $300 per child this year and his latest proposal would help , if approved.
But in the many months when day care has been out of reach, some parents have had to rearrange their work schedules to care for infants or toddlers while also helping school-age children with virtual learning. Others have relied on grandparents for help, although that option was potentially dangerous before vaccines were available. Keeping children apart from grandparents has been tough for both kids and seniors.
Even when parents could afford day care, fear of getting or spreading covid affected their choices about whether and when to send them. And some facilities closed temporarily during the pandemic.
Aimee Witzl, 34, of St. Louis, an accountant and new mom, said she and her husband were hesitant to send their daughter, Riley Witzl, to day care early in the pandemic. Riley was born prematurely in November 2019 and had to spend nine weeks in the neonatal intensive care unit before coming home. So, the couple waited until August to send her to day care part time, then until January to send her full time.
鈥淲e were already high-risk,鈥 Witzl said. 鈥淭hen covid happened, so we kept her home even longer than planned.鈥
Fortunately, she said, no one in her family has contracted the virus.
In March 2020, the , a global collection of agencies and institutions promoting child health and safety, shared by the World Health Organization saying they were concerned about the pandemic putting 鈥渃hildren at great risk of not reaching their full potential鈥 because the early years are a 鈥渃ritical window of rapid brain development that lays the foundation for health, wellbeing and productivity throughout life.鈥
Tandon, the Washington University psychiatrist, said she鈥檚 especially worried about young children who may have been isolated in unsafe homes where they were mistreated. Maltreatment is more likely to go unnoticed, she said, when children are outside of the day cares and schools where adults are required to report child abuse and neglect.
But Tandon said the stresses of the pandemic can affect the mental health of any child, which motivated her to write a children鈥檚 book about a .
Now, though covid vaccinations still remain months away for the youngest children, a shift is occurring that may cause a new round of disruptions for them. , a child psychologist and assistant professor at Harvard University, said young children may be experiencing separation anxiety as they fully transition back into their schools and day cares after being at home with their parents.
To help kids heal, families make sure kids stay connected to relatives and friends. The agency also advises that parents do their best to recognize and address fear and stress in themselves and their kids and seek professional help if needed. CDC experts suggest parents talk about emotions and provide opportunities for children to express their fears in a safe place.
Yet as children and toddlers return to a new normal, it may not be as strange to them as it is for adults. Though the pandemic has presented stressors, Rotter said, children can be very resilient.
鈥淪upportive caregivers and supportive emotional environments help with resilience in the child,鈥 she said. 鈥淩esilience is not just what鈥檚 in the child, but what鈥檚 within the child鈥檚 environment. It鈥檚 the home, religious community, school and day care environment that aid in the child鈥檚 development and how they cope with changes.鈥
And the pandemic may leave behind one benefit for children: the emphasis on washing hands. Child care experts said good hygiene habits are an important life lesson that will likely last beyond this health crisis.
