Published July 7th, 2020 at 6:00 AM
Imagine a baby crawling in the kitchen. The baby crawls over to the oven and reaches for the door. Before touching it, though, the baby looks back at mom and sees her look of horror. The baby decides not to touch the oven door.
The baby’s instinct to look at mom and change behavior is called social referencing. Hibba Haider, a pediatrician with the Shawnee Mission Health Partnership Clinic and Choice Physicians Group, said that process is essential to early learning.
But what happens when the baby’s caretaker is wearing a mask? Suddenly, those social cues are hidden behind a layer of fabric.
As COVID-19 cases spike again during the ongoing pandemic, child care providers are wrestling with the need for short-term safety and long-term social and emotional development. And with no clear end to the need for masks in sight, caretakers and their charges are having to adjust to a new reality.
Casey Hanson, director of outreach and engagement for Kids Win Missouri, said many child care providers she’s spoken to don’t wear masks when caring for infants and toddlers. Instead, they focus on other safety measures, such as daily temperature checks and small group sizes.
Cortaiga Collins, owner of Good Shepherd Preschool and Infant Toddler Center, said staff taking care of preschool groups wear masks, but those in the center’s infant rooms do not.
“It’s very difficult to give infants and toddlers the social-emotional connection that they need while wearing a mask,” Collins said. “Health and safety is our priority, but so is the emotional attachment.”
Wendy Ell, an occupational therapist and the Executive Director of the Missouri Child Psychiatry Access Project, said young children rely on seeing specific parts of their caretakers’ faces to determine whether someone is happy, sad or angry.
“When you put a mask on, it can become very difficult for the child, and maybe a little frightening as well,” Ell said. “Young children rely on their caregivers facial expression, and their tone of voice, to regulate their own responses towards people and new situations.”
To mitigate the developmental problems caused by masks, Ell recommends child care providers use clear face masks and face shields.
Haider said there is no golden rule that all child care providers should follow, but they should craft their policies based on CDC guidance. Keeping up with regular hygiene practices, including those in place before COVID-19, will help ensure a safer environment.
Haider said introducing young kids to masks in a familiar environment can help with their understanding of the issue. Parents put masks on themselves and show the kids, then take it off to reveal that they’re still the same person.
Playing games with the masks can also help kids become more comfortable, Ell said. Both Ell and Haider recommend playing peek-a-boo with the masks, and teaching young kids to read emotions using other parts of the face.
“You can say, ‘Watch my eyes! Watch my eyebrows!’, and then take off the mask to show them your facial expression,” Haider said.
Mary Esselman, CEO of Operation Breakthrough in Kansas City, said staff at her facility are required to wear masks, but they’ve gotten creative in getting the kids used to the idea.
“The infant-toddler teachers, they’ve gotten masks for the puppets,” Esselman said. The idea is to remain expressive and communicative, even with mouth coverings.
Ell said pretend play with dolls and other toys helps kids make sense of the world, and incorporating masks into that pretend play is one way to introduce the concept in a comforting way.
Amanda Atkins, owner of Briarwood Early Learning in Columbia, said early childhood educators have a unique opportunity to introduce masks to kids.
“This is probably not the last outbreak we’re going to see,” Atkins said. “And so we can use masks in our play, we can try them on, get used to figuring out what our eyes say when we can’t see our faces.”
The idea, she said, is to make sure kids are prepared when they move into the next stage of their education, such as public schools where masks may be required.
It may be years before we know the full impact the pandemic has had on childhood development.
“It may have an impact on their speech and language development,” Ell said. “Their development in the first few years of life is rapid. They rely a lot on reading mouths and facial expressions to learn words and language.”
Haider said even before kids learn to speak, they understand a lot of language. It will take time for them to understand how to communicate with someone wearing a mask, and she said it will definitely interfere with social and emotional development.
Despite the unknowns, Haider said science shows that kids are remarkably resilient. Ell said keeping daily routines as consistent as possible will help mitigate kids’ stress, as will making sure they feel comfortable asking questions about what’s going on.
“Hopefully they will be able to continue to adjust, and find a way around (the problems),” Haider said. “It’s going to be a learning curve for everyone.”
Emily Wolf is a Dow Jones summer intern at Kansas City PBS.