COVID-19 Special Edition: A Different World
While the coronavirus pandemic has changed many things around the world, it has not stopped child development. In this series of special episodes of The Brain Architects podcast, we aim to share helpful resources and ideas in support of all those who are caring for children while dealing with the impacts of COVID-19. The first guest of this special series is Center Director Dr. Jack Shonkoff. He and host Sally Pfitzer discuss how to support healthy child development during a pandemic, including the importance of caring for caregivers. They also talk about what we’ve already learned as a result of the coronavirus, and what we hope to continue learning. Upcoming episodes of this special series will focus on how pediatricians are responding, racial disparities in the impact of the virus, and more. Subscribe below via your podcast platform of choice to receive all new episodes as soon as they’re released. Speakers Sally Pfitzer, Podcast Host Dr. Jack Shonkoff, Center Director Transcript Sally: Welcome to The Brain Architects, a podcast from the Center on the Developing Child at Harvard University. I’m your host, Sally Pfitzer. Since our last podcast episode was released, things have changed quite drastically as a result of the Coronavirus pandemic. We hope you and your loved ones are safe and well. During this unprecedented time, we would like to share resources and provide guidance that you may find helpful, so we’re creating a series of podcasts episodes that address COVID-19 and how it relates to child development. Our guest today is Center Director, Dr. Jack Shonkoff. Jack, thanks so much for joining us. Jack: Thank you, Sally. It’s always a pleasure. Sally: So just so our listeners know, we’re recording this on a video call, so the sound quality will be a little different from when we are in the studio. We hope these conversations will be useful anyway. Especially to those parents, childcare providers, social workers, teachers, healthcare providers and any others who are with children every day during this crisis. So, I’ll start with the first one. Jack, how do you think the pandemic may be affecting very young children, so the infants and toddlers? There has been a lot of attention to the need for distance learning for older kids. But, what do you think about what these younger children might need? Jack: That’s a really important question, Sally, because this pandemic is different from anything that any of us have experienced around the world. Basic principles of child development, basic concepts of the science that we know don’t change, then I would say from my perspective try it on both the best science we have and the best common sense that once again this is all about relationships. This is all about the environment of relationships in which young children are developing and which they are growing up. So, the risk of the conversation is how do we feel that in this context, but it’s not a difference science, it’s not a different understanding of what children need, it’s just a different world right now. Sally: Yeah. So, I am sure many of our listeners have heard this term “social distancing,” but I know that it is also lately being referred to as the need for physical distancing. Can you talk a little bit more about the science behind that, and what it means for children? Jack: Yeah, this is the question that I’m most concerned about. There are two different bodies of science that we are talking about right now. Normally, we talk about the science of early childhood development—science of brain development—and now we are also dealing with the science of infectious disease. It’s really physical distancing that we are talking about. Actually, social distancing is exactly what we don’t want if social distancing means that we get further apart in terms of our interactions socially as opposed to physically. Let me just talk a little bit about each. So, why is physical distancing so important? Because this is the way we stop the spread of this virus. This virus is incredibly contagious. It can jump from one person to another over a six-foot span. Everybody has heard about keeping 6-feet away. And, because it is so contagious and spreading all over the world, and without a treatment and without a vaccine, the only real strategy we have to stop the spread of this virus is to not have people be close enough to each other so they can pass the virus from one person to another—it’s a population issue, it’s a community issue. So yeah, we have to do that. We have to minimize the physical contact to stop the spread of the virus. They’re saying time—social connection, hugging, being together— is one of the most critical dimensions of healthy development. It is the heart of serve and return interaction between young children and the adults that care for them. So, that’s a core concept for healthy development. Physical distancing is a core concept for stopping the spread of a virus. The challenge is: how do we reconcile those two? If we just come together physically, the virus doesn’t stop. If we separate physically and don’t find a way to stay connected, then we are creating an environment that is undermining the healthy development in young children. I have to say, I want to express tremendous solidarity with the parents, the caregivers, service providers, who are struggling with this tension between the need to get connected and the mandate to stay physically apart. Sally: Would you have any recommendations for any family members of caregivers who are experiencing that tension that you were just describing? Jack: Absolutely. So, I think the first thing—and this is again, a good example of where basic principle in development under normal circumstances doesn’t change—in a crisis, development goes on, even though the crisis is here. So, one really important thing to remember is that interaction between young children and the adults who care for them and serve and return responsiveness is not something that has to happen every minute of every waking hour. The issue is not all or nothing. And the extent to which it may be more difficult—not because people don’t have opportunities—because adults are really struggling with the pressures and the tensions that they’re feeling. I think many parents out there, many of the caregivers, all of us know that when we’re feeling significant stress, anxiety, unease and maybe even depression about what’s going on, that you don’t have as much energy to be on your best game all of the time. In this particular crisis, it is very important for people to understand that it is okay, and it is important for adults to have a little bit of downtime and pay attention to their own needs. It’s all a matter of balance, right? So, the first thing to think about is what your child needs is a reasonable amount of attentive interaction with you during the day, but that you also need time for yourself. You need time to have your needs met, and that’s also very true in non-crisis situations. In fact, one of the cardinal principals of the science of early childhood development is that if we want to create the best kind of environment for learning and healthy development for young children, we have to make sure that the adults who care for them are having their needs met as well. You know, people often use the example of the airplane: ‘parents put your own mask on before you put your child’s mask on.’ That’s not: ‘you’re more important than your child.’ It’s a way of saying, ‘you can’t take care of your child if your basic needs aren’t met.’ So this is where social relationships—networks—this is where parents supporting each other by smartphone, by FaceTime, or whatever. Interactions that parents have with other members of extended family, their community, their faith-based organizations, service providers you have a relationship with. All of these are necessary, not just to help you meet your child’s need, but to help you meet your own needs. In this particular crisis we are in right now, meeting the needs for the adults who care for children is the only way to meet the needs of children. You can not bypass the needs of the adults. Sally: So, I think one of the things that’s really obvious about this pandemic is that it is affecting everyone, and every person has some connection or story or something that they are grappling with. I have been thinking about a lot of families that are dealing with economic distress, and wondering if the children who are living in those families are more at risk for toxic stress, and if we can think more about how we might instead try to build resilience. Jack: Let’s talk a little bit about toxic stress first, before talking about if you’re more or less at risk for it. It’s very important to start with that toxic stress does not refer to the cause of the stress. It refers to the body’s physiological response to the stress: your heart rate goes up, your blood pressure goes up, your stress hormones are activated. The difference between toxic stress and what we call tolerable stress is the extent to which people can manage the stress and feel some sense of safety and control, which brings your stress system back down to baseline. So, for young children—babies, toddlers, preschoolers—obviously their capacity to manage their own stress is not entirely up to them, it’s up to the adults who care for them, who do two very important things that make toxic stress tolerable. One is to provide a sense of safety in the children—a sense that you are being taken care of in spite of what is going on around you by the adults who are caring for you. So, once again, we come back to the fact that the adults who provide that sense of safety have to feel that sense of safety themselves. And, none of us—none of us—are capable of feeling safe and secure all by ourselves, all of the time. It doesn’t matter how much money you have, how much education you have—we all need relationships to help us deal with stress. Now, the other part that turns toxic stress into tolerable stress is helping a child develop a sense of being able to cope. So, it’s not just protecting the child from the stress, but helping to build the skills that really make for resilience. It’s basically having some sense of regulating your activity and being engaged in things, but maybe you feel some sense of mastery. That’s why play is so important. Play is probably the most important thing. For those parents out there—anybody who is involved in childhood programs already knows this—let me tell you from a science point of view that if you’re concerned about how a young child can manage and learn to cope with the stresses going on around a family, create opportunities to play with your child, create opportunities for your child to play alone and not necessarily having always to play with an adult. Focus on: ‘how do I provide an environment in which my child can play?’ Because that kind of play is the way the brain builds strong circuits for resilience—for mastery. Give your child and yourself a break. Be comfortable with playing with your child and following your child’s lead and engaging with serve and return interactions will be tremendously protective for your child’s brain and the rest of the body. Your question, Sally, was is this even tougher for families who are more economically insecure, and certainly for families whose economic insecurity under normal times is not very stable, in these times right now, the pressures are immensely greater, So, what we have to do as a society—as human beings— is to recognize that some people are going to need more help from others to create that sense of safety and security in their homes while everyone is being isolated, and to be sure that we are protecting the developing brain, the physical and mental health for young children. Why is that important? It’s important because it’s the right thing to do. What kind of human beings would we be if we didn’t do that? It’s important also, because that’s how we are protecting society by making sure we are promoting healthy development in everyone so that we all benefit later because we have a healthier population and a more productive population. So, yes, some people need more support than others, particularly families who are dealing with housing instability, families who are dealing with food insecurity—those very basic bare essentials. There are a lot of families dealing with those kind economic insecurities now who have not dealt with this before. We absolutely have to pay attention to the needs of families who need extra support, who don’t have the reserves or the resources themselves—it’s an absolute imperative certainly for the well-being of the children. Give families security and stability, and they will provide a protective and safe environment for their children. Sally: I’ve certainly heard you say—and I know others have often said— that small things can make a big difference for kids and families. As I’m listening to you talk, I keep thinking it would be helpful to get again some concrete examples of what families, friends, neighbors, communities could do at this time to support each other, just to get us through with the least, long-term harm to children’s development. Jack: I’m going to start mostly with what adults can do for each other. I really think that the answers for what—in this crisis—what adults can do for children is very basic and simple: provide a sense of safety and security, provide opportunities to play, engage in an interactive way—serve and return interaction—and your child will get through this just fine. So, the concrete things that can be done to protect the development of children come down to a pretty standard list of things that basically adults need to feel safe and secure. I can mention a few of them, but I think the most important thing for starters is to say just like when we think about experiences and finding experiences for young children, there is no one size fits all, right? So, what do adults need to feel a sense of safety and security in the face of this tremendous anxiety? Before we go to services, let’s start with what people informally provide for themselves. You have friends. You have neighbors. You have extended family. They may be close by, they may be far away—ironically, in the world we are living in right now, it doesn’t matter how far they are away. You can’t be that close to them physically, so you have a telephone and a smartphone, you can look at people with whatever that media would be. People need to be able to share with each other what they need—generally emotionally, and socially—and be ready to give to each other what we’re each asking of each other. And that includes informal arrangements with communities that could include the house of worship and the community around that you may be affiliated with. It could be a mother’s group or play group, it could be whatever. So, that’s for starters. Some people really have a rich network of relationships to draw on—independent of income or education. But then there are people who either don’t have a rich network to start with, or have it and it’s not meeting the needs, and that’s where we could provide more assistance through services. This is a great investment, especially now, by us as a society to provide a safety and support and reassurance for families who don’t have the informal supports that are needed. There is no shame in asking for that and there should be no hesitance in providing that. Stress reduction, right? You need ways to reduce your stress, but different things work for different people. The list of the usual things that work for most people in some way in combination, start as simple as taking deep breaths. Especially if you’re feeling like you’re getting very stressed out. It’s not just a mindset thing, it’s actually physiologically—it’s helping to bring your blood pressure down, it’s helping to bring your heart rate down, so a deep breath and a slow exhale. Some people have learned how to do meditation. That’s important, that’s good. If you need a few minutes to do that, do it, and don’t worry about the fact ‘oh my goodness I am not interacting with my child’. Let your child play while you just go off on the side and relax. Music—dancing—could be a great way to reduce stress. And for some people, stress reduction is just getting on the phone with a good friend and pouring your heart out, and in the end saying, ‘thank you for this conversation, I feel so much better.’ So, stress reduction, finding what works for you—there’s no one size fits all. You’re giving yourself a little bit of space from your child during the day. Because at the end of the day, it’s all about us helping each other. So, the concrete things are not hard to remember and they’re not complicated. There is a lot of heavy-duty science behind it, but it can just point out to a few things: take care of yourself, figure out how to reduce the stress you’re feeling—the stress you’re feeling is normal, if it’s feeling out of control, then get some help. Don’t be afraid to ask for help, we all need help. The bottom line being is that it varies from person to person. This is the time to really be in touch with what works for you. Sally: So Jack, even though we are still in the really early days of this crisis, and I think it’s really important to emphasize that right now we’re completely, as you said, just try to get through day to day and understand the science behind this. It can also be tempting to start thinking about if there might be any long-term lessons that we could have in mind as a society that might eventually emerge. Again, recognizing fully that we are just at the beginning. Jack: I think that is a really important question, and for me, the first answer to that lessons learned is not so much a new lesson to be learned, but an old lesson that maybe we will learn this time in a way we haven’t before. We are all in this together. Everybody is affected by what is going on right now. The extent to which we share responsibility and help each other get through is really important for all of us, right? I mean, in some ways COVID-19 is an amazing example of how we each need everybody to behave responsibly and protect everybody else. This is not just about what is good for you. Let’s just take the physical distancing, right? If people don’t do it, other people are hurt by that. And if other people don’t do it, you are hurt by that. So, if we all share the responsibility, we all benefit. And if some part of the population is indifferent, doesn’t care, doesn’t pay attention, is just focused on its own needs, then we all pay a price for that. I mean, what great messages and lessons to take out of this crisis for how we should be under “normal circumstances.” Fast forward, at some point we’ll go back, and we will know that everybody with young kids is doing the best they can to raise healthy kids, and we all depend on that as a society. And some people are struggling more because they have less money, they have less education, they have less economic opportunity. We all benefit if we all take care of each other and do our job, and we all suffer, and we all pay a price if we don’t take care of each other and share the responsibility. I’d love that lesson to come out of this pandemic. Sally: Thank you so much, Jack for taking the time to be with us today. I really appreciated your concrete advice, and I also especially appreciated the remarks you made about how this might be affecting different families in a variety of ways. I know at the Center, we’re trying to think of ways in which we can support our community, and some of that, of course means that we’re asking. But it also means that we’re trying to be responsive and put out resources that we hope will be beneficial. In that way, we hope whatever was said here will be helpful. We recognize that it might not be beneficial for every person listening, but we hope that today we could have hit on something that might help someone through this time. We’re really looking forward to continuing to hear from some of your friends and colleagues, Jack, in upcoming episodes of this short podcast series we’re doing on COVID-19. And we’re really grateful for your time, so thanks again. Jack: Thank you, Sally. I’s always a pleasure to have these conversations with you. Thank you very much. Musical interlude Sally: I’m your host, Sally Pfitzer. The Brain Architects is a product of the Center on the Developing Child at Harvard University. You can find us at developingchild.harvard.edu. We’re also on Twitter @HarvardCenter, Facebook @CenterDevelopingChild, and Instagram @DevelopingChildHarvard. Brandi Thomas is our producer, and Charley Gibney is our producer and audio editor. Our music is “Brain Power,” by Mela from FreeMusicArchive.org. This podcast was recorded at my dining room table.