Mother of two Christina Ruigrok can clearly see the effect of the pandemic on her three-year-old son Jake and one-year-old daughter Hayley. "Jake lost all his interaction with any children. He went from doing activities like Jo Jingles, playgroups and swimming lessons every day to nothing. Hayley has had no classes at all. We have managed to avoid catching Covid as a family unit by keeping to ourselves, so I have never felt comfortable enough to bring her to baby classes."
Jake had a speech delay. “After speaking to his ECCE teachers, all children in his class are not where they should be speech wise, and they think it’s the Covid effect – not learning from their peers,” Ruigrok explains.
“Hayley doesn’t do well with crowds or groups of people. At her own christening she had to be taken away from the busyness of so many faces all at the one time.”
With Covid restrictions lifted, life has returned to normal for many of Ireland’s school-aged children. The catch-up awaits, however, as the full social, emotional, educational and developmental impacts of pandemic restrictions on children’s lives begin to unfold. But for those born into pandemic times, or who were mere babies when the world changed beyond recognition, there is no “return” – the only normal they’ve ever known is utterly abnormal. So how are the “Covid babies” doing now as they adjust to an unfamiliar world, and have we underestimated the effect of it all on our youngest members of society?
Ruigrok, owner of online baby store Kozy Kids, sought speech and language intervention for her son. He was assessed publicly, but had private treatment because of the waiting lists. She says Jake is now “a social butterfly” and is “delighted to be with friends again”. “He is a lot more aware of what has happened in the world and is asking why people aren’t wearing masks.”
But Hayley, who was born in the middle of the second lockdown, is still struggling to adjust to life without restrictions. “Hayley knows no different than mask wearing, so doesn’t really like seeing people without them,” she says. “Hayley doesn’t know what to do in a crowd. She is a very clingy baby and doesn’t like to be left with anyone other than a select few. I feel this is because this is all she knows.”
Dr Yvonne Quinn, principal clinical psychologist at Treehouse Practice in Dublin, believes we are "underestimating the impact of Covid on babies in the same way that we underestimate the impact of early years generally".
“Unfortunately there is a commonly held misbelief that babies don’t remember and therefore, they are not impacted by their environment and the quality of the relationships that they have in early years. Yet we know from neuroscience that, in fact, the opposite is true. Ninety per cent of brain development occurs in the first three years of life and therefore early experiences matter and have a disproportionate impact on wellbeing across the life span.”
Infants weren’t just impacted directly by restrictions, but also indirectly by the pressure placed on their caregivers and the impacts of these pressures on those relationships, Quinn explains. “As parents, we were isolated from the protective networks like access to family support, community engagement through playgroups, freedom and ease to connect with others and so on. Added to this were the complex societal challenges like loss of income, redefined working environments, heightened risk to vulnerable family members as well as the pervasive and chronic stress that resulted from the juggle of multiple roles for working parents.
“For many parents, reliance on technology to pacify children became a lifeline and took the place of parental presence. Babies and toddlers need attuned, responsive and present caregivers which shapes how they see the world, themselves and others.”
For infants, social engagement with caregivers is a primary mechanism for learning and development, she continues. “Eye contact, facial expressions . . . become a window for learning as they are the first exposure to communication and language. The over-reliance on technology impacted on reciprocal engagement for babies and toddlers.”
The use of face masks only exacerbated the issue, and “reduced all of the wonderful learning that occurs with face-to-face contact in the early months, particularly”.
For Quinn, the impact of the pandemic on parental presence is one of her greatest concerns for this age group. “Distress in any form – whether it’s chronic stress, anxiety, low mood – impacts on our capacity as parents to be present and attuned. We know that some of the risk factors associated with maternal mental health in the perinatal period (the period from conception to one year post birth) include social isolation and mental health difficulties, and leave mum and baby more vulnerable. Chronic levels of stress and adversity lead to heightened levels of arousal in infants – which impacts on all aspects of development.”
Clinically, Quinn reports seeing “higher levels of anxiety and heightened arousal in children”. “There are some emerging anecdotal reports of delays in development such as gross and fine motor skills and language development – particularly in populations that endured greater levels of adversity (such as families in homeless accommodation, direct provision and families who endure multiple psychosocial risk factors). Parents are also reporting deteriorations to their mental health, which has a direct impact on their children’s wellbeing.”
Suzanne Domotor ’s daughter Ella was born in August 2020. Living in a different county to her parents, kept apart by travel restrictions and with in-person antenatal classes and other groups and supports cancelled, she describes being pregnant at that time as “very isolating and scary”.
As a first-time mother, Domotor says Covid restrictions amplified the already “very difficult experience of having a baby and navigating post-partum”.
Her husband is from Budapest, and the pandemic meant that the couple's daughter Ella didn't get to meet many of her Hungarian family until she was 1½.
Domotor has noticed the impact of Ella’s limited interactions with others outside her immediate family. “Ella is the most bubbly, cheeky, outgoing little girl who’d buy you and sell you . . . she’s an incredible personality, but we were outdoors on a beautiful day meeting friends of ours – a couple who are expecting their first baby and they haven’t seen Ella much . . . and the whole time Ella didn’t make a sound. She wouldn’t go near them, and she was incredibly clingy,” she says.
“She was just terrified of these people she didn’t know . . . and my heart breaks for her because it’s so unfair, that such a bubbly, outgoing little personality is just not equipped for meeting people.”
Creche is helping, Domotor says, and she “loves her creche family now”, but as a bilingual child, the mask wearing has been a particular challenge for Ella. “It’s great they’re respecting Covid is still around . . . [but] it is having a huge impact on how many words she is learning.”
Domotor finds it hard as a parent to judge what might be a consequence of pandemic restrictions, and what might be a genuine cause for concern. “For every single parent impacted by Covid [the question is:] is this something normal, or is this something I should be worrying about and advocating for my child? You don’t want to look ridiculous . . . and look way too over the top and reading too much into everything. At the same time you want to get your child the help they need.”
Ruigrok’s baby son Jake attended playgroups and swimming lessons and Jo Jingles music classes. He had something on every day, she says, until Covid hit in March 2020 and all social interactions outside the household stopped overnight.
Father of five Alan Lacasse’s youngest son Josh was born in July 2020. He says he was lucky that restrictions started towards the end of his partner’s pregnancy, meaning he was able to be present for early scans and appointments, but “from March onwards it was strictly drop and go”.
As Josh was a breech baby, his partner Jen delivered him by elective C-section. “After the birth and Josh being placed on Mammy for a few minutes, he was given to me to dress and we were taken into the next room. I got to give him his bottle and hold him for about 30 minutes. Once Jen was finished in theatre, they sent me home and she and Josh were taken to the ward. That was the last I saw of them until they were discharged.”
Once home, things were very different in comparison to when other newborns in the family had arrived home, he says. “When my other children were born aunts, uncles, grandparents and friends would all have arrived within a few days. Even though we had gone to phase three [restrictions level] there are vulnerable people and carers in the family, so people were hesitant to travel.
“There were also none of the normal social events that happen – birthday parties, family barbecues and day trips – so he rarely saw anyone except his immediate family. There was a visit to the public health nurse within a few days of him coming home and then his vaccinations, but in the main his only human interaction was with us.
“Even when schools reopened in August there was none of the usual standing outside the gates until your kids came out. We all sat in our cars until we saw our children coming out. In pre-Covid times, he would have been out in the air saying ‘hello’ to all the kids and their parents.”
Lacasse says in spite of all this, Josh “is fine with new people”, but his speech “is way behind”. At almost two years old, he only has about five words. “Confidence he has in bucket-loads, mainly due to having four older siblings, who for large portions of his first year were stuck at home together.”
Lacasse’s biggest concern is that Josh’s developmental delay “could be more than just a delay due to lack of interaction and socialisation. With the already horrendous lists, that have only been made worse by the pandemic, I’d be concerned that early intervention, if needed, just won’t be there.”
Speech and language therapist Mary Hanly says between birth and two years of age, communication milestones can be difficult to judge for many parents. "Due to restrictions, parents were left without developmental checks, and meeting with other parents of babies and toddlers of a similar age who they might have 'compared' their own children with and noticed a communication difficulty," she says.
“Toddlers in 2020 who may have had subtle signs of communication difficulties have missed out on months of early intervention without any referral, and then endured the long waiting times for speech and language assessment and intervention both publicly and privately.”
“Research shows that when children don’t catch up in their language skills, they may have persistent language difficulties, as well as difficulty with reading and writing when they get to school. Early intervention involves treating the toddler, but it also provides education, support and guidance for parents. It can have a significant impact on a young child’s development, socially, emotionally and their future behaviour.”
Hanly says parents should seek help if their child is showing any signs of delayed communication milestones. “Covid babies do not need extra time to catch up,” she advises. “Do not take a ‘wait and see’ approach as early intervention is most beneficial.”
She suggests making “your home a language-rich environment by talking about what is happening in your child’s world every day”. Reading with your child, using all forms of communication, including non-verbal gestures and signs, and expanding on words – “if your toddler says ‘ball’, you respond ‘kick ball’” – can all help.
Early years teacher Eilish Balfe has seen first-hand the impacts of the pandemic on the toddlers and preschoolers who attend her service.
“They missed out on a lot of their social and emotional development and we can see it in here. When you’re locked away for the guts of two years, it is going to impact them. All they knew were their mums and dads. They weren’t going to see their grannies and grandads anymore . . . they weren’t going to normal places.”
As parents are returning to their workplaces, children are having to adjust too. “There’s different people collecting them or there’s a childminder. Things are coming back to our normal, and they haven’t experienced that.”
Balfe says they’re having “to go back to the very basics” with children. “Normally when they come in at preschool age – and we take them in from 2½ – they’ve some sort of emotional and social skills, but they didn’t. They didn’t know how to share. Normally when they come into us, their imaginative play has come along and they’re starting to play with each other, but we found the play, when they came in, was parallel play. They were playing beside each other, not with each other. We wouldn’t have experienced that before, unless the child had additional needs. We could see huge development regression in those children who were born into the pandemic.”
The prevalence of technology use throughout lockdowns is also evident, even at this young an age, Balfe says. “We’re seeing three- and four-year-olds who are already talking about Xboxes, because that’s what was going on. It’s no fault of the parents; they still had to work, early years were closed, and it probably wasn’t the best start in their life, unfortunately.”
Along with speech and language delay, Balfe is also seeing children “who are already presenting with anxiety in preschool, which is very worrying”.
The service focuses on the children’s emotional skills, and they have won an award for the way they teach kindness. Behavioural problems have rarely been an issue before.
“This year is the first year in about eight years we’ve had a lot of aggression from kids. I’ve had a lot of behavioural problems. They’re all over the place – one minute they were locked in, then they were out, then they were locked in again.”
Aware of the long waiting lists, now exacerbated further by the pandemic, Balfe advises any parent who comes to her with concerns about developmental delays and red flags to go private if they can afford it, as she has seen the difficulty some parents of toddlers and preschoolers have faced trying to access supports.
Quinn reminds parents who are worried about their “Covid toddlers” that “brains are malleable”. “For children who have experienced early adversity in the context of Covid, every interaction has the capacity to be an intervention and this offers great hope,” she says.
“Repetitive moments of nurture and attuned connection is at the heart of wellbeing. Parents often put too much pressure on themselves, when little and often doses, throughout the day are hugely beneficial,” she adds. For parents, “our capacity to do all of this is contingent on how resourced we are, and so prioritising our own needs becomes essential”.