Coming Out of Covid

Two years ago, I remember going into the quarantine thinking how crazy it was that we would be doing this for two weeks. I couldn’t even fathom shutting down our town, our country, our world for that long.

I naively started taking a photo for each day my toddler would be “in quarantine”, sharing with family with glib little captions. It stopped being fun after Day 30. I stopped doing it on Day 70, my son’s first birthday in quarantine.

Now it has been two years. Two years of quarantining, social distancing, outside gatherings, mask mandates, risk tolerance, vaccines, boosters, risk assessment, variants ... it has been so tough for everyone, especially parents, to navigate what is right for their family in a world where the situation changes constantly and the media and government have different priorities than our own.

So I want to take a second to talk a little bit about how the pandemic affected our kids' communication and development. And hopefully offer some reassurance and suggestions for how we can move forward.

My Pandemic Child

I am a parent myself, with two unvaccinated children under three. As you can imagine, this pandemic was not quite what I envisioned when we decided to start a family. When my son was 9 months old, the pandemic began. We spent a long time in near-isolation, seeing people virtually or outside (socially distanced). My husband and I watched my son grow from a baby to a toddler. And it hurt my heart to think about all the things he was missing.

My son was too young to wear masks, and it worried me to see all these masked faces. How would this impact his speech and language?

My son didn’t go anywhere except the playground where he stayed off on his own, interacting with nobody. How would this impact his play and communication skills?

My son saw us and occasionally his grandparents in person. Everyone else he saw over FaceTime, for about two seconds before he ran away from the screen. How would that impact his social skills and socio-emotional growth?

And then, along with everything else, my son missed all of his expressive language milestones. But I’m an SLP and I'm doing all the things for early language!?

I'd like to say I handled it calmly and professionally. I'm a speech pathologist, so I know there is a range of typical development. I know the techniques to help elicit language. I know the positive signs that my son was making progress: My son understood language well, he was happily engaging with me and my husband, he was a wonderful non-verbal communicator, he was slowly learning some signs and making word approximations.

But no, I was an anxious mess, frantically testing my own child every three months with an early language assessment from work. (My SLP friends can attest to this).

I was angry. I blamed the pandemic. I blamed myself. I didn't know what else I could do.

Fast forward a year or so. Vaccines came out. We made the decision to enroll my son in daycare a few days a week for socialization with peers and other adults. We started taking him to some indoor structured social groups and having some playdates with other vaccinated families. We gave him some time.

He is talking much more now. And, while still delayed, I'm much less anxious. These past two years have not been normal. My son may have been delayed regardless, but there is no doubt in my mind that the pandemic made it harder for him to learn language due to the lack of communication opportunities and communication partners.

Why did he have to learn to say a word when mama already knew everything he wanted in our tiny apartment? His nonverbal communication was working, why change it? And he didn't go to grocery stores or restaurants or other people's houses where he might have learned other words or had other people to try to talk to.

It's Not the Mask

Although mask mandates are coming down in many areas of the country, many parents are still concerned about the risk of COVID-19 for their unvaccinated children or for others in their household.

For those of you who are choosing to keep your child masked, I want to provide some reassurance.

Masks do not cause delays.

Let me say that again, louder for those in the back.

Masks do not cause delays.

The PANDEMIC caused delays. We made drastic changes to our children's lives including their exposure to other places and to other people. We have lived in a traumatic, anxiety-filled space for the past two years. This is what causes delays.

There are many other countries who use masking with young children during illnesses. There are also many studies that have been published since the pandemic began that show masking is not the causal element in speech and language delays.

But how will children learn to read facial cues?

Children are able to understand tone of voice and see emotions in a communication partner's eyes when they are wearing a mask. And even if their teachers and caregivers are masked at school or at daycare, children are also are exposed to parents and other caregivers unmasked during other parts of their week.

But there are so many kids with delays now!

Yes, there is a huge rise in referrals to speech language pathologists right now, especially for young children. But this is not because of masks. This is because of the pandemic. And remember that, regardless of the pandemic, there are always children who will need support reaching their communication milestones.

So, if keeping your child masked is the right choice for your family right now, please feel reassured that this will not cause them to have a language disorder.

Weighing the Risks

I feel like all I've done in the past few years is weigh risks. But please, bear with me.

If your child does have communication differences, this may be the time to consider a balance between physical health risks from COVID-19 and the risk to your child's communication development. For me, with my son, I chose to put him in part-time daycare because I saw him stagnating in his communication skills. This was the right choice for my family.

If your child has communication differences, you may want to consider some of the following options:

Unmasking

Young children who are highly unintelligible including typical toddlers or children with speech sound disorders
Wearing a mask can muffle sounds and make it difficult for listeners to use visual cues to determine the child's message
Over time, some children who are unintelligible get frustrated and may begin to shut down and talk less as a result. This may happen with or without a mask, but masks may heighten their frustration.
Again, while masks do not cause delays, if the mask is causing these types of challenges for your child, it may benefit them to unmask – depending on what you are comfortable with and what is right for your family.

Mask Talk

When your child is masked, encourage them to use the following strategies to increase their intelligibility
Overarticulate - Mark the sounds in your words
Slow Down - Use a slower rate when talking in masks. Talking too fast can make it hard for people to understand us.
Check In - Ask your listener if they heard you. If not, try again using the strategies above, gestures, or even different words.

Expanding Communication Opportunities

If you have a late talker who is not meeting their expressive language milestones, consider expanding their communication opportunities depending on your risk tolerance
Pod Up -- Find a family with a similarly-aged toddler to interact with, consider childcare options like a part-time babysitter, mother's helper, daycare, or a nanny to introduce your child to another provider and give them the opportunity to interact with new people.
Explore -- Visit a library, join a gym class, bring your child to a café, go grocery shopping or go to a farmer's market. Show your child new locations to expose them to new communication opportunities.
Facetime -- Set up weekly calls with grandparents or friends with other toddlers/babies.
Get Structured -- Free play and outdoor play is so important. But some children benefit from a more confined space or structured activities led by non-parents to help encourage them to try new language.

So whether you are still waiting for the pediatric vaccine, you are just starting to go back out in the world, or you have been out for a while, I hope this information helps you support your child’s communication as we start to make our way out of COVID (fingers crossed!).

Before you leave, let me just end by saying to each and every parent and caregiver: I see you. I see your frustration, your fear, your anxiety. You are doing the very best you can. And your child is lucky to have you.