Wearing Masks with Infants and Toddlers

Updated: Oct 13, 2020

Due to the coronavirus pandemic, childcare centers and Montessori schools have undergone drastic changes to ensure the health and safety of children, parents, and staff. Some of these new ways of conducting group care include screenings, increased frequency of sanitizing and hand washing, smaller group sizes, and caregivers wearing masks.


Masks are a protective barrier to help stop the spread of respiratory droplets, which are a common way COVID-19 is transmitted by both symptomatic and asymptomatic people. This is an important protection in place to keep both the child and the adult safe.


The CDC and my state's (Texas) guidelines both recommend caregivers and teachers wear masks when caring for children, especially when there is no ability to physically distance yourself from the child. With infants and toddlers, we know for healthy social and emotional development, close proximity and positive caregiver responsiveness is key. Factor in feeding, diapering, and aiding children in falling asleep, and this leaves caregivers spending a large part of their day wearing masks.


In some social media and discussion forums I am a part of, I have seen caregivers feel nervous about wearing masks because they believe it will hinder the child's language and emotional development. As an infant mental health professional and early interventionist in training, this is something I have thought of as well. It was through research, discussions with my professors and colleagues, and my own observations and experiences that I started to feel really comfortable about wearing a mask while supporting infants and toddlers in care.


Here are some things we thought about:

  1. Children who live in cultures around the world where covering the face is the norm due to pollution, religious or spiritual beliefs, etc. still learn language, grow, and develop.

  2. Children who never see faces due to blindness or vision impairments are able to learn language, despite never seeing someone's mouth movements.

  3. Children will still spend time with adults in the home where masks are not worn and will have the opportunity to still see facial expressions and mouth movements. This is a great opportunity for us to really connect with parents and educate them about their child's development.

We also discussed how it takes a lot to disrupt a typically developing child's language acquisition. The biggest concern with masks from a language development perspective we came up with is if you were a SLP working on cued speech with a child who was deaf, which would likely be switched to telemedicine anyway.


Something neat related to language development that I have observed is the way children are picking up on our use of American Sign Language (ASL). If you know me, you know that I have always used ASL with the children in my classrooms. One concern I had was that the infants/toddlers would not be able to correctly place the sign spatially on the lower half of their face due to me wearing a mask while demonstrating. I was surprised to see that the infants were able to sign 'eat' by bringing their hand to their mouth, despite seeing the sign with me masked at school. I encourage the parents to do the signs at home as well, but it was still a neat observation! I am actively searching for research or data that could explain this scientifically- so if you have a lead let me know!


Another concern I have heard expressed are that facial expressions are stunted through masks and that is important for social and emotional development. Even though facial expressions are important, we can still build relationships and attachment with children in other ways and may have to rely on these other ways for a while. Children can still read facial expressions even with our masks on by using our eyes. Responsive caregiving is what's key here. For many early care educators, this feels unnatural and strange to connect with children through a mask. I think we have to really focus on being responsive, warm, and nurturing in our care interactions.


I wanted to share some of the information that helped me with the hopes that it can help others feel comfortable when returning to their classrooms. There are so many things that are different about our classrooms but the role of the adult to provide comfort and a feeling of safety hasn't changed, it just looks different.⁣ We know that infants and toddlers use social referencing and their relationships with caregivers to determine how they should feel in situations. If we, as the adult, feel uncomfortable, the child will feel uncomfortable too.


I decided to make this video to help the children I am serving feel more comfortable about those around them wearing masks. We normally sing this song about different hats and it is a classroom favorite, so the tune is familiar to them!⁣


Videos like this and social stories are some of the ways my school is providing COVID-19 specific support. We have been serving children remotely and in-person since March 30th. All of us working on-site are wearing masks. In a way, this video helped prepare children for what they would now see at school.⁣


We can absolutely acknowledge how much it sucks to have to wear a mask and how it will change what we do in child care and the way children learn to feel safe with us as educators, while also realizing the masks are important to keep us all safe and healthy. It will be interesting to see the effects (or non-effect) in a few years. Now would be a great time to research different aspects of child learning and development. This crisis has opened up some interesting discussions on the ways to best support children's optimal development!


Zero to Three has a great resource on talking to young children about wearing masks: https://www.zerotothree.org/resources/3211-why-are-people-wearing-masks-why-are-people-covering-their-faces It even offers some suggestions on how to answer questions in a developmentally appropriate way.

Resource:

He, X., Lau, E.H.Y., Wu, P.et al. Temporal dynamics in viral shedding and transmissibility of COVID-19.Nat Med 26,672–675 (2020). https://doi.org/10.1038/s41591-020-0869-5


https://gov.texas.gov/uploads/files/organization/opentexas/OpenTexas-Checklist-Child-Care-Centers.pdf


https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-childcare.html

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