Air Hugs and ACEs: Trauma in Young Children During the Pandemic

COVID-19 closed down a big part of children’s lives when it forced many of our preschools to close. Besides being places where children learn, preschools provide children with chances to make friends and build their social-emotional skills. Preschools also give some children a haven from troubled family lives, and the problems that many children face at home have grown worse during the COVID crisis. In the past year, loss of jobs, financial pressures and stay-at-home orders have combined to put a strain on family life across the board.

These hardships could hurt children’s mental health because adverse childhood experiences, or ACEs, cause toxic stress in developing brains. And that has child advocates worried. “Because children have been relatively spared from serious illness caused by COVID-19, there might be a false sense that nothing bad is happening to young children,” said Jack Shonkoff, who heads Harvard’s Center on the Developing Child. “In fact, the stresses their families are experiencing have enormous effect on many, many children.”

COVID-19 is causing children nationwide to undergo trauma. Yet it’s taken a greater toll on those who were already under stress. Low-income and vulnerable families who typically had trouble affording their basic needs—food, shelter, transportation and education—have found it even harder. Children with parents whose first language isn’t English may be struggling with virtual home schooling. People of color are at more risk of contracting COVID-19, so more of their children have seen family members fall ill or die from the disease.

The past year brought these inequities to the forefront as alarming images filled our TV screens. Besides the pandemic, we’ve seen graphic images of police violence and the protests that followed the murder of George Floyd, an unarmed Black man. Many children have seen and heard about these alarming events, and their responses can vary greatly depending on the reactions of the adults around them. If a child’s parents or caregivers are relatively calm and reassuring, they can help children be resilient. Meanwhile, if the grownups are overwhelmed with their own sense of worry and grief, they’ll find it hard to give children the reassurance they need.

And it’s difficult to meet children’s needs when your own needs aren’t being met, according to the mom of two young children. She recalled how she ran “full speed into anxiety and depression” as she stayed home hearing about COVID-19 and the deaths of unarmed black folks. “The more time I spent shut up at home, the more terrifying it was to speak to any adult who wasn’t my husband or my mother,” she said looking back. “While everything overwhelmed me, the biggest challenge was trying to be there for my children in my new-found, continuous state of irritability and fear. My four-year-old has always been talkative, but suddenly his chattering and curiosity began to frustrate me, while I was becoming impatient with my one-year-old’s inability to communicate her needs.”

Losing her regular child care had increased this mom’s stress, she recalled. And a similar grievance came from a frazzled military spouse whose husband was on deployment when the pandemic hit. The closing of her children’s day care made it impossible for her to balance family life and work, as she remembered with distress. “I ended up losing that position because it was really difficult to manage juggling two kids and going into an office, then ultimately trying to work even more hours from home because my job is very demanding. I wouldn’t say necessarily that I was depressed in a sense, but I was very stressed out and very on edge.”

So are many U.S. parents, according to a national survey released by the American Academy of Pediatrics last fall. Since March 2020, 27 percent of parents reported that their mental health had suffered, and their children were behaving worse. They attributed these family issues to food insecurity, loss of employer-sponsored health insurance and the closing of their child care provider. “These challenges don’t just hurt adults,” said Tania Maria Caballero, a pediatrics professor at The Johns Hopkins University School of Medicine. “Since they hamper a family’s ability to adequately support their children, they are really intertwined with a child’s mental health.”

Young children may not have the language to describe the stress they’re feeling, but they can show it through their behavior. Some children might have disturbing nightmares or thoughts that they express through drawings. They might become anxious when separated from their caregivers. Some might display behaviors, such as bedwetting or trouble sleeping, that they had previously outgrown. Others might act silly, behave younger than their age or throw tantrums. And these preschool blues add to the challenges faced by child care settings during the current crisis.

Nationwide, many child care settings that managed to survive the shutdown are now trying to open their doors. Those that didn’t shut down for good face a horde of strict regulations that require them to clean incessantly and keep the children’s belongings at school. In many cases, parents can’t enter center buildings and must hand their children off at the front door—or even commit to sending their child to a center without ever having set a foot inside it. In addition, centers can no longer serve the family style meals that build a sense of community and closeness.

The new requirements also mean that centers must sacrifice some of the basic components of early childhood like exploring the world through touch or learning to share toys with friends. At a center in Utah, for example, older children wear masks and learn to “walk like mummies,” without ever swerving, to keep distant from other children. In an Arizona preschool, children make “airplane arms” when walking in line to leave more space for one another. Even hugs are discouraged, according to recent recommendations from the Child Development Associate® Credential Advisory Committee. The early childhood teachers on the committee have advised their peers to “teach children to air hug, hug a teddy bear or hug themselves.”

While essential now, some experts suggest that measures like these are not practical in the long run, according to Susan Hedges, director of quality assessment and assurance at the National Association for the Education of Young children. “You can’t tell a three-year-old not to hug their friends or be with a friend. It’s bad for them, it’s bad for their social-emotional health, and it’s just not feasible.”

Children are very reliant on social connections, so they should feel better when our preschools no longer have to enforce these burdensome—though needed—rules. But that alone will not ensure that children are healthy and learning after their COVID-related struggles. When the pandemic has passed, we’ll also need to address the aftermath of the trauma, especially among children who are most disadvantaged. The pandemic has put a spotlight on broad social inequities, and early childhood teachers can’t right them alone.

Instead, we must harness community-wide resources to help young children by helping their family members. The stresses and strains many families have been through are likely to increase their children’s risk of developing mental health problems both now and in the future. Experts in early childhood trauma have already seen the impact of COVID-driven hardship first hand. The sharp rise in ACEs has unmasked the epidemic inequities behind the current pandemic. They account for tragedies like that suffered by one family last year. The mom was in the ICU with COVID-19 and her husband had also caught a severe case of the virus. Still, he stayed home to care for their children and frantically struggled to meet his household’s needs.

As the pandemic has upended life for families like this, people say they wish everything would go back to normal. “But normal wasn’t such a great thing for most people in our country. We want a better normal,” said the founder of ACEs Connection, Jane Stevens. Granted the science of ACEs focuses on the unique ordeals of each single child. But the pandemic and renewed push for racial justice have shown the need for broader, social solutions to childhood trauma, as Stevens explained. Much of the stress our children feel comes from the stress their communities and families are going through. The mental health of our children depends on the mental health of the grownups who care for them.