Tuesday, May 12, 2020

None of This is "Normal"

Let me start this off by saying a few things that I think are very important to share upfront. First and foremost, I try to live and believe that “People do the best they can with what they’ve got.” I also know that nothing we are living through right now is “normal.” We are living through a global pandemic and all bets are off. Half of the time, I don’t know what day it is, what time it is or have any idea of how to think about anything. I’ve found myself in multiple discussions with good friends stating, “it is impossible to make a decision right now.” I’m all over the place, my thoughts, my dreams, my ideas are night and day from one moment to the next. How can anyone be expected to have a clear head and make sound judgments with so many unknowns right now? With so many multi-faceted fears about the present? future?
Before I get too far into this, I want to leave this right here… It is a little tidbit of information I picked up decades ago while attending a PIPfest weekend:

“There are 6 sides to a conversation:
What I said
What I thought I said
What I meant to say
What You Heard
What You Thought You Heard
What You Wanted to Hear”

I think it is really important, now more than ever to be aware of the communication we are sharing and to ask for clarification when necessary. Additionally, as my good friend Dan Hodgins says “We don’t always have to agree.” In fact, from a psychological perspective, the cognitive dissonance that is created when we are challenged in our thoughts and beliefs helps us to grow.

I have been fortunate to be a part of a number of wonderful discussions with other early childhood educators, professionals, and people who genuinely care about young people over the past many weeks. My range of emotions has run the gamut.. from pure joy and excitement to sadness, fear, and anger. One of the few things I know for certain right now is that none of this is normal, there is no playbook or one size fits all approach to living through a global pandemic. I know that one day I am super productive, painting and improving our classroom, catching up on paperwork… and then the next, I don’t even bother to change out of my pjs and I spend the day on the couch or in bed binge watching tv and eating ice cream. (and those of you who know me well know that I really don’t watch a lot of tv).

Earlier this year, I ran 2 childcare programs. Most of you are aware of Child Central Station, the group home child care program I run out of my home alongside my husband Allan. In September, we added a second program, Child Central Station, LLC, a before and after school program at one of the local elementary schools. It is a licensed childcare center in a school. Neither of our programs are currently running. After school closed down, I joined forces with another childcare provider in town to offer school aged care to children of essential workers, but we were only open for two weeks.

Recently, there have been a lot of recommendations and guidelines coming out for childcare programs. Many of the guidelines being suggested are not developmentally appropriate, but none of what we are living through right now is normal.

I’ve been in multiple conversations about the use of masks in childcare programs. I can tell you right now, we will not be using masks in our home based program. I’m not sure yet how we are going to approach this with the school aged program. However, I did not come to this decision lightly. Here are my major concerns with cloth masks-

1. The CDC and the WHO have had varying opinions on the use of cloth masks. Looking at the research pre-COVID19, the use of cloth masks was not recommended as they have not been proven to be very effective. Multiple research studies have proven that cloth masks are not very effective in preventing respiratory illnesses. Recently the CDC flip-flopped on the use of cloth masks and recommended their use. Do I believe that something is better than nothing? Of course I do, and yes, and I have sewn multiple masks. I wear one in public when we have to go out, but I don’t believe that the protection they provide outweighs the other concerns for our program with wearing masks. (I know that more studies and science are pointing toward a high efficacy of masks now- update August- I am very concerned about children's ability to wear them and use them effectively in order for them to do the job.) 

2. When we switched from social distancing to wearing masks, many people forgot that we are supposed to do both. I feel like a mask can give people a false sense of security, and as previously stated the efficacy of cloth masks is minimal.

3. Masks muffle your voice. Young children (infants and toddlers) learn to talk and communicate through interaction with their caregivers and peers. Will having to listen to speech through a muffled mask and not being able to see mouth movements impact speech and language development? I think about the early language development and play with an infant where they mimic your facial expressions and sounds. Will having a mask over your face delay this? I know that a loss of hearing causes developmental delays and issues for young children for communication, I worry that muffled speech could have a similar impact.

4. Very young children have a hard time with object permanence and they have a hard time separating real from imaginary. This is why Halloween masks are not appropriate for very young children. I don’t think that medical/cloth face masks will necessarily have that same effect as they are not covering the whole face, but masks could be intimidating or scary for some children.

5. What about attachment? A big part of attachment theory has to do with social referencing, or the watching and learning of how to react to something based upon how your caregiver reacts. Yes, a young child can see your eyes and part of your face, but infants do not have a highly developed sense of sight, and having a good portion of your face covered, could impede some of the social cues. What about the demeanor and availability of caregivers in this crisis? We are all living through trauma. I know that when I put my mask on, I don’t feel more secure. It is a constant reminder to me that nothing we are living through right now is normal, and I’m concerned that it will be more difficult to work through that with children. (Plus masks are uncomfortable and breathing is more difficult with them on.) Have we worked through enough of our own insecurity to be ready to give our all to the children? Do I think that it is possible to form a secure attachment by wearing a mask? Yes, I know that it happens for some children in various circumstances with medical conditions, but I don’t think it is ideal.

6. If the risk is so high that we are being told to wear masks, why are we putting the children at risk? Initially, there was not a lot of concern in regard to children contracting this virus. Now, we are hearing of more and more ways in which children have been impacted with different symptoms. Is caring for children worth the potential cost? Is this really the best solution? Is opening our program(s) in favor of the economy really worth it? Could children be better cared for with less risk by an individual caregiver at their home if their parent(s) are essential workers? I know when we decided to close down the school program, we helped match parents with potential staff and resources to have someone come into their home. With smaller numbers of children in attendance, could pairing staff with families be a more appropriate solution when families do not have someone to care for their children at home? I know that making this recommendation is a hard one to swallow when programs need to be open to survive, but I worry that opening programs could have greater costs than economics. I would hope that with all of the bail-outs happening and that have happened that the childcare industry could receive one to allow for the opening of doors when it is safer to do so.

I also think that individual programs need to look at a wide range of factors when making this decision. How much risk is there? Do you have community spread in your area? Do you have children of essential workers who are on the front lines? What about your staff- are they part of a high risk demographic? Are staff, children, and families practicing social distancing guidelines outside of your program?

Elliot Aronson stated, we are “social animals”. Not only do I worry about masks in our program, I also worry about the social distancing. Children in our program will be using shared space. They will be using shared equipment. We will be vigilant with health checks and cleaning/sanitizing even more than we have previously, but I will not expect them not to play together.

Many of the children in our program will ebb and flow between the various levels of play. I’m not going to police how close children are, or tell children who are working through their social skills that they need to move further apart. Is it impossible to keep them separated? No, but I worry about the policing of space and materials and the amount of control that would be relinquished. How much teacher control is there and how much of the child centered play will be lost if we impose those restrictions? And we need play, we need play now more than ever. Play is how we learn, and play is how children work through situations and things that scare them or they don’t understand.

I know that many of the points I make do not have any scientific research attached to them, but being that none of us have lived through a global pandemic, and none of this is normal, there are many unanswered questions. I think it is really important for us to look at the various angles and try to reason the risk/benefit analysis of our actions and the guidelines being suggested.

A good friend of mine pointed out that it would be a very long time before a vaccine is made if we are even able to prevent COVID-19 with a vaccine. We really don’t know yet if a vaccine will even be viable. How long do I think programs should be closed??? My answer- As long as it takes for children, families, and caregivers to be comfortable to come back. I can’t answer that question for you, I can only answer it for me. We never really “closed” our home based program, children and families stopped coming based on executive orders from our governor as various businesses closed. I know that we do not have any children of healthcare workers who are currently on the front line. Many of our families work from home or will be able to work while socially distanced. Right now, we are not seeing a community spread of the virus in our community. (This isn’t an assumption I have made, it is a statement I am making based on the statements from 3 different doctor’s offices and from elected officials in our area). We still need to be cautious, but we have flattened the curve in our state. If our families need us, we will open our doors tomorrow. Most of our families are looking at a late May to early June re-entry into our program. However, if we see an uptick of cases with higher community spread, I would not hesitate to recommend that the children in our program seek care in their homes.

Is my decision the right decision for you and your program? Maybe, maybe not. As I have previously stated, we are not all facing the same factors when it comes to making this decision. Our regions,areas, towns, programs all have different mitigating factors. No one can make the decisions for your business except for you.

Children and people are resilient, and they/we will find a way. 
But, I am concerned, really concerned.... At what cost? 

In closing for now, I am reminded of a question often asked by my good friend, Dan Hodgins, “Who is it for?” I implore you to ask that question and continue to ask “At what cost?” as you work through your decision making processes.

None of This is "Normal"

Let me start this off by saying a few things that I think are very important to share upfront. First and foremost, I try to live and ...