COVID-19 Special Edition: How Do We Rebuild and Re-Envision Early Childhood Services?

May 19, 2021

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The devastating toll of the pandemic has underscored the critical importance of connecting what science is telling us to the lived experiences of people and communities. In March of 2020, we recorded episodes exploring the impact the coronavirus pandemic could have on child development. Now, a year later, we wanted to continue these conversations and discuss what we’ve learned, what needs to change, and where we go from here.

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The first guest in this 4-part special series is Center Director Jack P. Shonkoff, M.D. He and host Sally Pfitzer discuss what COVID-19 revealed about the needs of caregivers with young children or during pregnancy, what we learned about the importance of science over the course of the pandemic, and how we can make changes going forward.

Upcoming episodes of this series will feature expert speakers reflecting on the pandemic’s impact on pediatric and mental health systems, and the longstanding social policies and systemic racism that resulted in the pandemic disparately impacting communities of color. The experts will discuss how we can take what we learned over the past year and make meaningful changes that will improve outcomes for children and families. Subscribe below via your podcast platform of choice to receive all new episodes as soon as they’re released.

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Sally: Welcome to The Brain Architects, a podcast from the Center on the Developing Child at Harvard University. I’m your host Sally Pfitzer. In March of 2020, we recorded episodes exploring the impact the coronavirus pandemic could have on child development. You may remember we discussed the importance of self-care for caregivers, and the importance of physical distancing, not social distancing.  And now a year later, we wanted to continue those conversations and discuss what we’ve learned, what needs to change, and where we go from here.

Joining us today is Dr. Jack Shonkoff, Director of the Center on the Developing Child. Jack, we really appreciate you being here, and I know we have a lot to cover, so let’s jump right in. Could you tell us what COVID-19 has revealed about the needs of young children, families and people who are pregnant?

Dr. Shonkoff: So immediately, we saw the difference between people who had access to resources that helped them get through and those who before the pandemic were always at the edge and that this put families over the edge in terms of meeting basic needs—food, clothing, housing.  But then, there’s the other universal experience of the critical importance of supportive relationships—the critical importance of extended family, neighbors, friends—and the extent to which every parent, regardless of your circumstances, cannot parent a child alone. And the social isolation that so many people felt, from the poorest to the wealthiest.

And so, I think if there’s anything good to take out of this past year, it’s a recognition of the universal needs that all families have to provide a healthy environment for their children, but the tremendous inequalities in resources and buffers and supports that we could all turn to when we are faced with really unusual hardships.  So, it’s this balance between kind of universal experience and highly unequal consequences that I think are the lessons from the past year.

Sally: Could you tell us what we’ve learned about science over the course of this pandemic? And especially, how that science relates to what children need.

Dr. Shonkoff: Our work has been deeply grounded in the importance and the value of bringing credible, trusted, scientific knowledge to the table in addressing all of the challenges and opportunities that face families with young children, especially families who are dealing with excessive adversity or burdens. And this past year, has been a real eye-opening experience I think for all of us about both the critical importance of trusted, credible science in the face of threats to our health and well-being and the very significant  limitations on how that science can provide direction or guidance about how to move forward.

We certainly learned this past year, not only that science doesn’t always have all of the answers—and especially at the beginning of problem—but that science doesn’t stand still, and that we depend upon science to keep moving forward. And we also have to learn how to make decisions based on incomplete science and based on the best science we have. And in many ways, we’ve always known that. We know that there aren’t answers to every problem.  But I think one of the really very complex and and sobering lessons we learned this past year is how science has to be aligned with the lived experiences and the values and beliefs of the population. Because when it isn’t aligned, people can choose to not only not believe in the science, but to adopt alternative perspectives that try to delegitimize science.

So, for me personally, and certainly for the work of our center, this is a real time to just step back and try to figure out how we can maximize the contributions of science and we can leverage cutting-edge science that has solutions—or partial solutions—to our problem, without expecting that science will have all the answers. And certainly, for those of us at the  Center on the Developing  Child, kind of recognize both the limitations of the science at any time and the power of the science to guide us in more effective approaches to deal with any of the challenges we’re facing.

Sally: Looking forward, what can we do? How can we make changes?

Dr. Shonkoff: We’ve all learned a lot about how much the health of any society depends upon a sense of shared responsibility for each other. To get through this together. Whether it be people caring about their communities, decision leaders caring about the well-being of the country. I think we’ve learned simultaneously that we are all in this together and we all have shared vested interests and we are not all in this with equal resources and equal assets.  And this has not just been about the pandemic. We have had the converging crises of an infection out of control,  of a massive economic disruption that did not have an equal impact on all parts of the population, and then, of course, we have the dramatically increased consciousness  about something that is not a new problem, but the dramatic increase in understanding the unbelievable threat and hardship of systemic racism and structural inequities imposes on families of color and other groups that are disadvantaged in ways that are kind of embedded in our society.

So going forward, I think the health of our society depends upon the extent to which we see all of us as having a shared investment in the well-being of each other. So, this is still politically extraordinarily complicated, but I think one lesson we might take from this is shared interest  in everybody doing well.  We do know a lot about the kinds of conditions in which young children grow up that increase the likelihood of a healthy, productive outcome: supportive relationships, manageable levels of stress, basic needs met, major opportunities for learning, and buffering and protection from excessive stress activation.

So what do we do going forward?  We start with the fact that in a society like ours with our political traditions, there’s a mix of self-reliance and kind of shared responsibility. And no family gets by by itself. So, the question is: Do you pay for it yourself or do we share the responsibility of paying for it for everyone else? Whether it be health care, child care—child care, there’s an interesting tension.  Is child care something we need so that parents can go to work or is child care something we need to make sure that children have kind of optimal environments,  for their development while their parents are working; because we have learned  how  the economy cannot move without child care to take care of children while their parents work. So, we could go down the slippery slope of seeing child care as basically something we need to promote parent employment and set very low standards and just say: make sure kids don’t fall our windows or run out in the street and we’re okay. Or we could say we need it for the economy to work, but we also need to build a strong foundation for the next generation.  We have to just recognize that at the end of the day, going forward is some combination of making sure that we find some way to support families to meet their children’s needs and promote their children’s health and development.  And then thinking about as a country, what kind of resources do we need for population health?  But let’s just remember at the end of the day,  governments do not raise children. Parents, families, caregivers, raise children.  But how they’re able to kind of provide for their children’s needs and their own needs, depends a lot on communities, depends a lot on government, and depends a lot on resources.  A lot.

And so, I think going forward for the early childhood system, I would say there are a couple of things that involve more than just how do we rebuild what’s broken down. Because, what we learned from this past year is how fragile the infrastructure is for  many essential early childhood services, whether it be child care, early education, early intervention programs, family support programs.  It’s a fragile infrastructure. It’s not permanently supported, and its funding  is always up in the air.  So going forward, I think the big challenges for the early childhood field come in two categories.  One is how do we rebuild and re-envision early childhood services so that they are able to have a more stable infrastructure and more predictable funding , so that all of the energies could go into providing supports for families instead of half of the energies going into trying to keep the money flowing. That’s a huge problem. But there’s another part of the early childhood world that hasn’t traditionally been thought of as the early childhood world, but I think is one of the most important messages just coming out of the past year. Which is that for families experiencing structural inequities—the families who are from generation to generation dealing with the way certain structures and policies in our country disadvantage some groups over others , with racism being at the top of the list—the question is how are we going to deal with that and break down those hardships and threats that are critical to the early childhood system.

So, let me be very specific about this. Right now, in the early childhood world, most of our resources, most of our energy is focused on children, their families, and adults who work in programs that provide essential services—and there is a lot that can be done to improve life prospects for children.  But, at some point, we’ve got to think about how we go upstream and how do we prevent the things that are causing the problems rather than just figuring out how better and better to kind of  treat or help people cope with things that ultimately have to be prevented. So, it’s like this is not just about rebuilding what was lost during the pandemic. It’s not just about trying to reopen child-care centers . It’s taking the best of what we have, but not just trying to kind of rebuild and replenish, but try to re-envision what an early childhood field will look like. And it’s got to be more of a balanced combination.  To do what we know how to do to  promote responsive relationships and health-promoting environments, but also start to pay more attention to going upstream and at a macro level, at a society level, dealing with what is imposing very unequal hardships and burdens and threats on families raising young children.

Sally: That’s such an important point, Jack. There’s clearly a lot of work that needs to be done. Thanks so much for your time again today.

I’m your host, Sally Pfitzer. The Brain Architects is a product of the Center on the Developing child at Harvard University. You can find us at developingchild.harvard.edu. We’re also on Twitter @HarvardCenter, Facebook @CenterDevelopingChild, Instagram @developingchildharvard, and LinkedIn: Center on the Developing Child at Harvard University. Brandi Thomas is our producer. Our music is Brain Power by Mela from freemusicarchive.org. This podcast was recorded at my dining room table.