Childhood Interrupted

This is an edited version of BIC Streams session titled ‘Childhood Interrupted’, a discussion that looks at the impact of the pandemic on children, especially between ages 8 to 18. Hosted by Rohini Nilekani, the participants included Dr. Shekhar Seshadri, professor of the Department of Child and Adolescent Psychiatry at NIMHANS; Kavita Gupta, founder of Neev Academy; Deepika Mogilishetty, a legal activist and core team member at EkStep Foundation; and Vishal Talreja, co-founder of Dream A Dream.

We have 320 million children in India and this pandemic has impacted every aspect of their lives. For millions of those with socio-economic disadvantages, the repercussions are going to be much worse. For example, with all the school closures, 95 million children who avail of midday meals have lost that very critical source of nutrition. In terms of online learning, an Oxfam survey found that 85% of rural households in five states are struggling with the digital mediums of education. Finally, there is the psychological impact – in just 11 days in March, Childline India received 92,000 distress calls from children expressing many anxieties.

There have been several studies on the impact of past epidemics and disasters on children globally, and they’re not very encouraging. There’s a range of issues that emerge – social, emotional, educational, and much more. For example, some research on earlier outbreaks, such as Ebola, showed significant impact on children’s mental health. One qualitative study of children who experienced the Ebola outbreak, found that they were expressing the stigma and fear of the disease through the pictures they were drawing. This is something we need to be very aware of in India, because not only do we already have a heinous caste system, we have created more social outcasts during this time without seriously discussing the negative repercussions of this.

Even short-lived events such as earthquakes can have a lasting impact on children, including unborn children. Scholars who studied the effect of the 2005 earthquake in Pakistan concluded that children living close to the fault line were significantly shorter four years later if they were in utero or under the age of three. The authors of the study tell us that the two million children born in India during the lockdown, and the millions more who are under the age of three, may be subject to severe health deprivation which could affect them all their lives. They also suggest that school-going children will suffer in terms of their learning. In a NIMHANS study of Indian children who were proximate but not directly affected by the 2004 tsunami, one-third of them reported a loss in concentration, decreased sleep, and anxiety about the future. During the COVID-19 pandemic too, these kinds of studies are now ongoing.

Reports from Italy, Spain, and China show significant emotional and behavioural changes during quarantine or lockdown in children and adolescents. Younger children become clingier or regress in their behaviour and older children become more anxious, angry, restless, or withdrawn. Children subjected to quarantine have more likelihood of developing acute stress disorder, adjustment disorder, and grief. Those who were quarantined showed four times higher scores of post-traumatic stress disorder (PTSD), compared to those not under lockdown. Even short outbreaks like SARS have shown children to have long-lasting trauma, so we can only imagine the extent of the impact of a long, drawn-out pandemic like this one.

The authors of the study on the earthquake in Pakistan do suggest that governments begin to track some indicators immediately, so that losses can be known and quickly mitigated. Society as a whole can prevent harm to children, but we must acknowledge and understand the potential impact and create effective nationwide programs to stem the loss. For example, one study showed that children who were part of a Vitamin A trial when a typhoon struck in Bangladesh, were fully protected in terms of their height losses. Post-tsunami, so much aid came to the way of children who were directly impacted, that they were not only able to fully catch up with others, but they even outgrew children who lived further away. So there are plenty of creative opportunities for us as parents, grandparents, teachers, educators, healthcare practitioners, and just as caring adults to nurture this generation of children. It is an important issue to us as a nation as well, because the future of India will be shaped by a generation coming of age at the time of this pandemic, so we need much more discourse on how to support them.

Coping With Ambiguous Loss

As Shekhar Seshadari points out, children are losing a lot right now. They are experiencing a loss of routine, structure, predictability, learning spaces, opportunities, peer interaction, social spaces, and play. This will all have a significant developmental impact. We need to consider what this pandemic is doing in terms of interruptions in child development, especially for children who have special needs, whose parents have suffered loss of livelihood, who have had to migrate back to their villages, etc. We also need to look at what happens post-pandemic, in terms of the economy and the financial fallout, and how it’s going to affect family structures. The ecology of our lives have changed, and this generates a loss of developmental experiences, while also exacerbating pre-existing concerns and anxieties. Coupled with that, there are new worries about the reality of the pandemic and the misinformation and anxieties around whether friends or family members are infected, hospitalised, or pass away, how long this will continue, and worries about examinations and what the future holds. Shekhar argues that this is based on a primary psychological construct called, the ‘intolerance of uncertainty.’ Most anxiety is based on an intolerance of uncertainty, and children’s psyche responds differently than adults’, through simple first-level responses. Dr. Pauline Boss calls it ‘ambiguous loss’ – when we can’t pinpoint the loss, we find different coping mechanisms to deal with it.

What we know now, thanks to neuroscience research, is that early experiences of adversity in children can have lifelong impact, says Vishal Talreja. Experiences of neglect, lack of emotional love and care, abuse, violence, or a pandemic of this nature, may prevent children from achieving developmental milestones. The pandemic has amplified a lot of those experiences of adversity for children coming from some kind of marginalisation. In his experience reaching out to communities after the lockdown was announced, Vishal notes the high levels of uncertainty and anxiety, in many cases caused by misinformation. Fears of their family members dying caused a tremendous amount of distress for children. There was also heightened abuse and violence, since schools provide a safe space for many children. Living in cramped communities, they see sickness and death every day, which also causes distress.

Studies also tell us that there’s a heightened gendered impact, since girls have had to take on adult roles in homes including taking care of parents who may have lost incomes and livelihood opportunities. When the migrant crisis happened many children were distressed because they felt the lack of support from the system and from the cities they lived in. So in addition to the loss of learning, there is also a lot of trauma that children have experienced, argues Vishal. The last six months have been ones of sustained trauma for many families. There has also been heightened impact on minority communities, especially young people from Muslim families who felt that they were being held responsible for the pandemic.

Learning Losses and Digital Classrooms

It’s said that schools are the miniature of the nation’s future but with schools closed for such a long time, our future looks uncertain. Not only is distance-learning a cause for disruptions, Kavita Gupta also points out that there is a learning loss on assessments and exams scores. In studies conducted in the US, home-schooled children score 20% to 25% lower than children who are learning face-to-face. Even in large systems like in Australia where distance-learning has a 100-year legacy, when children enter school, they enter at about 20% lower than other children. There also are benefits of distance-learning which are measurable. In situations where intrinsic motivation is high and relationships at home are strong, distance-learning actually can be more successful, however this may not be true or possible for many families. With educators having to teach as many as 50 students on one screen or on a WhatsApp call, it’s difficult to assess and engage with each child. This lack of engagement and social interaction is what causes the greatest amount of loss, according to Kavita. There’s often social isolation and screen fatigue that sets in, no matter how well-organised and motivated they are. For children who don’t have a strong support system at home, they face many challenges including how to self-organise and do things on their own.

Alongside the disruptions, new possibilities are also playing out. Deepika Mogilishetty mentions that different sorts of relationships and conversations are developing now, between educators, parents, and institutions. But children are feeling stuck, confined to certain spaces and confined to their screens. In terms of examinations, many students aren’t able to access the assistance they otherwise would have, in terms of tuition classes, etc. With increased adult scrutiny there also isn’t any way for them to be a bit naughty, play hooky, and conspire with their friends. They have no option but to take on adult-like behaviours like scheduling and calendaring things since classes are online, as well as the children who have to do domestic work or take on other roles in the house. Adolescent boys who were struggling in school are dropping out now and juvenile crime rates, particularly Kerala and Bihar, reflect this.

People like Ken Robinson have talked about what schools are doing to creativity, says Kavita, where they’re more concerned with the ‘what to learn’ rather than the ‘how to learn’. Even outside of the scope of the school system, what we’re seeing in society is an increase in social isolation, a culture of indifference, and a low tolerance for failure. Sherry Turkle, an MIT Scholar and author, calls the coming generation the Alone Together generation, and that’s never been more obvious than right now. With digital classrooms, children opt out of the classroom by saying their video isn’t working, or they can be physically present but mentally absent. Even though they are in school, many children don’t develop relationships and because of that, they are not really learning or performing to their potential. So how can we deal with that? How do we empower children and give them agency on their learning? How do we become clearer about the outcomes? We need to start doing things differently, by empowering children and creating social groups for learning.

One of the strategies Kavita mentions is longer cycle planning on the side of the teachers, through Hyperdocs where teachers’ planning is made visible to children. In case there’s a power outage or videos and WhatsApp calls get cut off, children have an idea of the outcomes expected and can take their learning further themselves until they can connect back. In terms of learning loss, the gaps are larger for younger children who need the physical environment to develop cognitive skills associated with a motor region of the brain. That’s something our school systems will need to catch up on once things resume.

Innovating to Mitigate Losses

So how do we, as parents, teachers, or just caring adults mitigate these kinds of losses? For Shekhar, the solution is to create a national initiative to ensure children’s protection. His project, fortunately received approval from the ministry just before COVID-19 hit India, serves as an integrated resource on child protection, mental health, and psychosocial care. They are already working to support frontline workers, equipping them with first line responses for children with anxiety, and conducting simple mental health interventions. They are also providing simple materials that any service provider or parent can use to assist children across socio-economic classes. We need to think about how to repurpose education, parenting, and organisations so that communities can come together, while maintaining social distancing, to have some time in the day that serves as a break and a kind of healing space, says Vishal. COVID-19 has ruptured our existing world, but we need to see this altered environment as an inflection point where new structural scaffolding can be erected.

Deepika explains that EkStep has built up the digital infrastructure for learning which is currently being used by the government as the school education platform, DIKSHA. But when the pandemic hit and schools shut down, they had to navigate how to scale infrastructure for the nation to enable access anytime and anywhere, with whatever children had access to. Therefore, the thought process is centred around the idea of coherent access, resulting in governments across the country creating time tables and streaming learning content on television. The same content is also available on the DIKSHA platform, in case students want to come back to it later. From March onwards, they have also seen over 400 million learning sessions across the country. So something shifted when accessibility opened up from school to anytime and anywhere. Very often, children may not get access to devices until late in the evening, when one parent who has access to a smart phone is able to provide it to them. In spite of constraints like this, there has been a shift in attitude, mindset, acceptance – that we will learn, no matter what comes our way.

There’s a lot of innovation in this regard, not just from EkStep but from communities as well. In Bangalore, a group called Gubbachi learning centers, had physical learning centers and worked with communities to bridge children who were unable to go to regular schools. But with the pandemic, those school centers have disappeared along with the families who have returned to their home states. So today, they make learning happen by sending worksheets over WhatsApp and then following up with calls. State governments like Karnataka, with their Vidyagama program, are also printing out and delivering learning materials with the help of community workers. There has also been a rise in informal community learning spaces, where small groups of children get together to learn, while maintaining social distancing. Parents of families who have been staying safe get together and create learning pods or bubbles to restore social interaction for children. Organisations are getting involved, working particularly with children of frontline workers, health care workers, and police personnel, since children from those communities may be neglected because their parents are out working. Studies tell us that we need to pay attention to long-term loss as well as immediate loss – if adults, school systems, and institutions try to jump back to normal and ignore this pandemic, that may also affect learning outcomes for years to come. Deepika suggests that we need to consider ideas like a reduction in syllabus and how to use digital infrastructures to level everyone up to the same place.

While it’s been heartening to see how quickly the education system was able to move content online, we also need to move interventions online. We must transfer those caring, empathetic learning spaces for children in the presence of a caring adult, using art, play, nature and ecology, to an online format. Vishal and his team’s solution for this was moving towards interventions that are contextual to the current challenge and using art and play as mediums to design interventions for children who are going through trauma and adversity.

Teachers are going through their own set of traumas and anxieties as well, especially in the affordable schools market where teachers are experiencing loss of jobs and may not have received salaries for several months. So teachers need help making sense of their own trauma before being able to help their students. In these situations, storytelling is a very strong medium, which is also in use in the happiness curriculum work that Vishal does with the Delhi government. Parents can give a missed call to the number and receive a message with a story which the whole family can sit together to listen to and discuss. The goal is to create community spaces for meaningful social interaction. We need to be thinking about how we, as a society, are going to build new narratives for our children, to help them come together and move forward.

An Opportunity to Build Resilience

What we’re seeing today from parents is a lot of anxiety, says Vishal, and solutions coming from a place of anxiety are not going to work for our children. We need to pause and come to terms with the trauma that we have all been experiencing in the last six months, before we begin to think about solutions. We need to start changing our approach to the situation. For example, one of the key mindset shifts that we’re talking about is learning loss. But if we look at it differently, this is one of the most important life lessons that children will experience. How are we helping our children make sense of this new reality that they are living in now, which might actually continue if the climate crisis continues? Instead of looking at this just in terms of academic learning loss, Vishal suggests expanding our thinking and creating spaces for children where they can talk about what they’re going through and process their feelings during this difficult time. Many organisations have set up mental health helplines for children, to give them the space to talk about their distress. It’s not necessary to provide solutions, but rather listen, validate, and acknowledge how they feel.

Resilience is always called upon in the context of adversity, says Shekhar. Although children’s resilience is based on their innate temperament, it is also triggered by their exposure to adverse childhood experiences and how a child experiences their caretakers and peers dealing with conflict. Unfortunately, parents’ and teachers’ relationships with children are often based on a culture of instruction, expectation, and obedience, rather than a culture of conversations. Shekhar suggests that we need to bring conversation back into our relationships with children, communicate what your concerns might be, and truly hear their responses. We need to bring in more openness and transparency, and rebuild trust between the generations.

In addition to transparency, Vishal also argues that we need to invest in an adolescent agency, life skills, and the capacities to respond to the complexities of life. Over the course of this pandemic, we’ve seen many young people who have become volunteers with the government and in their communities, they have thought of solutions, set up camps and parent pods, and have taken on the income earning needs of the family and supported their own parents’ mental health crisis. So we need to trust adolescents because they have agency, skills, and the capacities to deal with ambiguity, possibly better than adults, because they’re still building those faculties. If we can re-purpose education from old notions of academics to notions of life skills and social-emotional learning capacities, then when crises emerge, adolescents will have much better capacities to respond.

While learning loss is a reality, children out of school environments are also experiencing a loss of relationships and interactions. Kavita notes that parents can help stem this in two ways – play and reading. Play can happen at different ages whether it’s physical play, board games, creating videos, etc. Play has many definitions because it’s a big part of relationship building. Reading is also something which truly builds empathy and contemplation, and quiets the mind. Once the distance learning is done, Kavita suggests leaving the devices at the door and creating the space for reading. Pandemics like this have an unequal impact on the most vulnerable and so Shekhar asks us to reassess our systems going forward and seek out innovation and pedagogies that might bridge these inequities. If we look at our public health system, it is focused on infectious diseases and rightly so, but the anxiety and uncertainty that COVID-19 has generated is also an epidemic. There are also other ongoing epidemics such as domestic violence and child abuse, all of which are coming into sharp focus now.

This pandemic is forcing us all to learn, as human beings but also as systems. It’s an opportunity to renew, learn, and push new ideas like critical thinking and social-emotional learning. We must intentionally create new narratives that are filled with kindness and empathy. In terms of our children, we need to repurpose social spaces and re-establish a culture of conversations with them. Our consciousness is nothing but stories, says Shekhar. So we need to build these narratives with a special focus on children’s social and emotional growth. Children are natural learners, they will learn anyway but it is their social and emotional world that is of paramount importance. So we need to encourage a culture of conversation in the home and outside, so that children are not afraid to speak up, to be heard, and allow them agency. We have a long journey ahead of us, and we need to replenish ourselves so that we can help children replenish themselves.