Urgently revive children’s support services

Providing nurturing, supportive relationships in safe spaces will go a long way in enabling young children’s development and fostering resilience in the face of the COVID-19 crisis, said Lizette Berry, a researcher at the Children’s Institute at the University of Cape Town (UCT). Berry was speaking in the wake of National Child Protection Week, which ended on 7 June.

This year’s theme, “Let us all protect children during COVID-19 and beyond”, is a reminder of the challenges affecting the country’s youngest, most vulnerable and most invisible citizens, particularly during lockdown.

Part of that care and support includes early childhood development centres – these should be “urgently revived” at community level at this stage of the pandemic. Social workers and other social service practitioners must be made available, especially to address parental mental health risks and stressors prevalent in families experiencing ongoing and multiple adversities.

Meaningful and holistic support to families is essential in times of crises, said Berry.

She said that after President Cyril Ramaphosa’s announcement of the national lockdown from 27 March, all early childhood development centres and learning programmes were shut down, along with the rest of the country. All forms of social and support services to children and families were also suspended.

“This saw millions of young children being ‘locked down’ with their parents or primary caregivers, many of whom were faced with escalating financial challenges, job insecurity and food shortages.

“For many, the focus was on survival and ensuring that all family members had a meal each day.”

“The responsibility for caregiving was placed on primary caregivers, mostly women who did not necessarily have the resources or capacity for full-time care and supporting young children’s learning. For many, the focus was on survival and ensuring that all family members had a meal each day.”

Support for survival

Berry said that early childhood development organisations quickly recognised the need to support families with basic information and resources to care for and stimulate children while at home.

“While resources were adapted and delivered for free via mobile phone technology, anecdotal evidence suggests that take-up was low and the technology platforms problematic, particularly among impoverished, rural families.

“In addition to the emphasis on resuming economic activities, families with young children need access to social services, including cash transfer programmes, resources for early learning, health and nutrition support and prevention of food insecurity.”

The reality of the prolonged stress on families and communities also manifests in its children, with serious long-term consequences. The age group from nought to six and those in the foundation phases of schooling are the most vulnerable.

“In times of crisis, it is normal for children to feel fear, anxiety or low mood – these feelings should be acknowledged and children assisted to express their feelings in appropriate and playful ways,” Berry added.

But the long-term effects of deprivation on children creates toxic stress and lifelong problems.

Toxic stress

Parents and caregivers are urged to watch for signs of emotional distress in young children following the lockdown. This may reflect in unusual behaviours – a gregarious child becoming withdrawn or children showing learning problems, delays or regressions in their development.

“Stress becomes toxic when the activation of the stress response system is prolonged or excessive,” Berry added. “So, the frequent, severe or continuous experience of an adversity, such as domestic violence, maltreatment or chronic neglect, can lead to toxic stress.”

In our context, the accumulation of adversity is a grave cause for concern, as large numbers of children experience multiple adversities at the same time.

“Stress becomes toxic when the activation of the stress response system is prolonged or excessive.”

In a recent communique, the Children’s Institute said that evidence from the Center on the Developing Child at Harvard University shows that extreme poverty, malnutrition, violence and neglect can, in the absence of care and protection, precipitate toxic stress. This can cause lasting damage to the developing brain and can lead to aggressive and antisocial behaviour.

It states: “Early exposure to adversity drives an intergenerational cycle of poverty, malnutrition, violence and ill health. For example, children who are abused or who witness violence at home are at increased risk of youth violence and of both suffering and perpetrating intimate partner violence in adulthood.”

A primary factor is the absence of a protective adult relationship to cushion the impact of the stressors on the child.

“While children also need to develop healthy stress response systems, supportive relationships, present as early as possible in young children’s lives, are critical to buffer the negative effects of stressors, which also enables the building of trust in others and lays the foundation for the development of future relationships,” Berry added.

Statistics are hard to come by, particularly those focused on children’s issues during the pandemic.

“This alone is an indicator of how young children have been mostly invisible during the COVID-19 crisis, confined to their family homes,” Berry said. “The assumed increase of gender-based and family violence under lockdown is particularly worrying, as young children may have been exposed to increased violence in their homes, likely to have negative effects on their emotional health and sense of security.”

“Younger children are at increased risk of abuse and neglect.”

Berry added that data released by Childline South Africa showed that their helpline service received nearly double the number of calls during April 2020 when compared with April 2019. The top three categories of calls received during Level 5 lockdown were requests for information about support services such as social grants and food parcels (23%), concerns about physical health (21%), and child abuse (17%).

“While these figures and the increase in calls probably reflect the immediate concerns and violations of older children trying to make sense of the hard lockdown, we know that younger children are at increased risk of abuse and neglect and are more vulnerable to the negative effects of poverty and deprivation.”

Access to support

Parents and caregivers should look for signs of emotional distress. Usually these are demonstrated in behaviours that are not typical for the child, for example, an outgoing child may become more withdrawn,” said Berry. “Young children may act out and display violent or challenging behaviours.”

Building resilience in families is essential. Parents and caregivers should reach out for support should they need assistance during this unprecedented crisis.

“One hopes that the intensity of the hardship experienced by the most under-resourced communities, as a result of hard lockdown, will be relatively short lived. While we will experience the effects of COVID-19 and the resultant measures to curb it well into the future, I am hopeful that families and the children that they support, will develop enough resilience to withstand the shocks of the current crisis.

“If robust support measures are put in place rapidly and responsively, families and community structures may have the opportunity to recover and rebuild its resources.”