The vast majority of infants and a plurality of toddlers in Massachusetts live in child care deserts, new state data show. Despite the recent increases in early education system capacity, sizeable gaps remain between available seats and the overall number of children, and program capacity falls short for tens of thousands of young children in each early education age group across the state.

Around 59,000 (70 percent) of infants, around 43,000 (43 percent) of toddlers, and around 10,000 (5 percent) of preschoolers in Massachusetts live in an access desert. The state defines this as areas where for every three children there is only one child care slot, though there are regions particularly in central Massachusetts where the ratio is greater than ten children to one slot.

Enrollment differences between regions, student age groups, and income levels paint a picture of a system struggling to meet potential demand and that is most available to those at the highest income brackets.

“We know the need is considerable, so we know that growth is good, but it doesn’t tell us whether or not that growth is particularly responsive to where child and family need is perhaps strongest and greatest,” Tom Weber, executive director of the Massachusetts Business Coalition for Early Childhood Education, said at a recent  focused on improving early education data practices. “Or is it in fact responsive to other environmental factors, like the rules and policies that we put in place or where we have decided presently to concentrate our public funding?”

The data were presented at the second meeting of the Data Advisory Commission on Early Education and Care, an entity created in the state budget signed in July 2024 to better understand the gaps in the child care landscape. Comprised of state, education, and business leaders, the commission’s goal is to improve the quality of data collection on child care needs, figure out how best to use it, and make sure the public has access to it.

Coming out of the peak of the Covid pandemic, which shuttered centers and placed much of the child care burden on parents juggling remote or essential in-person work, enrollment and capacity have been on the rise, researchers with the Department of Early Education and Care noted.

Over the last two years, the early education and care system has added about 17,000 new seats, bringing the total capacity of licensed center-based care, licensed family child care, and state-funded programs to 259,744. Care options for infants and toddlers have the fewest overall seats compared to other age groups, but their capacity has risen the most – 5 percent over the last year compared with 3 percent growth for preschoolers and 1 percent growth for school-age children.

While all regions of the state have seen increased capacity since 2023, the rate of growth slowed in central and southeast Massachusetts over the past year – regions already struggling with accessible child care. Enrollment in formal care for newborns to 5-year-olds peaks at 56 percent in the Boston area and northeast Massachusetts, with the least (48 and 47 percent) in central and southeast Massachusetts, respectively.

In families earning less than half of the average median income, 51 percent of children are enrolled in formal care. That drops to between 37 and 35 percent for families making half to 100 percent of the standard income, and spikes to 66 percent at the highest wage brackets of more than 150 percent of the standard income.

“We see the highest enrollment rates or those who have higher financial resources,” said Michelle Saulnier, a data analyst at the early education department. “This is an opportunity for us to maybe conclude that those who are in the higher income bracket may be a closer measure to parent preference and demand for enrollment in formal care,” she said.

Essentially, the families with the most resources are enrolling about two-thirds of their children in formal care, which can give education researchers clues about how many children may need spots to meet true demand.

Research published last year from Professor Jeffrey Liebman at the Harvard Kennedy School that 80 percent of families surveyed who were not currently using formal care would use it if they could afford it. Plus, 70 percent of those currently using it would use more hours if it were more affordable.

Ashley White, research director for the early education department, noted that the state collects information on child age, care type, and region for those using child care financial assistance programs. But there are still holes in data on family income, race and ethnicity, country of origin, disability status, and household language. Improvements to systematically collecting that information would bolster the data sets, White said.

The department does not currently collect data on early intervention for developmental delays, though partner groups and sister agencies focused on these interventions have some relevant data that the early education department can aggregate.

There are similar data gaps for families on wait lists for licensed programs, making it hard to gauge the demand for the different types of child care and where it would make sense to add seats.  Across the state, data on children and families is generally limited to those accessing care funded through the grant program that supports child care providers, so White said there is a need to “think creatively” about how best to gather information on education and care needs outside of the C3 program.

The state is also the family portal and case management system for child care financial assistance programs, which at the moment involves a number of different tools and applications. Some parts involve more of an open notes field, which makes it hard to capture and sort information systemically. A better digital intake process would let them collect more “granular” data, unify the experience for families, streamline care management, and improve operational efficiency.

“I think one of the wonderful things about the family portal is that it’s going to allow us to collect more information earlier in the process and have to do less verification and going back to families and asking for them to update information,” White said. “So we’ll know more initially than we ever have before.”

This first appeared on and is republished here under a .

Screen time permeates the lives of toddlers and preschoolers. For many young children, their exposure includes both direct viewing, such as watching a TV show, and indirect viewing, such as when media is on in the background during other daily activities.

As many parents will know, . As scholars who specialize in and , we are particularly interested in the recent finding that too much screen time is associated with less parent-child talk, such as .

As a result, the and suggest limiting screen time for children.

Beyond quantity, they also emphasize the quality of a child’s engagement with digital media. Used in moderation, certain kinds of media can – and even contribute to language development.

These tips may help parents structure and manage screen time more effectively.

No. 1: Choose high-quality content

Parents can enhance their children’s screen-time value by choosing high-quality media – that is, content with educational benefit. , from “Nature Cat” to “Sid the Science Kid,” that would qualify as educational.

Two other elements contribute to the quality of screen time.

First, screen content should be age-appropriate – that is, parents should choose shows, apps and games that are specifically designed for young children. Using a resource such as allows parents to check recommended ages for television shows, movies and apps.

Second, parents can look for shows that use evidence-based educational techniques, such as participatory cues. That’s when characters in shows break the “fourth wall” by directly talking to their young audience to prompt reflection, action or response. that children learn new words better when a show has participatory cues – perhaps because it encourages active engagement rather than passive viewing.

Many classic, high-quality television shows for young children feature participatory cues, including “,” “,” “” and “.”

No. 2: Join in on screen time

The that whenever possible.

This recommendation is based on the evidence that increased screen media use can reduce parent-child conversation. This, in turn, can affect . Intentionally discussing media content with children increases language exposure during screen time.

Parents may find the following joint media engagement strategies useful:

• Press pause and ask questions.
• Point out basic concepts, such as letters and colors.
• Model more advanced language using a “think aloud” approach, such as, “That surprised me! I wonder what will happen next?”

No. 3: Connect what’s on screen to real life

because their brains struggle to transfer information and ideas from screens to the real world. Children learn more from screen media, research shows, when the content connects to their real-life experiences.

To maximize the benefits of screen time, parents can help children connect what they are viewing with experiences they’ve had. For example, while watching content together, a parent might say, “They’re going to the zoo. Do you remember what we saw when we went to the zoo?”

This approach promotes language development and cognitive skills, including . Children learn better with repeated exposure to words, so selecting media that relates to a child’s real-life experiences can help reinforce new vocabulary.

No. 4: Enjoy screen-free times

Ensuring that a child’s day is filled with varied experiences, including periods that don’t involve screens, increases language exposure in children’s daily routines.

Two ideal screen-free times are mealtimes and bedtime. Mealtimes present opportunities for back-and-forth conversation with children, exposing them to a lot of language. Additionally, bedtime should be screen-free, as using screens near bedtime or having a TV in children’s bedrooms .

Alternatively, devoting bedtime to reading children’s books accomplishes the dual goals of helping children wind down and creating a .

Having additional screen-free, one-on-one, parent-child play for at least 10 minutes at some other point in the day is good for young children. Parents can maximize the benefits of one-on-one play by letting .

A parent’s role here is to follow their child’s lead, play along, give their child their full attention – so no phones for mom or dad, either – and provide language enrichment. They can do this by labeling toys, pointing out shapes, colors and sizes. It can also be done by describing activities – “You’re rolling the car across the floor” – and responding when their child speaks.

Parent-child playtime is also a great opportunity to extend interests from screen time. Including toys of your child’s favorite characters from the shows or movies they love in playtime transforms that enjoyment from screen time into learning.

This article is republished from under a Creative Commons license. Read the .

It had only been a year since Estelle Sievert and her wife, Jane, joined the foster care program at in Austin when they were introduced to 3-week-old Noah in 2022.

The couple immediately fell in love with their soon-to-be adopted son but knew the future might contain some challenges. The infant’s biological parent had a lifetime of severe mental illness compounded by years of using methamphetamines and PCP that went unaddressed, and show that trauma and mental illness can be passed down through generations.

This meant the early stages of this child’s life could be the key to ensuring a healthy physical and mental future.

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“We wanted to take a proactive approach to parenting to set him up with skills from very early on to identify emotions and validate his feelings,” Sievert said. “Kind of preparing for whatever may come down the line.”

Among the resources the couple found was Austin-based Mainspring Schools, a child care center that has built a nationally recognized mental health program for children as young as infants and toddlers.

Although a focus on mental wellness for infants, toddlers, and kindergarteners started to develop about 30 years ago, a growing number of child care centers, such as Mainspring, are emphasizing mental health as much as literacy in their curriculum — that the ability to is equally crucial to school success as learning to read at an early age.

Additionally, Texas officials — after lagging behind other states such as Arkansas and Colorado for decades — are starting to study the current state of early childhood mental health care in Texas to determine the best way to create a statewide mental health system for the state’s youngest residents — an effort driven in large part by the COVID-19 pandemic.

While the pandemic accelerated incidents of mental health concerns, rates of childhood mental health challenges and suicide had been rising steadily for at least a decade before and have only.

In Texas, more than 500,000 children were diagnosed with anxiety or depression in 2020, an increase of 23% since 2016, according to a on child and youth behavioral health.

Seventy-one percent of Texas youth with mental health issues will go untreated, compared with the national average of 61.5%, due in part to a severe shortage of child and adolescent psychiatrists in the state. Jarring statistics like these point to the necessity for early identification and intervention in facilities that touch the most children at very young ages — child care centers.

In partnership with nonprofits like United Way, grassroots organizations do much of the work in early child care mental health, a feat that has impressed the most ardent supporters of children’s mental wellness.

“You will hear people say, ‘Oh c’mon, it’s just child care,’ but no, it’s so much more. This can alter the direction of these kids’ lives,” said Colin Denby Swanson, executive director of Mainspring Schools.

Mental wellness in toddlers

While it’s too early to tell if Noah has inherited mental illnesses, he can become overwhelmed in certain everyday situations. The Sieverts found that a traditional day care setting was too intense for their child.

However, finding a preschool or day care that fits those needs was more complex than expected.

“We learned quickly not all day cares are created equally,” Sievert said.

Mainspring Schools, where Noah has been enrolled in since early 2023, prepares children ages 6 weeks to 5 years old for success in school through early education and mental wellness. This includes specializing in designed to help children who have experienced adversity. Children with these needs often have trouble trusting adults, which frequently leads to perplexing behavior at a young age.

Mainspring Schools tries to address this issue through monthly family dinners and weekly family support nights, where the children and their parents can form a relationship while receiving parenting advice from licensed professionals. The school also has a low child-to-teacher ratio of four to one, allowing for more detailed learning and observation.

“We wanted a program that didn’t use the traditional punitive punishments for children,” Sievert said. “Mainspring School shared the same language that we used at home and understanding of support we felt was needed. We are already seeing the results of this work.”

At 1 or 2 years old, understanding and managing one’s behaviors and reactions becomes critical. At 2 to 3 years old, a child with good mental health will continue to interact with people and build healthy relationships, including copying what other people say and do — a primary reason why young children and their parents can benefit from a robust mental wellness program in a child care center, said Barbara Grant Boneta, director of the Success by 6 coalition, a childhood wellness program in Travis County.

“We are almost teaching adults how to allow children to be children again. We are focusing on forming a loving relationship and giving kids time and space to have big feelings and help them label those feelings,” Boneta said.

This is a change to the child-rearing process where literacy and education at an early age were given priority in child care facilities and preschools. Studies have found play and good mental health are just as key to success in school later on in life as much as literacy does.

“The two can go hand in hand,” Boneta said. “It’s one of those things you want to infuse throughout the curriculum.”

The pandemic’s impact

Boneta said trauma-informed care programs like those at Mainspring Schools doesn’t need to be limited to families who have dealt with severe trauma, since the COVID-19 pandemic’s effect on young children is still being studied.

“Families were stressed, and it was a pressure cooker, and children could not form relationships,” Boneta said. “Some of these preschoolers and kindergartners never got to go to a library or gymnastics class before entering elementary school. They missed out on key experiences.”

Children born during the pandemic scored lower in gross motor, fine motor and social-emotional development than before, according to a Columbia University . Children with poor or underdeveloped social and emotional skills display more challenging behavior, including anger, withdrawal, anxiety, and aggression.

Additionally, since the onset of the pandemic, fewer toddlers and young children have been receiving . Underidentification could increase referrals in elementary schools in the next few years.

The pandemic shuttered many child care facilities, making it hard for parents to find programs like Mainspring Schools, said , founder of the Center for Youth Wellness and former Surgeon General of California, when she visited Mainspring Schools last month.

In 2023, the University of Texas at Austin’s Texas Institute for Excellence in Mental Health attempted to from state programs and organizations implementing trauma-informed care to infants and early childhood. What they found was that there was no universal understanding of Texas’ approach to delivering infant and early childhood mental health care, meaning it currently looks different from community to community.

“This is precisely the type of program I was talking about when I said there were solutions to adverse childhood trauma, and it can make all the difference in the world,” Harris said. “We need to ask ourselves how we can all play our part as a community because if we address this in our children, we can transform the outcomes of entire communities.”

Texas’ progress

The state of Texas is ready to listen. In 2023, the federal government the state $16 million a year until December 2025 to address the gaps in its early childhood system, which were made worse by the COVID-19 crisis.

This has led to a partnership between UT-Austin’s mental health institute and the Texas Workforce Commission to analyze the landscape of infant and early childhood mental health and present recommendations for a state system. The institute’s researchers 14 states and nine Texas child care stakeholders and conducted two surveys of statewide early childhood programs to determine the best way to create a statewide toddler and early childhood mental health care system in light of the COVID-19 pandemic.

The Texas Legislature also directed the to develop a children’s mental health strategic plan to be published Dec. 1. The plan will cover children from birth through 17 years of age.

These efforts will complement the state’s Early Childhood Intervention program, which supports families with children from birth through 35 months of age who have disabilities or delays in any area of development, including social-emotional development. The program offers counseling, behavior intervention, occupational therapy, social work, specialized skills training and case management.

Although Texas has no statewide effort, many states for decades have used infant and early childhood mental health consultants as a critical component of their continuum of care, especially for children from birth to 5 years old.

primarily work in homes or in early childhood education settings with the adults in the young children’s lives to build their capacity to support their child’s healthy social and emotional development — before formalized intervention is needed.

Arkansas has a statewide program established in 2004 and overseen by the University of Arkansas School of Medical Services. The university provides all training and supervision to consultants across the state.

Colorado’s Early Childhood Mental Health Consultation program focuses on building a qualified workforce by investing in higher education pathways, such as the Colorado State University School of Social Work’s mental health consultant program.

Connecticut is the national leader in infant and early childhood mental health consultations. Established in 2002, it was the first state to standardize its state program model, which is overseen by a nonprofit organization called Advanced Behavioral Health.

Workforce strain

To achieve a statewide program similar to what other states have created, Texas officials must develop a workforce for this specific field.

The American Academy of Child and Adolescent Psychiatry that the country needs 47 child and adolescent psychiatrists per 100,000 children. In Texas, there are roughly 10 CAPs per 100,000 children, illustrating the dire state of youth mental health services.

“There isn’t a lot of funding available, and you got to be trained in this and have the education around this, and unless you are in a place that can give you that training, it can be hard to get into the industry,” said Boneta.

Meanwhile, child care centers, where many of these youngest Texans can receive mental health services, have struggled since the COVID-19 pandemic.

About one-third of Texas child care centers and homes closed at some point during the pandemic, according to the Bipartisan Policy Center.

This is due to the cost of running a child care facility.

More than 75% of Mainspring’s students receive need-based tuition subsidies or scholarships, but state and federal reimbursements through programs like Early Head Start and the Texas Workforce Commission cover less than half of that amount.

“For a program like Mainspring, the cost is about $2,100 to $2,400 per child per month,” said Swanson, executive director of Mainspring, which has an annual budget of $2.3 million “We rely exclusively on grants and individual giving to support the family services piece.”

The Texas Legislature has attempted to address the child care crisis by allowing cities and counties to exempt specific child care centers from some or all of their property taxes, but local governments have been slow to adopt the exemptions.

In addition to a full property exemption for child care centers, Travis County leaders are allowing voters to determine in November whether to create a 2.5 cent property tax hike to infuse $75 million into child care.

“This is a once-in-a-lifetime opportunity to address child care in our county and support the mental health services needed here,” Aaron DeLaO, vice president of impact for United Way for Greater Austin, said about the tax initiative. “We are on the cusp of being able to address generational trauma in our communities.”

Noah just turned 2 years old this year, and the Sieverts and Mainspring Schools are starting to work on his emotional regulation and finding out how important it is for parents to model behaviors.

For the family, there isn’t an age too young or too old for mental wellness education.

“It makes just as much sense to them as anything else we are telling them at that age,” Sievert said. “So why not start talking earlier about mental health and just identify feelings and how to deal with them?”

For 24/7 mental health support in English or Spanish, call the Substance Abuse and Mental Health Services Administration’s at 800-662-4357. You can also reach a trained crisis counselor through the by calling or texting 988.

Disclosure: The University of Texas at Austin has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete .

This article originally appeared in , a member-supported, nonpartisan newsroom informing and engaging Texans on state politics and policy. Learn more at texastribune.org.

The Federal Food and Drug Administration on Friday authorized both Moderna’s and Pfizer-BioNTech’s vaccines for children as young as 6 months old — meaning COVID shots for the last age group of Americans without access may be just days away.

The vaccines now await sign-off from the Centers for Disease Control and Prevention, the final step before children under 5 can begin rolling up their sleeves. The White House expects providers to begin administering doses on Tuesday, immediately after the federal Juneteenth holiday.

On Wednesday, an FDA panel of experts — made up of pediatricians, infectious disease experts and vaccine researchers — voted 21-0 in favor of both vaccine options.

“There are so many parents who are absolutely desperate to get this vaccine, and I think we owe it to them to give them the choice,” said committee member Jay Portnoy, a professor of pediatrics at Children’s Mercy Hospital in Kansas City, Missouri.

Philip Chan, medical director for the Rhode Island Department of Health, called the panel’s unanimous vote a “major milestone in COVID prevention.” His state is ready to distribute the shots as soon as they receive the all clear, he said.

“We’ve pre-ordered thousands of [doses], and we expect them to ship within 24 or 48 hours after the FDA issues the EUA” (emergency use authorization), he told The 74 Wednesday. With EUA now granted, the COVID shots should soon be on their way.

Parents who are eager to finally vaccinate their young children took advantage of the public comment period at the FDA’s Wednesday committee meeting to urge advisors to recommend authorization. Michael Baker, the father of a 1 and a 3 year old, described the tough choices he has had to make to protect his children from the virus. He shared a slide of all the events they have missed out on during the pandemic, including weddings, holidays and funerals.

“All I am asking is now that … I have the choice to vaccinate my children, [that] I have the choice to do it in the most timely fashion possible,” he said to the committee.

Parents like Baker awaiting vaccines for their little ones have been on a months-long rollercoaster that has repeatedly raised their hopes only to later send them crashing down. In late February, Pfizer-BioNTech first submitted a request asking the FDA to grant emergency authorization for a two-dose regimen of their vaccine for children 6 months to 4 years old, only to then withdraw the application just five days later. Then in April, when Moderna was on the verge of submitting its EUA application for the age group, the FDA postponed the committee review process until Pfizer’s shots were also ready.

Just 29% of children 5 to 11 years old and 59% of youth 12 to 17 years old have so far received two vaccine doses, according to data from the American Academy of Pediatrics. 

However, Katelyn Jetelina, creator of Your Local Epidemiologist, wrote in her hyper-popular newsletter that parents of young kids should still take COVID seriously and vaccinate their children.

“The rate of severe disease is lower compared to adults, but this is an inherently flawed comparison because kids don’t die as often as adults. Since the beginning of the pandemic, 442 children aged 0-4 years old have died from COVID-19. If we compare to other vaccine preventable diseases among children, deaths due to COVID19 are highest. We cannot become numb to these deaths,” she explained.

COVID cases across the U.S. are finally leveling off after a springtime surge fueled by an Omicron subvariant spurred bumps in pediatric infections and hospitalizations through the final weeks of the school year.

You can view the FDA’s and watch the full recording of its June 15 vaccine advisory committee’s virtual meeting:

The Food and Drug Administration April 29 that it will reserve the dates June 8, 21 and 22 for its vaccine advisory committee to review the emergency use authorization requests of Moderna’s and Pfizer-BioNTech’s coronavirus shots for toddlers. While the dates remain subject to change, they provide an indication of when doses may be available to those under 5, as the FDA typically follows the recommendation of the committee in the weeks following its meeting.

Members of Congress sent a to the U.S. Food and Drug Administration Monday asking whether the agency intended to delay reviewing Moderna’s coronavirus vaccine for children 5 years old and younger and for “the scientific basis and any other rationale” for such an action.

The move comes after White House officials told last week that young kids, the last age group not yet eligible for coronavirus vaccines, will likely have to wait until the summer for immunizations — a longer timeline than previously expected.

Although Moderna completed the trial for its toddler vaccine in late March and submitted a on Thursday, Anthony Fauci said that the FDA is considering reviewing the pharmaceutical company’s application at the same time as Pfizer-BioNTech’s, which has not yet been submitted.

“[The] two products … are similar but not identical, particularly with regard to the dose. And what the FDA wants to do is to get it so that we don’t confuse people to say, ‘this is the dose. This is the dose regimen for children within that age group of 6 months to 5 years,'” President Biden’s chief medical advisor on Thursday.

“Such a decision could delay the potential authorization and administration of the Moderna vaccine by several weeks,” points out Rep. James Clyburn, chair of the House Subcommittee on the Coronavirus Crisis, in its letter to the FDA. The committee asked for a staff briefing on the subject by May 9.

In early February, Pfizer-BioNTech submitted data on a two-dose vaccine series for children under 5 to the FDA, but in a highly unusual move withdrew their application just 10 days later. The two shots, which are 10 times less potent than the companies’ adult doses, were safe for all age groups, but did not provide enough protection against the Omicron variant for 3- and 4-year-olds. Pfizer-BioNTech now plans to request that the FDA authorize a three-dose regimen for children under 5, the companies have said.

The Moderna series currently submitted for review includes two shots that are each one-quarter the dose adults received. Trial data showed shots to be 44% and 38% effective in preventing illness among children 6 months to 2 years old and 2 years to under 6 years old, respectively.

But despite the relatively low efficacy, many parents of young children are anxious for a base level of protection for their kids, especially as mask mandates and social distancing requirements continue to fall across the country. 

For some, the idea that the FDA would delay the Moderna shots on parents’ behalf — ostensibly to avoid confusion — struck the wrong chord.

“If I sign a waiver saying ‘I don’t find this confusing at all,” can I go ahead and get the vaccine for my four-year-old?” parent and New York Times writer Whet Moser .

Meanwhile, a Tuesday report from the Centers for Disease Control and Prevention revealed that more than half of Americans have been infected by the coronavirus, including . Rates of prior infection nearly doubled over the course of the Omicron surge, the agency found.

Jennifer Shu, an Atlanta-based pediatrician, agrees that if doses are ready for emergency use authorization, Washington should not delay the rollout. After all, vaccines from separate companies were approved at different times for other age groups, she pointed out.

“If it’s ready to go, if the science has proven that the vaccine is safe and effective, then why not let the parents educate themselves on it?” she told The 74, adding that health professionals like herself can help families make an informed choice.

Parents of kids under 5 may feel they’re being “thrown under the bus” as pandemic precautions dwindle and the BA.2 Omicron subvariant threatens, said Shu.

But despite thousands of families eager to vaccinate their toddlers, still more are likely to pass on the opportunity when it becomes available. 

Immunization rates remain relatively low for older kids and teens with 28% of 5- to 11-year-olds and 58% of 12- to 17-years-old fully vaccinated as of April 20, according to the . New immunizations have slowed nearly to a halt, with vaccine coverage having increased only 1 percentage point in each age group since mid-March.

Even as vaccination rates are flatlining, Pfizer-BioNTech is planning to seek authorization for a third booster shot for kids 5- to 11-years old after trials found that it offers added protection against the Omicron variant.

In early March, a pandemic celebrity best known for advocating that schools should move toward a pre-COVID normal wielded her weapon of choice, arguing in The Atlantic that lifting mask mandates for all but the youngest students is “.”

Emily Oster laid out what she, and many others, understood to be the situation at hand in her opening paragraph: “Although the CDC recently moved to relax COVID guidelines, it continues to recommend universal indoor masking in early-childhood-education programs for those ages 2 and older.” 

The CDC’s coronavirus for child care providers, last updated Jan. 28, lists a number of “key takeaways,” including that the agency “recommends universal indoor masking in [early childhood education] programs for those ages 2 years and older, regardless of vaccination status.”

But in a surprising twist, about a week later, the Brown University economist posted an update on her Instagram story.

“After my piece in @theatlantic last week, the CDC emailed me to let me know they DO NOT recommend masking for toddlers in areas with low or moderate transmission. Toddlers’ masking recommended to align with everyone else,” she wrote. “They are struggling to get the message out so maybe this will help!”

“I realize that seems a little crazy, but I am telling you that is the email I received from a senior person at the CDC.”

The federal agency has a yellow banner at the top of its that says the CDC’s latest recommendations “align precautions for educational settings with those for other community settings.”

“That banner … is intended to replace all of the information that is below it in the bullets that say that kids should still be masking,” Oster said in an Instagram video.

In late February, the CDC made major news when it replaced its previous recommendation that all schools require universal masking, stipulating instead that classrooms could now go mask-optional when community COVID rates were low or moderate, the current virus level across most of the country.

But without a vaccine available for those younger than 5, Oster and many others understood the guidance to apply only to K-12 schools, not early child care and pre-K programs. The CDC is “easing its recommendations for wearing masks in indoor K-12 settings,” the Los Angeles Times .

But in fact, the guidance was meant to apply to all educational levels, including those under 5.

In a Thursday email to The 74, the CDC confirmed that “recommendations for masks in K-12 schools and early care and education (ECE) programs are consistent with recommendations for other community settings.” 

“Children ages 2-4 have a lower risk of severe disease from COVID-19 and parents of children in ECE programs as well as ECE staff can make appropriate choices about mask wearing in school settings based on local requirements and their personal levels of risk,” wrote spokesperson Jade Fulce.

She did not explain why it has taken the agency several weeks to update its website, but said they would make the information available “as soon as possible.”

To New York City parent Daniela Jampel, whose 4-year-old daughter has continued masking while her older sister goes to school face exposed, the delay is unacceptable.

“It’s ridiculous,” she said. “The CDC is having trouble updating its website so they reach out to Emily Oster?”

“Their website on this issue should not be left to interpretation. It should be very clear,” said Jampel, an early advocate for amid remote learning and now an outspoken critic of the city’s decision to leave masking in place for preschoolers.

Oster agreed that the unconventional communication method underscores the widespread confusion on the issue, but clarified that the CDC did not contact her asking her to spread the word about their policy. Rather, they were correcting what they said was inaccurate information in her Atlantic piece.

“They weren’t like, ‘Oh, by the way, it would be great if you could share with people this information,’” Oster told The 74. “They just said, ‘Everybody should already know this.’ But I think it’s pretty clear looking at … how people responded that they have not managed to make that clear.”

Several parents, mostly in blue states like New Jersey, Connecticut and Illinois, responded to Oster’s update saying that their child care provider was still requiring masks, said the professor.

“I showed this (post) to my provider,” many parents wrote, and in response were told, “Well, if the website still says that masks are required, that’s not our interpretation of what that banner is.”

“There is a fair amount of people looking to this guidance and trying to interpret it and the way that it is currently stated is extremely difficult to interpret clearly,” said Oster.

The confusion extended to The Atlantic itself, which did not immediately update Oster’s original column to reflect the CDC’s clarified guidance after Oster received the agency’s email. In a follow-up interview with The 74, Oster said she corresponded with her editor, but because the CDC had made no official announcement on how to interpret the vague website, the outlet decided not to alter its story at that time.

“[The fact-checker] read the banner at the top, but then everything below it still said there should be masking,” she said. “It went under the radar.”

However, after this story first published and The 74 requested comment from The Atlantic, Oster’s piece was updated Thursday night to reflect the disconnect in the CDC’s guidance between the banner and the information below it.

Many early childhood education providers nationwide continue to require universal masking for 2- to 4-year olds.

Head Start, a federal school readiness program serving over 800,000 children from low-income families each year, 2-year-olds and up to wear face masks indoors, although in a Jan. 1 ruling, a U.S. district judge on the program’s rule in 24 states, mostly Republican. In the remaining 26 states, even those that long ago lifted their school mask mandates, participating toddlers are still required to cover up.

New York City Mayor Eric Adams cited hospitalization data when announcing earlier this month that the country’s largest school district was lifting its K-12 mask mandate but keeping the rule for 2- to 4-year-olds.

“When you look at those under 5, they were more likely to be hospitalized,” Adams . “People wanted to say, ‘Let’s lift it across the board,’ but that’s not what the science was showing us.”

Masking in early child care settings is associated with a in program closures due to virus outbreaks, according to a recent study from doctors at Yale University. But the data were collected during the early months of the pandemic before vaccines were available to staff.

And while federal data show that hospitalizations for children under 5 did spike during the Omicron surge, an outsized share of that uptick was driven by newborns not yet 6 months old, who the masking guidance does not apply to anyway.

Meanwhile, COVID cases in Europe are , fueled by a more transmissible Omicron subvariant. Even as infections continue to , many experts warn that the increases across the pond could foreshadow a coming wave in America.

Jampel, despite frustration with the CDC’s haphazard rollout of its guidance for toddlers, doubts whether more clarity would impact the rules affecting her family. 

“New York City schools have done many things that go far beyond what the CDC recommends,” she said. “I’m not convinced that it’s the CDC holding us up, and I’m not convinced that a CDC change will mean that our political leaders will take notice and change their policies.”

Neither the Department of Education nor the Department of Health immediately responded to requests for comment.

Steven Barnett, co-director of the National Institute for Early Education Research, said the two key questions on the issue are “What are the health benefits from masking young children?” and “What are the developmental consequences?”

“The problem with trying to be an expert on this issue is that there is very limited science on which to base conclusions,” he told The 74 in an email. “With respect to the health benefits, the known risks to young children from infection are quite small but this is a novel virus with unknown long-term risks.”

“All this leads me to think,” he continued, “that masks for young children may be prudent when there is a high rate of community transmission” — a conclusion that lands him in alignment with the now clarified CDC guidance.

But with all the CDC’s communication glitches along the way, Oster worries it will impact the public’s faith in the agency, which has been shaken several times throughout the two-year pandemic.

“This erodes trust,” she said. “If people are trying to trust the CDC, they’re trying to listen to them, when the messaging is confused in this way, or incomplete in this way, it makes people less likely to pay attention to the CDC.” 

Although it’s been a while for anyone reading this article, try to imagine all that it takes to go from being an infant lying on a blanket to being a little human who can flip over, rock back and forth, engage your core, take off and crawl to that dog bowl that’s just out of reach. Then to pull up, stand and finally take those first wobbly steps? What an astonishing achievement.

Those first steps are more often the side-to-side lurch best known to drunken sailors and adults navigating icy patches, but with practice, babies’ movement becomes more efficient and coordinated. They’re able to cover some ground; over time, they learn to navigate their environment in ways mere crawlers could never imagine. Today the dog dish, tomorrow the world!

Though a long-standing body of research and caregivers’ empirical observation shows that infants’ walking skill improves with time spent walking, researchers with New York University’s wanted to learn more about the factors that influence the development of walking skill.

They found that, even though the amount of time elapsed since a baby begins walking is a strong predictor of their skill at walking, other factors also affect how quickly infants progress in their mastery. One of the more eye-opening findings is the difference made by the amount of space a baby has for practice.

Imagine trying to learn complicated dance moves on a disco floor crowded with revelers and you’ll get some sense of the challenges for a baby staggering into their first attempts to get from Point A to B.

“If an infant learning to walk doesn’t have the physical space to practice, whether it’s a crowded home or their day care, that can affect how quickly they develop their walking skills,” says New York University doctoral candidate Christina Hospodar, lead author of “Practice and Proficiency: Factors that Facilitate Infant Walking Skill.” “Of the factors we tested, it was one of the most robust and relevant factors contributing to an infant’s walking skill.” Adjusting for all other factors, more crowded homes predicted shorter steps and wider step widths — which indicate less mature walking. More space meant the longer, narrower steps associated with being an experienced walker.

The study compared two different groups of infants from the greater New York City area. All the infants were healthy and born at term with roughly half born at Langone Health Center and half at Bellevue Hospital. Babies in the study were from 13 to 19 months old.

Caregivers brought their infants to the lab where they played for 20 minutes, then walked on a sensor-rich, pressure-sensitive that allowed researchers to track the timing and location of their steps. Step width, length and speed are traditional indicators of walking skill, Hospodar says, so these were measured along with the percentage of the session the infant spent walking, how many steps they took per walking minute, and the percentage of walking bouts that were 3 steps or less. Along with these data and basic demographic information, including the number of rooms in their homes and the number of adults and children living there, parents reported when their baby had started walking. Walking onset was defined as the first day caregivers saw their babies walk three meters across a room without holding onto anything, stopping or falling.

In what they believe is the first study to locate any factor aside from months walking that strongly predicts walking skill, the researchers found that each additional person per room decreased the baby’s walking skill by approximately one month of walking. Co-authors of the paper are post-doctoral fellow Justine E. Hoch, Do Kyeong Lee, Patrick E. Shrout and Dr. Karen E. Adolph, NYU’s Julius Silver Professor of Psychology and Neural Science. The researchers measured children’s race, ethnicity, the family’s primary language and caregivers’ education, but these sociodemographic factors didn’t hold statistical value, Hospodar says.

Ultimately, crowded environments had more bearing than other factors in the babies’ development of walking skills. The U.S. Census classifies homes as “crowded” if they contain more than one person per room. By that definition, she says, all the homes of Bellevue infants and half of the Langone infants would be classified as crowded. Previous studies found a reduction in gross motor skills among infants in crowded homes. In a different research group’s study of infant activity recruited from the same population as the Bellevue sample, only half of mothers gave their infants daily “tummy time,” essential to strengthening the child’s core muscles (again with the core!), only 34% placed their pre-walking babies on the floor and 57% reported that their babies were constrained for more than one hour a day, spending their time in equipment such as high chairs, car seats and playpens. Nearly half reported they were concerned about giving their babies unrestrained access to the floor because they feared possible injury due to the presence of other children, pets or vermin. That reluctance, Hospodar says, may be a logical explanation for why the Bellevue babies in the recent study would have a later onset age for walking.

Even within the parameters of living space, she says, individual babies respond to the challenge of walking in different ways; some choose to really go for it while others hang back. The researchers found that the babies’ weight and height did not predict their walking skill, though some studies have found that heavier babies tend to crawl and walk somewhat later than others. In other studies, factors such as race, ethnicity and socioeconomic status have been found to affect infants’ age to start walking because they’re associated with caregiving practices, such as keeping babies cradle-bound for most of their early infancy. In cultures that endorse rigorous handling and deliberate exercise, babies begin walking several weeks to months earlier than cultures without such practices, researchers say.

The transition from crawling to walking allows the infant to go farther, faster and expands their vantage point from the floor below them to the room around them, which provides endless opportunities to play and learn. The good news is that babies who’ve gotten a later start tend to catch up, though Hospodar says the research on long-term consequences is limited.

“Parents really shouldn’t get hung up on the exact age their babies start walking,” she says. “In terms of U.S. norms, typically if a baby isn’t walking by 16 months the pediatrician would be on alert — and that might just mean they need some physical therapy or early intervention services. The fact that a baby is late to start walking doesn’t necessarily mean they’re disadvantaged. There may be other factors that we didn’t study or measure, and there will always be trade-offs.

“If an infant isn’t walking yet,” she says, “maybe they’re working on other developmental skills and may be more cognitively developed than younger infants.”

Whenever they get started, once babies have the distinction of “walking,” they’re off to the races. Just make sure they have some room to roam.

The capacity to synchronize movement with another human is central to social interaction. When children jump rope, when one player passes and the other blocks, or when partners grab hands for the next round of West Coast swing, all those actions involve the ability to move in relation to one another.

Scientists have studied this “behavioral synchrony” primarily during stationary, face-to-face interactions between infants and adults, observing the matchup between facial expressions and vocalizations that make up the social dance between baby and caregiver. Drs. Justine Hoch and Ori Ossmy, postdoctoral fellows with New York University’s department of psychology, and Dr. Karen E. Adoph, NYU professor of psychology and neural science, wondered if that dance continues once the infants have begun to find their own way around the dance floor.

To find out, they set up a large playroom in their laboratory outfitted with toys, risers, slides with stairs and platforms, and observed 30 pairs of infants aged 13 months to 19 months and their mothers for 20 minutes. The mothers were instructed to play with their children as they normally would in their homes. From the moms’ and toddlers’ perspective, it was a fairly low-tech challenge. The children didn’t have to wear any monitoring devices and the mothers didn’t have to keep track of anything except keeping baby from doing a faceplant off the little slide. Behind the scenes, however, was whirring along.

Using wall-mounted and hand-held video cameras, researchers tracked mothers’ and babies’ even-miniscule movements, which were then analyzed by cutting-edge recording technology and machine-learning. The lab is among the first to document in this ultra-high-tech way what babies see, hear and do in their everyday lives, and how the input changes when infants acquire new knowledge and skills as they develop.

The lab developed , a free, open-source coding tool, to powerfully annotate this video data and founded  a secure web-based video library, now available for other scientists to use in their research on human movement.

What the researchers discovered in the mother-child synchrony study was the mother-child dyads do engage in a coordinated, related way as they moved through the playroom, though not all synchronize in the same way.

“In this lab playground environment with things to climb on and things babies maybe could fall off of, we found that moms and babies synchronize their locomotor activity,” Hoch says. “More interesting is that we found two distinct groups that accomplished that synchrony differently. One group had a leader-follower dynamic and the other had a dynamic where both the baby and the mother went away and then came back to their partner.”

The mothers and babies didn’t mirror each other’s movements, but their locomotion was coordinated and correlated, indicating that they scaled their movements to each other. Patterns of locomotion differed among the mother-child duets with about half the moms keeping pace with their infants and following whenever the child veered in a certain direction (see “faceplant” above). The other half of mom and baby duos “yo-yoed” to and from each other, with the infants doing most of the back-and-forth, often in an attempt to get Mama’s attention or just to touch base for a little dollop of social interaction. And then off they would go again.

Differences in how much the children moved and the ground they covered were not influenced by differences in age, experience or walking skills. Predictably, the babies moved much more than the mothers did and covered more ground relative to their size, with moms able to cover the territory they just galloped over with three big steps to their 30. (Some of the lab’s earlier research found that the average toddler clocks more than two and a half miles a day.)

“In general, mothers move about a third as much as their babies do,” Hoch says, “but how much they move is correlated with their babies’ movement. The best predictor of how much moms move is how much their babies move.” Baby leads, Mama follows, moving in close when they climb too high or get too close to edges. In turn, mothers sometimes take the lead in ways that expand the child’s horizons—encouraging them to take a look at this or that thing just out of their reach. “What’s over here?” “Look at this!”

In addition to supporting the theory that mothers and babies synchronize their movements, this and related studies provide a few other important takeaways, the researchers say. One is that toddlers don’t need a destination to get in motion: They just move to be moving.

“We have found that a lot of our ‘commonsense’ assumptions are just wrong,” Adolph says. “Like everyone else, we thought, ‘Well, babies move for the same reason we do. To get to a destination. And, of course, they can. But if you put toys or snacks on the floor, about half the time, they’ll just walk to the other end of the room.”

Another takeaway from observing the babies is how they play with different types of toys. “When the babies have things like a stroller or balls, a broom and rolling carts, not having their mom right there isn’t a big deal,” Adolph says. “But when the toys are manipulative, like shape sorters or a Pop-Up Pal, the babies just carry them around. When the caregivers come play with them, it depresses locomotor activity and boosts manual play.

“That’s how caregivers play with little babies. They don’t do a lot of, ‘Let’s run, run, run. Chase me!’ stuff. They’re more like, ‘What’s this? Look at this thing? What’s this called? Let’s put that shape here …’ Which is what you want if you want your child to learn manual and fine motor skills. Babies are going to learn how to run and walk and explore the larger environment without their caregiver. But to learn the toys requiring fine motor skills, they need a knowledgeable adult with them to help them discover what to do.”

Another important takeaway, Adolph says, is how adept babies are at making their own fun. Left to their own devices with just about anything they can manipulate with their hands — a building block, a crumpled piece of paper, the dog food bowl — they’re going to have fun with it whether it comes with a “Made for Babies” label or not. (This information should gladden the heart of anyone working on a holiday gift list for the 3-and-under set: Get them a set of plastic measuring cups and some nesting mixing bowls and don’t go crazy with trending toys from big name brands.)

Their paper, “Dancing’ Together: Infant-Mother Locomotor Synchrony,” proposes that both the face-to-face and locomotor synchrony that researchers have observed serve a similar function in the child’s development. They create a pathway — a scaffold — to the child’s interactions with the outside world. In coordinating face-to-face with mother or other caring adults, babies learn social skills, how to coordinate their attention with another human, how to interact with objects — how to be social beings in the complex world they now inhabit. And once they get their walking papers, whole new realms open. With Mother’s support and synchrony, they can move beyond the blanket and start investigating boundaries.

The work being done at the Infant Action Lab shines a bright light on the mother-baby social dance that gives infants what they need to make their way in the big, wide world.