In early 2022, the third year of the COVID-19 pandemic, many were debating the effects of masks and lockdowns on early childhood development.
Internet rumors abounded, including one claiming that the Centers for Disease Control and Prevention (CDC) actually lowered the standard milestones for measuring childhood development largely because of the allegedly deleterious effects of pandemic safety measures, particularly wearing masks.
One post claimed:
The CDC just quietly lowered the standards for speech in early childhood development. Now children should know [about] 50 words at 30 [months] rather than 24 [months]. Instead of highlighting the harmful effects masks and lockdowns have had on children, the CDC just lowered the bar for milestones.
The CDC just quietly lowered the standards for speech in early childhood development.
Now children should know ~50 words at 30mo rather than 24mo.
Instead of highlighting the harmful effects ?s & lockdowns have had on children, the CDC just lowered the bar for milestones. pic.twitter.com/11QraOgFbJ
— BowTiedRanger (@BowTiedRanger) February 18, 2022
The posts claim that the CDC intentionally and “quietly” lowered childhood linguistic development standards because of the supposedly adverse developmental effects lockdowns and wearing masks during the COVID-19 pandemic had on them. This was not the case.
In February 2022, the CDC and American Academy of Pediatrics (AAP) did release a statement describing updates to their developmental milestone checklists. The updates included “Adding checklists for ages 15 and 30 months; now there is a checklist for every well-child visit from 2 months to 5 years.”
Before this, in addition to checklists for older age groups, there was already a checklist for children 2 years old (24 months). That checklist is on the CDC’s website. The checklist for 24-month-olds never stipulated the number of words a child should be able to speak at that age, only that a 2-year-old “says sentences with 2 to 4 words.” (See archived versions of that same checklist from 2020 and 2017, for example.)
The CDC specified the following in its “Language/Communication Milestones” for a 30-month-old child:
Says about 50 words
Says two or more words, with one action word, like “Doggie run”
Names things in a book when you point and ask, “What is this?”
Says words like “I,” “me,” or “we”
The point about knowing 50 words was new (for any age group), and had not been part of the 2-year milestones on the CDC website prior to this addition.
According to Dr. Paul H. Lipkin who assisted with the revisions, the goal of the checklist was to identify developmental delays early. “The earlier a child is identified with a developmental delay the better, as treatment as well as learning interventions can begin,” he said. “At the same time, we don’t want to cause unnecessary confusion for families or professionals. Revising the guidelines with expertise and data from clinicians in the field accomplishes these goals. Review of a child’s development with these milestones also opens up a continuous dialogue between a parent and the health care provider about their child’s present and future development.”
It should be noted that according to the American Speech-Language-Hearing Association (ASHA), a child saying fewer than 50 words at 2 years old is a sign of a language disorder. ASHA released a statement about the updated milestones, expressing concern:
ASHA has reached out to CDC, expressing its concern about inconsistencies and urging the agency to utilize the expertise of SLPs when making changes to developmental milestones in speech, language, feeding, and social communication. In general, ASHA is supportive of efforts to help identify children earlier, but the milestones presented to parents must be evidence-based in order for families to make well-informed decisions about their children’s care.
That said, the CDC’s milestone revisions were already in development before the pandemic began, with a broad literature search underway in 2019. According to a research article detailing the process and philosophy behind the revisions, the new milestones aim to capture the 75th percentile, or what 3/4 of children are expected to achieve at a particular age, instead of the previously used 50th percentile, which was found to be less helpful for families and clinicians.
The CDC’s milestones are intended to help “parents identify autism and developmental delays in their children,” and not act as a screening tool for medical professionals. “The revised developmental milestones are written in family-friendly language and identify the behaviors that 75% or more of children can be expected to exhibit at a certain age based on data, developmental resources and clinician experience,” their news release stated.
As of this writing, no evidence has emerged that shows masking negatively affects childhood development, so the claim that the CDC intentionally obscured masking harm is incorrect. The AAP website states:
A key part of learning to communicate for a child is watching the faces, mouths, and expressions of the people closest to them. Babies and young children study faces intently, so the concern about solid masks covering the face is understandable. However, there are no known studies that use of a face mask negatively impacts a child’s speech and language development.
And consider this: visually impaired children develop speech and language skills at the same rate as their peers. In fact, when one sense is taken away, the others may be heightened. Young children will use other clues provided to them to understand and learn language. They will watch gestures, hear changes in tone of voice, see eyes convey emotions, and listen to words.
A 2021 University of Miami study also found, “Wearing a mask in school does not hinder a young child’s ability to learn language, even if they have hearing loss.”
Meanwhile, studies of the effects of a range of pandemic lockdowns on childhood development have shown mixed results. A study conducted by the Early Intervention Foundation (EIF) in the U.K. showed that the pandemic had a significant adverse impact on mostly vulnerable, low-income older children, and those who were from minority ethnic backgrounds. But the study emphasized that more research was needed on the effects of the pandemic on childhood development for children aged 0–5 years.
A number of studies by an international consortium of researchers from 13 countries, including from the University of Oslo, the University of Göttingen, and University of Applied Sciences and Arts Western Switzerland, looked at the effects of COVID-19 lockdown on early development. Shortly after isolation began in March 2020, parents were asked to fill out questionnaires, and then contacted at the end of the lockdown. The studies found that “despite having increased exposure to screen time during lockdown, children learned more words during the lockdown period in March 2020, relative to before the pandemic. This is potentially due to other activities that parents undertook with their children during lockdown.”
Another report on behalf of the International Society for Social Pediatrics & Child Health (ISSOP) included studies conducted across 22 countries, and a wide age range (0-18 years) and concluded that “pandemic school closure and lockdown have adverse effects on child health and well-being in the short and probably long term.”
A January 2022 report in Nature detailed how varied the data could be:
Some babies born during the past two years might be experiencing developmental delays, whereas others might have thrived, if carers were at home for extended periods and there were more opportunities for siblings to interact. As with many aspects of health during the pandemic, social and economic disparities have a clear role in who is affected the most. Early data suggest that the use of masks has not negatively affected children’s emotional development. But prenatal stress might contribute to some changes in brain connectivity. The picture is evolving and many studies have not yet been peer reviewed.
And one particular study by Brown University’s Advanced Baby Imaging Lab found that the pandemic-born babies they tested scored lower during early learning tests including for language, puzzle-solving, and motor skills. But other researchers argued that these tests were not necessarily indicative of longer term problems, and the findings are currently under revision.
While the CDC did update its checklist to include development milestones for 30-month-old children, those changes were already in process before the pandemic began. The 50-word expectation was new and did not exist in older versions of the milestones. Furthermore, there is no evidence to date that masks cause developmental delays in children, and the evidence regarding the effects of lockdowns on childhood development has been mixed, so it’s illogical to claim that the CDC obscured such information or revised the milestones due to the effects of masking and lockdowns. Given all of the above, we rate this claim as “Mostly False.”
“ASHA Statement on CDC’s Updated Developmental Milestones.” American Speech-Language-Hearing Association, https://www.asha.org/about/statements/ASHA-Statement-on-CDC-Developmental-Milestones/. Accessed 4 Mar. 2022.
“Do Masks Delay Speech and Language Development?” HealthyChildren.Org. https://perma.cc/CS22-HG2P. Accessed 4 Mar. 2022.
“Early Identification of Speech, Language, and Hearing Disorders.” American Speech-Language-Hearing Association, https://www.asha.org/public/early-identification-of-speech-language-and-hearing-disorders/. Accessed 4 Mar. 2022.
“Growing up in Lockdown: The Impacts of Pandemic Life on Children’s Early Physical Development.” Early Intervention Foundation, 26 Nov. 2021, https://www.eif.org.uk/blog/growing-up-in-lockdown-the-impacts-of-pandemic-life-on-childrens-early-physical-development. Accessed 4 March 2022.
“Psychologists: Masks Do Not Impede Preschoolers’ Language Development.” University of Miami, 13 Sept. 2022. https://perma.cc/AY3A-EBR2. Accessed 4 Mar. 2022.
Rajmil, Louis, and Anders Hjern, Perran Boran, and on behalf of International Society for Social Pediatrics & Child Health (ISSOP) and International Network for Research on Inequalities in Child Health (INRICH) COVID-19 Working Group, et al. “Impact of lockdown and school closure on children’s health and well-being during the first wave of COVID-19: a narrative review.” BMJ Paediatrics Open, 2021. https://bmjpaedsopen.bmj.com/content/5/1/e001043. Accessed 4 March 2022.
Schering, Steve. “CDC, AAP Update Developmental Milestones for Surveillance Program.” Feb. 2022. publications.aap.org, https://publications.aap.org/aapnews/news/19554/CDC-AAP-update-developmental-milestones-for. Accessed 4 March 2022.
University of Göttingen. “Impact of COVID-19 social isolation measures on early development: Researchers investigate impact of lockdown measures on 8- to 36-month-old infants across 13 countries.” ScienceDaily. ScienceDaily, 7 February 2022. <www.sciencedaily.com/releases/2022/02/220207083421.htm>. Accessed 4 March 2022.
Wenner Moyer, Melinda. “The COVID Generation: How Is the Pandemic Affecting Kids’ Brains?” Nature, vol. 601, no. 7892, Jan. 2022, pp. 180–83. https://doi.org/10.1038/d41586-022-00027-4. Accessed 4 March 2022.
“What Developmental Milestones Is Your 30-Month-Old Reaching?” Centers for Disease Control and Prevention, 17 Feb. 2022, https://www.cdc.gov/ncbddd/actearly/milestones/milestones-30mo.html. Accessed 4 March 2022.
“Your Child at 2 Years.” Centers for Disease Control and Prevention, https://www.cdc.gov/ncbddd/actearly/pdf/checklists/checklists_2yr.pdf. Accessed 4 March 2022.
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