When do children avoid infection risks: Lessons for schools during the COVID-19 pandemic

Abstract

The physical closing of schools because of COVID-19 has disrupted both student learning and family logistics. There is significant pressure for in-person learning to remain open for all children. However, as is expected with outbreaks of novel infections, vaccines and other pharmaceutical therapeutics may not be instantly available. This raises serious public health questions about the risks to children and society at large. The best protective measures for keeping young children in school focus on behaviors that limit transmission. It is therefore critical to understand how we can engage children in age-appropriate ways that will best support their ability to adhere to protocols effectively. Here, we synthesize published studies with new results to investigate the earliest ages at which children form an understanding of infection risk and when they can translate that understanding effectively to protective action.

Keywords: Behavioral neuroscience; Virology.

Figure 1

Child understanding and caretaker intervention Children develop an understanding of direct contagion before an understanding of contamination. As such, caretakers should emphasize the development of skills to prevent transmission before teaching an understanding of how and why disease transmission occurs. Children exhibit considerable variability when they begin to develop a mechanistic understanding of disease transmission. Although there is agreement between the timeline and when age specific behaviors occur, caretakers should allow for variability in children’s aptitude in acquiring mechanistic knowledge of disease transmission.