KANSAS CITY, MO – Wearing a tutu and a messy ponytail, CJ RainingBird, age 4, sprawls out on her carpeted living room floor, scribbling on a notebook. She looks up eagerly after completing each pen stroke, her eyes widening and her mouth stretching into a grin when she notices her masterpiece is being admired.

CJ’s drawing indicates a child who’s on track if not ahead in her development. It’s of a horse-like figure with big, round eyes, a scruffy mane and a tail coming out of its belly. Children typically begin to draw body parts at age 4, according to some developmental research, often starting with simple head-torso renderings and graduating into details such as facial features.

But on other measures, it seems CJ is struggling. She lacks a sense of personal boundaries and often clings to those around her. She doesn’t talk a lot and sometimes needs to be dragged into her new preschool. When she’s uncomfortable or upset, she screams at a pitch that pierces the ears. 

“She doesn’t know how to work through her emotions,” said Jillian RainingBird-Minme, CJ’s adoptive mom. 

Emerging evidence reveals an uptick in developmental delays and challenging behaviors in children belonging to the so-called “COVID generation.” Born during or shortly before the pandemic, many of these children are talking, walking and interacting later and less frequently. They're also more prone to certain behaviors, like outbursts, physical aggression and separation anxiety. 

It's unclear how much the COVID-19 pandemic and related economic fallout are to blame. But experts note many young children in recent years have had uneven access to health and child care and relatively little exposure to the outside world.

And in many cases, the adults in their lives have suffered unrelenting and unprecedented levels of emotional or financial stress – stress pandemic babies have absorbed at a time when their brains are developing at a faster rate than any other point in the human experience.

“The infant-toddler brain is the best sponge you could ever buy,” said Rahil Briggs, who oversees HealthySteps, a national program that provides early childhood development support to families at their pediatric visits. “It sucks up everything really good and everything really bad.” 

Many early childhood experts said more children are not as good at playing with one another, or at any activities that involve sharing or paying attention. 

“We (adults) have the language to express what it is we’re feeling, what it is we’re thinking,” said Jamiylah Miller, an advocate in Norristown, Pennsylvania, who provides home-based education under Early Head Start, the federal early learning program for families from pregnancy to age 3. “When we disagree, we can say we disagree."

"With children, it shows up primarily in their behavior.” 

Foals can stand within an hour of being born. Baby sea turtles manage to make their way to the shore shortly after hatching. Humans? We exit the womb “totally helpless,” said Dana Suskind, a University of Chicago researcher, professor and pediatric surgeon who specializes in cochlear implants.

Our intelligence and capacities as a species require a brain far too large to sustain in utero. According to Suskind, evolution made a trade-off: Human brains are born underdeveloped, with billions of unconnected neurons, and caregivers are expected “to help finish off the job.”

What transpires over the next three years is what, experts say, makes them the most critical period in a person’s development. More than 1 million neural connections are formed every second, laying down the infrastructure of the brain. At least 85% of its development occurs before age 5, with the majority occurring in the first few years of life.

"Learning doesn't start on the first day of school, but the first day of life," said Suskind, author of the new book "Parent Nation," which pairs stories and science about early childhood development with a call to action to ease the burdens of parenting in the United States. 

Every emotional experience – every environment, every interaction – gives instructions to a young child’s brain, telling it which neuronal connections to make stronger and which it doesn't need and can prune away. Safe, nurturing, responsive environments and interactions foster healthy brain development. 

If a child’s brain is continually exposed to stress, that brain is going to wire with the assumption that the environment is always going to be like that, Suskind said.

According to a handful of small studies published within the last few months, children born during the pandemic are scoring lower, on average, on tests of gross motor, fine motor, social and problem-solving skills compared with those born before it. For instance, a 6-month-old pandemic baby is less likely than a previous 6-month-old to get into a crawling position or smile at herself in the mirror – both of which are considered milestones for that age group. 

Some of the research comes out of Columbia University’s COVID-19 Mother Baby Outcomes study, which uses data from parents’ responses to questionnaires. The researchers partly attributed the decreases to maternal stress, including that during pregnancy.

Two additional recent studies, meanwhile, found that babies born during the pandemic vocalize and engage in verbal interactions much less than their pre-pandemic counterparts did. The researchers point to lack of exposure, compounded, again, by caregivers’ stress. Pandemic babies had fewer people talking and interacting with them, for less time every day.

Some experts point to increased screen time, while other research has suggested that mask-wearing is a factor. Babies and toddlers watch the way adults’ mouths move as they learn how to form the sounds of letters. They also pick up on facial expressions, which are restricted when half of the face is covered by a mask.

It could be years before researchers can adequately measure whether the pandemic had any material, long-term effect on early childhood development. In many cases, the lagging social skills are recoverable.

But interviews with dozens of parents, providers and educators across the nation seem to confirm what the data are starting to reveal: Young children born in the past few years are more likely to be stunted developmentally – especially on social and emotional measures.

Usually, young children's learning progress starts to pick up in the spring, said Dominique Spencer, a director at the Washington, D.C., nonprofit early learning center Jubilee JumpStart. The babies begin walking, becoming more physical. The older ones begin asking more questions. 

It’s as if “their brains open up and they start experiencing more,” Spencer said. 

But since the pandemic started, things are different, Spencer said back in April: “They’re still growing, because they always grow, but it’s at a slower pace.”

A study published in the United Kingdom in May found similarly troubling trends among slightly older kids: Teachers of children in the lowest primary grades reported an increase in behavior such as biting and hitting, as well as in difficulties being in large groups. The 4- and 5-year-olds studied were less likely to meet the expected levels of development in 2021 than before the pandemic, the authors concluded. 

Research on the ideal conditions for early childhood development offers clues as to what’s going on.

Children thrive on routine and predictability, studies show. Stability helps children regulate their own emotions, which further foster executive functioning skills.

For many families, bad stuff piled up over the course of the pandemic. Poverty and food insecurity rates surged, as did those of parental stress, loneliness, anxiety and depression. Nearly 1 in 5 of the country's more than 11 million babies are being raised by families in poverty, according to ZERO TO THREE's most recent "State of Babies Yearbook" report.

More than half of children in families experiencing severe financial hardship at the beginning of the pandemic were facing “emotional distress,” according to data from RAPID-EC, an early childhood research group that has been regularly surveying parents of children 5 and under since the start of the pandemic.

Children “develop within the context of relationships,” said Donna Housman, a child development expert and founder of Housman Institute, an educator training​, professional development, curriculum and​ research organization. The institute's teaching model is based on emotional foundations of learning and cognition, focusing on the regulation of emotion for both children and their adult caregivers.

Intervening early is key, experts say, because of what we know about early childhood development. After age 3, the brain begins to prune itself: The neural connections that are used frequently become more secure while the others fade away. Essentially, the brain loses what it doesn’t use.

According to RainingBird-Minme, CJ had signs of physical abuse when she was adopted: cigarette burns, missing patches of hair and a broken tooth. She was terrified of water and sometimes tried to eat food out of the trash. 

As she transitioned from baby to toddler, she didn't seem to behave like a child her age should, RainingBird-Minme said. CJ would shriek at anyone who touched her stuff yet allow others, even strangers, to enter her personal space, often entering theirs as well. She'd struggle to pay attention and follow instructions and engage in activities independently after being shown how to do them. 

CJ’s behavior could be a response to any trauma she endured or it could be a side effect of all the disruption, pandemic-related and otherwise. Maybe it points to a developmental delay or some sort of disorder. Perhaps, RainingBird-Minme wonders, it’s some combination of the above.

For a long time, RainingBird-Minme had no way of knowing what was going on or how to help. Thanks to the pandemic, it took months before she found a pediatrician who was accepting new patients. By the time CJ got screened, she was too old to qualify for state-provided early intervention services, which stop at 3. 

Data nationally show a dip in referrals for early intervention services at the beginning of the pandemic, as well as in visits to primary care physicians. And in many cases, the children who needed the services most are least likely to receive them. The disparities are likely to become worse as demand rebounds, experts say. 

Dani Dumitriu, a pediatrician and professor in New York City who oversees the Columbia University research on pandemic-era maternal and child well-being, has estimated that based on her team's findings, society could see a threefold increase in the number of babies needing referrals for early intervention. 

Some, like CJ, are now getting the services and education and care they need to catch up. CJ is now in a publicly funded special-needs prekindergarten classroom and her individualized education program was finalized in May.

But others – absent greater support for the adults in their life – might not get that chance. 

In University City, Missouri, the Urban Sprouts Child Development Center is rooted in a learning philosophy known as Reggio Emilia, which celebrates aesthetics and sensory experiences and encourages students to guide their own learning.

Urban Sprouts' classrooms are filled with plants and string lights and student art. Soothing videos – of kids dancing and birds chirping and rain falling – are projected on the walls, the overhead lights dimmed. Every day, children enjoy farm-to-table, home-cooked meals in a café-style dining area.

Two of the rooms are dark and empty. Despite concerted efforts, Urban Sprouts has failed to fill the positions needed to staff its infant classrooms.

At a time when many employers are struggling to fill jobs as Americans demand higher wagers and other benefits, understaffing has become the rule versus the exception for many child care providers. Providers said that’s largely because limited governmental support forces them to pay poverty-level wages, often without fringe benefits. 

A recently released report examining the child care sector this past school year found that roughly half (48%) remained understaffed. A separate report, by a trio of progressive think tanks, found the child care workforce has dropped by more than 10% from its pre-pandemic levels. By comparison, the average decline among all sectors was 2%.

That means more kids who are going without care. And it’s those children Ellicia Lanier, Urban Sprouts's founding executive director, worries about most.

"I worry about the homes that they go into and the stressed-out parents -- I worry about the amount of time they have with somebody who's responsive to their needs," Lanier said. "I worry about their ability to be able to process this trauma."

Many pandemic baby parents described feeling like they’ve been trapped in their own, chaotic world for the past two-plus years, with little insight into how their children compare developmentally.

“We often get this question of, ‘Is this child pandemic behind or are they actually behind?’” said Emily Levitt, vice president of education at Sylvan Learning, one of the country’s largest tutoring center networks. “And getting to the correct answer for each child is not always easy.”

Tutoring demand has grown across the board, but at Sylvan and other centers, the biggest surge has been among children in the prekindergarten-2 levels.

Anissa Parra-Grooms never thought that she’d become a mother, let alone that the moment would coincide with the onset of a global pandemic. But that’s what happened on Feb. 27, 2020, when Parra-Grooms’s daughter, Elvira, was born.

Like many new parents at the time, Parra-Grooms and her husband held off on enrolling Elvira in care for as long as they could. Keeping her at home felt like the safest and most convenient option, a cost-saving blessing in disguise even. Parra-Grooms, who doesn’t have much close family nearby and works in the nonprofit world, landed a remote-friendly job, allowing her to have lots of quality time with the baby.

At Elvira’s 18-month doctor’s appointment, however, Parra-Grooms learned her daughter was below average in language development. She was speaking just a dozen or so words, not the ideal 50. 

“Every parent thinks their child is the smartest child ever, and I firmly believe that she's super intelligent,” she said.

Hearing the numbers left Parra-Grooms feeling “totally clueless” and then worried and then guilty – all the typical parenting emotions that have felt more acute during the pandemic. 

Parra-Grooms quickly called a number the pediatrician provided for the state’s early intervention system and left a voicemail requesting a screening. Soon after that, a specialist came into their home to assess Elvira for an hour or two. The verdict? Everything’s fine, the specialist said – turns out, lots of pandemic tots are lagging a bit in language and other skills. She’ll catch up. 

Catch-up Elvira did, thanks largely to the fact that she’s now in an early childhood education program and has opportunities to socialize, Parra-Grooms said. Elvira is a sweet, happy, curious toddler. On a recent evening, she ran in and around a playset, misplacing a shoe along the way. She asked for and then blew bubbles, one of her favorite activities. She showed off her Mr. Potato Head, describing its facial accessories with a mix of words and babble.

"I didn't even realize how challenging it was until she started daycare," Parra-Grooms said, reflecting on the emotional exhaustion and logistical headaches of raising and educating a toddler during the pandemic. 

A while back, Parra-Grooms typed into a search engine: "When does raising a child get easier?" 

"It doesn't get easier -- it just changes. And when you get comfortable is usually when it changes," she said. "I've had that at the back of my mind ever since."

“So,” begins a doctor on a recent visit with a patient and her mother at the University of Missouri’s pediatric hospital in Columbia. “How’s life with a 3-year-old?”

Jessica Mahurin, 32, settles into her seat as the toddler, Nylah, begins playing with a pretend doctor’s kit. Nearby is Andrea Pauley, a social worker who’s been working with the pair since birth through HealthySteps, a national early childhood development program run by the advocacy and research organization ZERO TO THREE. 

HealthySteps specialists, often social workers, accompany families with children below 3 on their pediatric visits, monitoring and supporting the babies' development and helping with everything from counselor referrals to diaper drop-offs. Pauley begins going through Mahurin's responses on a standard developmental questionnaire with prompts such as "Can your child string small items such as beads?" and "Does your child take turns by waiting?"

Mahurin exhales slowly before answering the doctor’s question, letting out a strained laugh. “It’s fine,” she starts. “I’m dealing with a miniature me.” 

Nylah has learned to be defiant, Mahurin explains, and how to manipulate adults around her. She’s discovered how to get what she wants, in particular from her grandparents. Nylah has a lot of temper tantrums and a tendency of “lashing out.” 

All of that’s pretty typical, the doctor says. And indeed, Nylah performs well on her developmental screening. He and Pauley offer advice on how to respond to certain behaviors, as well as some referrals for local dentists. He encourages her to consider Head Start or another publicly funded early learning program.

After he leaves, Pauley asks Mahurin how she's doing. Unable to afford child care, Mahurin moved in with her parents. She recently landed a housekeeping job at the university and can’t wait to live in her own space again. Mahurin loves her miniature me like no other but spending so much time with her while not working “has been driving me up a wall,” she said. She’s going to start seeing a therapist to work through her own traumas. 

"I want her to have a childhood she does not have to recover from," Mahurin says. "Trying to do that is a little difficult."

Later, as she leaves, Mahurin fights back tears. It’s the end of an era: the last visit with Pauley. Now that Nylah is 3, she's no longer eligible for the program. 

In ideal scenarios, the adults are emotionally and physically available for the child at all times. They are responsive to their kid's needs, helping them regulate their emotions and understand the myriad stimuli they’re taking in.

But for many parents, doing that became all but impossible once the pandemic hit: “It’s really hard to be present and responsive to your child when you yourself are stressed and dealing with your trauma,” said Jennifer Boss, who directs infant and early childhood mental health coordination and strategy efforts at ZERO TO THREE, based in Washington, D.C.

That was especially true for low-income families, who often experienced a “hardship chain reaction,” said Phil Fisher, lead investigator in the RAPID-EC project and a professor in the graduate education school at Stanford University in California.

They were more likely to lose loved ones and their jobs, to deal with hardship after hardship, making routine out of reach. For many, the emotional and financial stress grew exponentially as their ability to buffer dropped, enabling stressors to saturate their babies’ spongey brains. 

“The ability to provide nurturing and supportive care – it gets increasingly challenging to the extent that people are preoccupied with obtaining basic needs,” Fisher said. “For any individual kid, if you want to know how they've been doing, it’s very tied to how parents are doing.”

Experts tend to agree that parents' and caregivers' well-being – and capacity to be emotionally and physically available for their baby – is the biggest predictor of that in a child. 

If a parent is responsive and nurturing at least 51% of the time, they’re doing a great job, said Housman, the developmental psychologist. “The roles of parent and teacher are some of the most important and yet most stressful roles at any time," she added, "but especially now."

Back at the RainingBird-Minme household, stress levels are high. RainingBird-Minme and her husband Enoche are still raw from the grief of losing their middle daughter, who died from a brain tumor at the age of 6 shortly before the pandemic. 

In addition to working as a cash operations manager at a local casino, she spends much of her time advocating for CJ. He has a labor-intensive day job working for the city and a time-consuming side gig as a youth soccer coach. 

But they do their best to be the parents CJ deserves. 

CJ hasn't yet warmed up to the idea of being in a classroom with rules and other students. When she heard her mom mention the word school, she froze, dropping the pen and abandoning her artwork. Her eyebrows furrowed; her shoulders hunched. 

But then CJ's dad summoned her to his lap and wrapped his arms around her tiny body, swaddling her as he whispered in her ear and kissed her cheek. Soon, she was giggling. 

This story was produced with support from the Education Writers Association's Reporting Fellowship.

Contact Alia Wong at (202) 507-2256 or awong@usatoday.com. Follow her on Twitter at @aliaemily.