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Patient Education - HELPING CHILDREN COPE WITH CHANGES RESULTING FROM COVID-19

HELPING CHILDREN COPE WITH CHANGES RESULTING FROM COVID-19

  • Dr. Niraj Kumar, Paediatrician
HELPING CHILDREN COPE WITH CHANGES RESULTING FROM COVID-19

Families across the country are adapting to the evolving changes in daily life caused by the COVID-19 pandemic. Most schools, places of public gathering, and nonessential businesses are closed, and parents and other caregivers are faced with helping their families adjust to the new normal. This includes trying to keep children occupied, feeling safe, and attempting to keep up with schoolwork as best as possible. None of this is easy, but it helps to stay focused on what is possible in order to reinforce a sense of control and to reassure children that they are okay, and that the situation will get better. 

It is very important to remember that children look to adults for guidance on how to react to stressful events. Acknowledging some level of concern, without panicking, is appropriate and can result in taking the necessary actions that reduce the risk of illness. Teaching children positive preventive measures, talking with them about their fears, and giving them a sense of some control over their risk of infection can help reduce anxiety. This is also a tremendous opportunity for adults to model for children problem-solving, flexibility, and compassion as we all work through adjustting daily schedules, balancing work and other activities, getting creative about how we spend time, processing new information from authorities, and connecting and supporting friends and family members in new ways. The following tips can help.

Stay Calm, Listen, And Offer Reassurance

  • Be a role model. Children will react to and follow your reactions. They learn from your example.
  • Be aware of how you talk about COVID-19. Your discussion about COVID-19 can increase or decrease your child's fear. If true, remind your child that your family is healthy, and you are going to do everything within your power to keep loved ones safe and well. Carefully listen or have them draw or write out their thoughts and feelings and respond with truth and reassurance.
  • Explain social distancing. Children probably don’t fully understand why parents/guardians aren’t allowing them to be with friends. Tell your child that your family is following the guidelines of the Centers for Disease Control and Prevention (CDC), which include social distancing. Social distancing means staying away from others until the risk of contracting COVID-19 is under control. Showing older children the "flatten the curve" charts will help them grasp the significance of social distancing. Explain that while we don't know how long it will take to "flatten the curve" to reduce the number of those infected, we do know that this is a critical time—we must follow the guidelines of health experts to do our part.
  • Demonstrate deep breathing. Deep breathing is a valuable tool for calming the nervous system. Do breathing exercises with your children.
  • Focus on the positive. Celebrate having more time to spend as a family. Make it as fun as possible. Do family projects. Organize belongings, create masterpieces. Sing, laugh, and go outside, if possible, to connect with nature and get needed exercise. Allow older children to connect with their friends virtually.
  • Establish and maintain a daily routine. Keeping a regular schedule provides a sense of control, predictability, calm, and well-being. It also helps children and other family members respect others’ need for quiet or uninterrupted time and when they can connect with friends virtually.
  • Identify projects that might help others. This could include: writing letters to the neighbors or others who might be stuck at home alone or to healthcare workers; sending positive messages over social media; or reading a favorite children’s book on a social media platform for younger children to hear.
  • Offer lots of love and affection.

Monitor Television Viewing And Social Media

  • Parents/guardians should monitor television, internet, and social media viewing—both for themselves and their children. Watching continual updates on COVID-19 may increase fear and anxiety. Developmentally inappropriate information, or information designed for adults, can also cause anxiety or confusion, particularly in young children.
  • Dispel rumors and inaccurate information. Explain to your child that many stories about COVID-19 on the internet may include rumors and inaccurate information. Older children, in particular, may be accessing a great deal of information online and from friends that contains inaccuracies. Talk to your child about factual disease information.
  • Provide alternatives. Engage your child in games or other exciting activities instead.

Take Time To Talk

  • Let your children's questions guide you. Answer their questions truthfully, but don't offer unnecessary details or facts. Don't avoid giving them the information that experts indicate as crucial to your children's well-being. Often, children and youth do not talk about their concerns because they are confused or don't want to worry loved ones. Younger children absorb scary information in waves. They ask questions, listen, play, and then repeat the cycle. Children always feel empowered if they can control some aspects of their life. A sense of control reduces fear. 

Be Honest And Accurate

  • Correct misinformation. Children often imagine situations worse than reality; therefore, offering developmentally appropriate facts can reduce fears. 
  • Explain simple safety steps. Tell your child this disease spreads between people who are in close contact with one another, when an infected person coughs or sneezes, or when one touches infected objects or surfaces.

Keep Explanations Age-Appropriate

  • Early elementary school children. Provide brief, simple information that balances COVID-19 facts with appropriate reassurances that adults are there to help keep them healthy and to take care of them if they do get sick. Give simple examples of the steps people make every day to stop germs and stay healthy, such as washing hands. Use language such as "adults are working hard to keep you safe."
  • Upper elementary and early middle school children. This age group often is more vocal in asking questions about whether they indeed are safe and what will happen if COVID-19 spreads in their area. They may need assistance separating reality from rumor and fantasy. Discuss the efforts national, state, and community leaders are doing to prevent germs from spreading.
  • Upper middle and high school students. Issues can be discussed in more depth. Refer them to appropriate sources of COVID-19 facts. Provide honest, accurate, and factual information about the current status of COVID-19. Engage them in decision-making about family plans, scheduling, and helping with chores at home.
    For all children, encourage them to verbalize their thoughts and feelings. Be a good listener!

Stay Connected To School

  • Locate learning resources. Schools’ capacity to conduct virtual learning experiences will vary greatly, but most schools are providing lessons and learning activities for children to do. Take advantage of the many companies and online platforms currently offering free learning opportunities.
  • Identify additional resources. Know if your school or district is providing additional resources, such meals, or technology, such as a laptop or tablet.
  • Stay in touch. Find out how the school is communicating with families and students. Be sure to read any communications you receive. Check with you children, particularly older ones, as they may be receiving information directly that would be helpful for you to know.
  • Connect with school staff. Reach out to your child’s teacher and other relevant school staff if you have concerns about their coping and keeping up with assignments or activities. 

Know The Symptoms Of Covid-19

  • According to the CDC, symptoms of fever, cough, and/or shortness of breath appear within 14 days after being exposed to the disease.
  • For some people, the symptoms are similar to having a cold; for others, they are more severe or even life threatening.  

Model Basic Hygiene And Healthy Lifestyle Practices 

  • Practice daily good hygiene. Encourage your child to practice these simple steps to prevent spreading the virus. 
  • Wash your hands multiple times a day for 20 seconds. Singing “Twinkle, Twinkle Little Star” or “Happy Birthday” twice is about 20 seconds.
  • Compliment your children when they use a Kleenex or sneeze or cough into the bend of their elbow. Teach them the importance of throwing away used tissues immediately after sneezing or coughing.
  • Sadly, handshakes and hugs need to be limited to immediate family members, at least for now.  
  • Foster a sense of control. Offering guidance on what your child/children can do to prevent infection offers them a greater sense of control, which reduces anxiety. 
  • Build the immune system. Encourage your child to eat a balanced diet, get enough sleep, and exercise regularly; this will help them develop a robust immune system to fight off illness.

Be Aware Of Your Children’s Mental Health

Most children will manage well with the support of parents and other family members, even if showing signs of some anxiety or concerns, such as difficulty sleeping or concentrating. Some children, however, may have risk factors for more intense reactions, including severe anxiety, depression, and suicidal behaviors. Risk factors can include a pre-existing mental health problem, prior traumatic experiences or abuse, family instability, or the loss of a loved one. Parents and caregivers should contact a professional if children exhibit significant changes in behavior or any of the following symptoms for more than 2 weeks.

Preschoolers — thumb sucking, bedwetting, clinging to parents, sleep disturbances, loss of appetite, fear of the dark, regression in behavior, and withdrawal.

Elementary school children — irritability, aggressiveness, clinginess, nightmares, school avoidance, poor concentration, and withdrawal from activities and friends.

Adolescents — sleeping and eating disturbances, agitation, increase in conflicts, physical complaints, delinquent behavior, and poor concentration.

Additional Resources

  • Coping With Stress During Infectious Disease Outbreaks, Centers for Disease Control and Prevention, Coronavirus Disease 2019 (COVID-19),
  • Handwashing and Hand Sanitizer Use at Home, at Play, and Out and About,
  • NASP COVID-19 Resource Center
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