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Seven months into the death march of COVID-19, many children are suffering the effects of the multiple adaptations required for them to find a new normal in a strange world of dread disease, absent friends and remote learning. A study cited in an article by Harvard researcher and psychologist Archana Basu noted that 14% of children (and 27% of parents) have seen worsening mental health problems in the pandemic. While worry is a normal response to the virus, some children – especially those who have suffered previous traumas such as abuse and neglect – are at risk for deeper problems, writes Ms. Basu.
Like symptoms of the coronavirus, signs of stress in children vary widely. But stress, like the virus, can potentially be mitigated. Parents can help children manage stress before it becomes trauma; expert advice is available online and from experienced therapists like Sandra Small, a licensed clinical professional counselor (LCPC) at Evanston’s Erie Family Health Center.
Children’s reactions to life in the pandemic manifest themselves in myriad behaviors: clinginess, regression, (e.g. bedwetting), temper tantrums, anger, aggression, somatic symptoms (stomach- or headaches), an inability to focus, withdrawal or emotional numbness. Sometimes a change in behavior signals larger issues. If symptoms are severe enough to impede daily activities or if they do not improve in four to six weeks, parents might consider contacting their primary care provider for a referral to a mental health professional.
Of course, generalizations do not fit every individual. Some children are thriving with schools closed – appreciating the absence of bullying or the solitude of home or reveling in time spent on a digital device of their own without parental restraints. But for most kids, remote learning is a challenge requiring “a level of sustained attention and emotional regulation that is a very big demand, developmentally, for kids in middle school or younger,” Ms. Basu says.
Tasked with overseeing their children’s emotional and academic well-being, parents can do some things to smooth the path.
“Make sure there’s a structure,” Ms. Small says. A chorus of experts agrees. Predictability, says a recent article in Huff Post, makes kids feel comfortable and safe. The daily schedule should include time for exercise and play as well as academic enrichment. Ms. Small also emphasizes the importance of good meals and the benefits of gathering one night a week for a family dinner. “Everyone puts down what they are doing, and they talk to each other,” she says.
Anxious children are looking for reassurance and attention. Some need more from their parents, even if they are with them all day. But many parents are stretched thin, struggling to fulfill their own responsibilities. The Huff Post suggests that adults conduct an “attention audit,” looking at the last time they were with their child and not multitasking. Giving five to 10 minutes of focused attention, combined with setting an expectation like “I’m busy now, but we can talk about that at dinner,” can satisfy a child’s need to be heard.
Ms. Small suggests that the day close with a “good bedtime.” Screen time should end two hours before bedtime, she says, in plenty of time to establish a nightly routine such as enjoying a mug of warm milk.
Children pick up on tension in the house. It is important – and difficult – for parents to stay calm. Ms. Small encourages adults to practice speaking in a soft, deliberate voice, which tends to slow down a frenetic household and sets an example for children. Commenting in an NYU Langone News article, a doctor and clinical assistant professor says, “The way a child reacts may therefore be strongly influenced by how others around them are reacting.”
Children who overhear conversations or see television news about the virus are often frightened. The NYU doctor cautions adults to be careful about discussing the pandemic with others when their child is present and suggests limiting media exposure.
Most children have information about the pandemic, but often it is inaccurate. Parents can help by asking their kids if they have questions and then responding in concrete language children can understand, avoiding euphemisms like “grandma went away.”
Rather than focusing on a child’s worrisome behavior, therapists say, parents can help anxious children by reinforcing what they are doing right.
Parents can also reassure kids by giving them a sense of control. They can point to specific examples of how they and others are following guidelines to stay healthy and keep safe.
Parents should make a point of checking in regularly with their children, being present for them and creating opportunities for discussion. Ms. Small gives clients two fundamental rules. The first is “get down on their level” – meaning literally sit or kneel when talking to children – and practice listening for five or 10 minutes.
And above all, she insists, “Respect the child.”
“One of our jobs as adults is to help [children] regulate their emotions,” Ms. Small says. Some kids do not have words to describe what they are feeling. Parents need to validate and help kids label their feelings: “Of course it makes you sad that we can’t see the cousins.”
Now is the time to help a child discover ways to strengthen self-regulation skills. Drawing is known to be therapeutic; music can cheer or settle listeners; physical activity can release stress.
And increasingly often, Ms. Small says, meditation and yoga enter the conversation about stress relief. A number of yoga studios in Evanston offer yoga and meditation for kids. Marissa Woods, co-founder of the currently virtual Kids HeART Yoga, says, “Yoga has always been good for kids with anxiety. We make it fun.”
Ms. Woods works with children as young as 3 1/2. But because she incorporates drama, music and dance, her small students are not aware they are learning the serious art of yoga.
Each class begins with a Mindful Minute and ends with relaxation. Breath work is incorporated into various activities – as art, for example (“Draw your breath when you are anxious and then when you are relaxed”), and as a noisy exhale in Lion’s Breath. After practicing “sun wraps,” even the littlest kids can do a whole yoga sun salutation by the end of a term, Ms. Woods says.
Relationships are vital. Parents can help kids find ways to stay connected with friends while being safe. And Ms. Small has one other suggestion for families: “Play games.”