HealthONE - May 21, 2020

In the face of the coronavirus (COVID-19) pandemic and its impact on our day-to-day lives, we have all had to adjust to the changing times and find creative ways to cope with this “new normal.” Deviating from normal, comfortable routines is stressful for anyone, but children, in particular, may be experiencing difficulties coping with these changes during COVID-19.

Keep reading to learn supportive ways to help them cope with this difficult situation. You can also help by staying informed with the latest health information from the Centers for Disease Control and Prevention (CDC) and continuing to refer to our hospital website, as guidance frequently changes.

Q: How can I comfort my child in these unprecedented times?

Everyone reacts differently to stressful situations, and children and teens are more likely to have stronger reactions. As public conversations around COVID-19 continue, children may worry about loved ones becoming ill with COVID-19. Parents, family members, school staff and other trusted adults can play an important role in easing concerns through honest conversation with a compassionate tone.

Stress during an outbreak like COVID-19 may include:

  • Fear and worry about one’s own health and the health of loved ones
  • Changes in sleep or eating patterns
  • Difficulty sleeping or concentrating
  • Worsening of chronic health problems
  • Worsening of mental health conditions

Read additional information about managing stress and anxiety during COVID-19.

Remain calm and reassuring.

  • Children and teens react, in part, to what they see from the adults around them. When parents and caregivers deal with COVID-19 calmly and confidently, they can provide the best support for children. It is important for adults to also recognize their own fears and concerns and openly share with their kids. Let them know it is okay if they feel upset.
  • Preparing for conversations is key to providing reassurance and staying calm. It is important to recognize that children will react to both what you say and how you say it. They will pick up on both verbal and non-verbal cues from conversations, including body language and tone.
  • Be a role model. Set a good example for your children by managing your stress through healthy lifestyle choices, such as eating healthy, exercising regularly, getting plenty of sleep and avoiding drugs and alcohol. Connect with your friends and family members. When you are prepared, rested and relaxed, you can respond better to unexpected questions or events.
  • Try to keep up with regular routines. If schools are closed, create a schedule for learning activities and relaxing or fun activities.

Make yourself available to listen and to talk.

  • Set aside time to talk and remind your children that you are there to keep them safe. Follow your child’s lead and make sure they know they can come to you with any questions or concerns. Kids notice when you are sad, mad or avoidant and can pick up on your own concern. Be mindful of this. If they are worried about family or friends, video chat may help them feel better.

Avoid language that might blame others and lead to stigma.

  • Remember that viruses can make anyone sick, regardless of a person’s age, race or ethnicity. Treat everyone with respect and avoid making assumptions about who might have COVID-19.

Pay attention to what children see or hear on television, radio or online.

  • Consider reducing the amount of screen time focused on COVID-19. Too much information on one topic can lead to more fear and worry, or children may misinterpret what they hear and become frightened.

Provide information that is honest and accurate.

  • Give children information that is truthful and appropriate for the age and developmental level of the child. Keep it simple. See development chart below.
  • Talk to children about how some COVID-19 stories may contain incorrect or exaggerated information.

Teach children everyday actions to reduce the spread of germs.

  • Remind children to keep their distance from people who are sick, especially those who are coughing or sneezing.
  • Stress the importance of coughing or sneezing into a tissue or their elbow, then throwing the tissue into the trash.
  • Discuss any new actions that may be taken at school to help protect children and teachers (e.g., more handwashing, cancellation of events or activities).
  • Get children into the habit of washing their hands often.
    • Teach them to wash their hands with soap and water for at least 20 seconds, especially after blowing their nose, coughing or sneezing; going to the bathroom; playing outside; and before eating.
    • If soap and water are not available, teach them to use hand sanitizer. Hand sanitizer should contain at least 60% alcohol. Watch young children when they use hand sanitizer to avoid swallowing.

Q: Are there different coping mechanisms I should be aware of post-COVID-19?

Here are some unique strategies to think about post-COVID-19:

  • Provide children with opportunities to talk about what they went through or what they think about it.
  • Encourage them to share concerns and ask questions.
  • It is difficult to predict how some children will respond to difficult events and illnesses such as COVID-19. Because parents, teachers and other adults see children in different situations, it is important for them to share information about how children are coping after these tough times.

Learn more about helping children cope.

Q: What behavioral changes should I watch for in my child?

Not all children and teens respond to stress in the same way. See development chart below. Here are some common changes to watch for:

  • Extreme crying or irritation in younger children
  • Returning to behaviors they have outgrown (ex: wetting the bed)
  • Excessive worry or sadness
  • Unhealthy eating or sleeping habits
  • Irritability and “acting out” behaviors in teens
  • Poor school performance or avoiding school
  • Difficulty with attention and concentration
  • Avoidance of activities enjoyed in the past
  • Unexplained headaches or body pain
  • Use of alcohol, tobacco or other drugs

Development Chart – What’s going to happen?

Navigating developmental coping with stress and change
Created by Megan Gerber, BS, CCLS

Developmental stage (age)Difficult emotions you may noticePotential behaviorsWays to help
2-4 years old Clingy, less independent, angry, tearful…remember they are out of their normal routine Bed-wetting, throwing toys or objects, regression in potty training or other skills, biting, talking to whoever (even strangers) about details Be patient. Listen to the “why.” Sit down with the child, hug them and be flexible. Create a new routine that they can trust.
These children WILL notice any changes in adult behaviors and/or emotions.
5-8 years old Fear, insecurity, nightmares, physical complaints (stomach pain, headaches, or generalized pain), feelings of being out of control, thinking they caused the sickness Yelling, regressive behaviors, acting like nothing is happening or asking repetitive questions (needing too much information) Create a safe place for regression; do not criticize for regressive behaviors. Identify opportunities for play, both medical and non-medical. Create boundaries and a trustworthy routine. Answer repetitive questions concretely and honestly.
8-12 years old Insecurity, loneliness, isolation, anger, abandonment, worry, anxiety, thinking they caused the sickness Not following or always following (extreme) the boundaries/rules, yelling, sneaking around the house or outside, concentration difficulties. Provide opportunities for expression inside/outside. Slow down and listen to your child. Involve more complex medical play. Provide creative social interactions through technology.
13-18 years old Insecurity, loss of independence, irritability, increase in risk taking, feelings of loss and isolation, solitude or abandonment Pushing boundaries, arguments with families and siblings, withdrawal from social activities Provide as many social opportunities as possible. Have conversations about the importance of rules/ guidelines. Give them space.