Child Social-Emotional Health Experts Answer Questions About Coping With COVID-19

In response to the recent COVID-19 outbreak and resulting steps taken to reduce the spread of the disease, many families are facing unprecedented challenges in parenting.  

GEEARS: Georgia Early Education Alliance for Ready Students turned to Dr. David O’Banion, a developmental pediatrician in Atlanta, GA and Dr. Trasie Topple, an Infant and Early Childhood Mental Health Therapist in Athens, GA to answer questions parents might be facing when explaining the virus or the new resulting routines to young children.

Do you have any tips for parents/caregivers on shielding their children from the stress of the outbreak? 

Dr. O’Banion: 

• Mind your own stress as a parent, choose what you can control and control those things. So much of the pandemic’s worry is that we don’t know enough about it. As a physician and parent, that uncertainty does worry me. I have to choose to focus on the things I can control. I can respectfully tell neighbors that we can’t come over because we want to protect everyone, and I can do that without worrying about coming across as rude. I can control whether we really need to take trip as a family to a grocery store. I can’t control what others are doing, so I have to choose not to worry about it.
  
• Once you feel in control of your stress, you can talk to your kids.  But listen to them first.  Are they asking why school is out?  Do they seem worried to you?  If they seem worried, acknowledge their feelings first.  You can say, “I can tell that you’re worried.  Let’s talk about the things we can do to stay safe.”
• Emphasize safety precautions as they relate to your family’s values.  Perhaps your family is community-oriented, then you can talk about all the things that your community does to keep everyone safe, such as, “People in our neighborhood are trying to stay home to keep the germs from spreading.”   If your family identifies as their own source of resilience, you can lean on that idea: “We take care of each other in our family, don’t we?  So you can be a big girl and remind me to wash my hands in 20 minutes.  It’s your turn to show me how to do it the right way.”
  
• Tie the safety precautions to other safety precautions.  Right now, we need to be doing a lot of hand washing.  “What do we do when we cross the street? Look both ways! Ok, what do we do when we come inside our front door?  Wash our hands! Great, let’s go wash our hands.”
  
• Keep everything kid-appropriate.  You don’t need to over-share about everything going on, even if the pandemic precautions are spilling into your job security.  Keep it simple: “We need to wash our hands to keep germs off of our hands.”  You don’t need to have a conversation about things children shouldn’t be worried about – like your employment, rent, or a national crisis.
  
• Choose your source of news.  Pick the source, maybe even write it down – like CDC.gov.  Use that source, but don’t read everything everywhere.   

Dr. Topple: 

• Remain calm yourself, and practice self-care; young children pick up on our anxieties and stress. Also, arrange times that you can connect with your support system (i.e friends, family members, parenting support groups or other community members). It’s hard for our children to be well, if we are not well.
• It’s important that children know your job, as a caregiver, is to protect them and keep them safe. Talk to them about ways we are staying safe.
• As much as possible, set up predictable daily routines and predictable caregiving routine for children. It may take time for children to fall into and rely on new routines but be patience and keep providing the structure.
• Limit the viewing of news channels and social media.
• Keep your children connected to loved ones they are unable to interact with (i.e. grandparents) by drawing pictures, sending letters in the mail, and facetime conversations.
• Know that young children may expression unsure feelings through challenging behaviors. They may display behaviors such as clinginess, withdrawnness, temper tanturms, or demandingness. They may communicate that the feelings are too overwhelming for them and they needs adults compassionate support in understanding and organizing these feelings.
• Notice if your child’s play contains any themes from what they may be hearing and experiencing and take opportunities to join in children’s play. Often times children will work out amazing solutions to life’s challenges in their play!
• Seek a mental health professional if you have concerns for you or anyone in your family. 

How can parents/caregivers talk to their children about the outbreak about school and child care closures? 

Dr. O’Banion: School is closed because there is a germ that can make some people sick.  The germ can get on our hands when we are in big groups.  At school there are lots of big groups.  Right now, it’s better for some people if we all just stay home.  That’s why school is closed.  School will open again when the germ isn’t such a problem.  

Dr. Topple: It’s important that in all communication about change that children know your job, as a caregiver, is to protect them and keep them safe. If possible, keep connection with teachers or childcare workers. You can read books together about separation, such as The Invisible String by Patrice Karst. Talk about what they enjoyed at school and ways you can still “do school” at home. Practice ways you keep each other safe by washing hands, keeping hands to ourselves (and off our faces!). Use concrete words like bugs and germs, spit, boogies, noses, and coughs, etc.

How can parents/caregivers talk to their children about the outbreak about changes to daily routines (e.g., social activities, extracurriculars, etc.)? 

Dr. Topple: Acknowledge that we are doing something new together to keep everyone safe. Schools are moved to the home and the other things we’ve enjoyed doing are now being done at home, too. Try to make a flow of the day (i.e. wake-up and get dressed, have breakfast, read a book together, go outside, lunch, naptime, art/craft project, outside time, dinner, bath time, nighttime routine). Keeping kids on a similar flow of a schedule will help keep things predictable for little ones. Talk to them about how they may see new things, like people wearing masks or walking far apart from each other. Explain that people wear masks to help keep them from getting sick or keep others from getting sick. If your child had a particular interest or social activity before the outbreak, look for ways to nurture their interest at home. For example, if you attended a music class, look for on-line music class for kids.

How can parents and caregivers talk to their children about the outbreak about social distancing and quarantining (especially explaining social distancing from older relatives like grandparents)? 

Dr. O’Banion: Parents might say, “Right now, there is a germ that can make people sick.  We can try and keep other people from getting sick by keeping away for a while.  Let’s call grandpa on facetime, instead.” 

Dr. Topple: You could say, “The whole world is taking a break so the sick bugs can go away. While we are waiting for the sick bugs to go away, the safest place for us to be is at our home or outside as long as we are not too close to other people. When we see other people, like grandma and grandpa, we have to stand far away so the germs (or sick bugs) don’t stick to us or them. We can hold our arms out like this to give them a hug, we can blow a kiss and ask them to catch it, or a distant high five, etc.”

What steps can parents/caregivers take to talk to their child if a family member gets sick? 

Dr. O’Banion: Keep things simple and developmentally appropriate.  Remember that you are talking to a child that might not know what’s so different from a boo–boo, to a cold, to COVID, to a heart attack.  “Grandpa has a germ and he is not feeling well. Let’s draw him a picture and I’ll text it to him.” If your family prays or meditates or has a way to reflect on these situations, then I would recommend doing it with your child to emphasize your family’s cultural values more than your own worry.   

How should families explain economic impacts like food scarcity, housing changes, income or job loss should they be experiencing it? 

Dr. O’Banion: Emphasize your family’s strengths way more than worrying your child about things your child can’t control.  You can be direct and honest without telling them too much about things that a child can’t help you with: “We are a family that has been through a lot and we are strong.  Right now, we need to be careful with the food in the refrigerator and pantry.”   

Dr. Topple: You could say something like, “Mommy and daddy (or whoever is caregiver) is unable to work right now while we are waiting for the sick bugs to go away. We work to get money to buy the things we need. Right now this means we can only buy things we really need like food. We will always take care of you and make sure you are safe and have enough food.”

If parents/caregivers must utilize a new or emergency child care situation, how can they help their child adjust? 

Dr. O’Banion: Be calm and cool about it.  Your child might be upset – that’s quite understandable. Be direct about your plans for the day: “Gigi can’t stay with you today and I’m sorry. Today, you’re going to stay with Ms. Ellen while I go to work.  I will be home at 5:30. Can you show Ms. Ellen how we have been washing our hands?  I think you’re a great teacher, I bet you can teach her later about all the fun things we do in our house.” 

Dr. Topple: 

• Make sure your child knows the person first. Take extra time to stay with your child to transition. Use language like, “Mommy is going to work and Ms. Jane will take care of you, like Ms. Alice takes care of you at school. I will be back and can’t wait to hear all about your day. I will be thinking of you while I’m at work.”
• Have a goodbye routine that you can always use no matter the caregiver. Important that the child care worker also participate and support the transition.
• For child care providers: Welcome the child in. For example, “I am so glad you are here. I am taking care of you while Mommy is at work. Today we are going to play with playdough. I can’t wait to show you my special playdough toys.” Bend down to the child’s level.
• For all: Slow and intentional transitions, rather than quick or drawn out transitions are better for kids. Kids can also use transition objects such as stuffed animals, special blanket, picture of parent, etc. It is important that the new caregiver communicate that their job is to take care of them and keep them safe until mommy or daddy come back.

Can you share any basic tips for managing parents’ own stress and expectations? 

Dr. Topple:Find other parents/adults/support group to message with or talk on the phone. Find things you enjoy doing with your child and try to do that at least once a day (read a book, roll a ball, color, blocks, or just snuggle up together).