GLOBAL – June 24 2020 How COVID-19 affects children: A child psychologist weighs in Elisabeth Kaspar, a clinical psychologist, works with children and adolescents at a hospital in Vienna, Austria. She shares some advice on how parents and caregivers can best help their children manage the stress and anxiety of the COVID-19 crisis. COVID-19 has altered the lives of millions of people. In what ways will COVID-19 affect the mental wellbeing and health of children? COVID-19 affects all of us, no matter how old we are. Like with everyone, not every child reacts the same way. Some children might not be very concerned, whereas others develop unpleasant feelings. Like adults, children also have different personalities and levels of resilience, which affects their wellbeing. Some children might develop higher levels of stress, feeling restless or grumpy. Some might develop anxiety and become irritable, aggressive or scared. Depending on how long the situation lasts, feelings of sadness or depression could appear, which could lead to social withdrawal or crying. All these feelings can also display in physical reactions including stomachaches, headaches, or loss of appetite. Reactions to the pandemic, including school closures, home office and the closing of all non-essential shops, have essentially put life as we know it on hold. Which of these changes has a particular effect on children? The lack of routine is probably one of the biggest factors affects children. Routines (e.g. getting up at 6.30 am, kindergarten/school from 8 am to 3 pm, meeting friends, having dinner, going to bed at 8 pm) give children structure and a framework they can rely on, which is very important. Routine and structure give them a feeling of safety and comfort. Another big thing is the loss of social contact. Imagine how children miss their grandparents, playmates and friends! Younger children are not even capable of getting in contact with their friends/grandparents by themselves. To accept the recommended and necessary barriers is difficult for us adults and probably much more difficult for our little ones. The fact that many parents have to do home office now is also not easy for children to accept and understand, especially for the younger ones: “My mom/dad is at home and has no time for me?” Just keep in mind that this situation, as difficult as it is for you, is also difficult, new and unexpected for children. Finally, the impact of media can have a negative effect on children, just as it might have on you. The continuous stream of reports and pictures of people who are getting sick and even dying that children are seeing on TV, the radio and social media can lead to fear and anxiety. It seems that there is no certainty about how long the measures being imposed around the world will last. Will staying home and out of school for a longer period have a greater effect on their mental health, or will they adapt over time? Fortunately, people, including children, are very flexible and adaptable beings. Still, the longer children are not allowed to have direct contact with their friends and grandparents, the more they will miss them. Staying at home for a long time can be tough, feelings of isolation and fear could appear. Cabin fever could arise when the whole family is together 24/7 for many weeks. This can lead to conflicts within the family which also can frighten children. What can parents and caretakers do to alleviate the mental stress that the pandemic places on children? 1. One of the most important things is talk to them! Talk about what is going on, ask them about their thoughts and feelings. Be there for them when they are upset because you have to cancel their birthday party, or because they can’t see their grandparents. Be a compassionate and safe adult for them. Research shows that this has a very calming effect on kids. 2. Let your children play. Free and undirected playing is essential for their emotional well-being, especially in these times. It also has a tremendous impact on their cognitive and social development. Through playing, children express and conquer their feelings which helps them develop emotional strength. 3. Let your children be physically active. Exercise increases the psychological and physical wellbeing and also reduces stress hormones. If the measures in your country permit, go outside and get some fresh air with your children. 4. A technique that reduces mental and emotional stress – from preschoolers to adults – is mindful breathing. Teach your children to observe their breath and take deep breaths together. One way to do this: lay down, place a cuddly toy on your belly and watch the stuffed animal slowly move up and down as you inhale and exhale. 5. Help your children, especially the younger ones, sustain their social life and stay in contact with their friends and grandparents. Let them write letters or draw pictures to send to family, and make phone calls or video calls. They will be happy to see that everything is okay. 6. Finally: Practice self-reflection as a parent and caretaker. How do you feel? Are you anxious? Stressed? Overstrained? If these feelings are too strong to handle, please seek professional help for yourself. This will also help your children. Should parents and care-takers tell their children about what is going on? In what detail? Three key things I would consider when communicating with children about COVID-19 are: Facts should be age-appropriate. Your small child probably knows how it feels to have a cold or the flu, right? Use that to explain that people can get sick from the coronavirus and have to stay at home, like when they have the flu. It is not necessary to tell them the exact amount of numbers of newly infected people or of people who have died. Focus on the good things, namely: what can YOU do in your family to stay healthy and to help others stay healthy (washing hands, staying at home, establishing healthy habits so that the body is strong, etc.). This will make you and your child feel safe. Turn off the TV and radio. It is not necessary to hear every single piece of news, especially not when your child is around you. Don’t let yourself and your child get flooded by all the information surrounding you. It is enough to check out the news once a day. At SOS Children’s Villages, we work with children who have often lost parental care or grown up in alternative care. Some of them have experienced trauma. Is there a risk that COVID-19 can worsen their mental state specifically, perhaps sparking previous trauma? As mentioned before COVID-19 can lead to stress, anxiety or fear. These feelings can worsen and trigger previous symptoms or even lead to re-traumatization. The important thing is to stay in close contact to the children. Talk to them frankly and listen carefully. Observe if the behavior and habits of the children are changing for the worse. If so, get professional help. Given that the situation might not change any time soon, what are some ways to maintain normalcy in the lives of children during this time? Try to maintain as much structure and routine as possible. You could establish fixed times for mealtime, playtime with the parents and so on. Make a weekly schedule for or with them so they can see what is coming up next. You can also plan one fun and special thing to do together each day that they can look forward to – have a dance party, bake a pizza or have a pillow fight! Most important thing: have fun together. Laughing brings joy to both your life and the life of your child. It increases the release of the happiness hormones serotonin and endorphins, which help everyone feel better. Laughing also reduces the production of stress hormones, like adrenalin and cortisol. Last but not least: do things that make your children and you happy!