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Published on March 31, 2020

Reassuring children in the age of COVID-19

Children COVID

A Cape Cod Health News reader whose 8-year-old grandchild has been experiencing anxiety because of the COVID-19 pandemic, wrote this on social media:

“I’m watching my grandchildren now that they don’t have school. Angela, (not her real name) is making herself sick and has been filled with anxiety. She is afraid we are all going to die. She has been crying herself to sleep, and my daughter (Angela’s mother) is beside herself. We don’t know what to do.”

Many children, teens and adults can identify with Angela’s reaction to the upheaval, but clinical psychiatrist Colleen Sari, MD thinks young children are having the most difficult time coping with the stress imposed by the pandemic.

“This is a very trying time,” said Dr. Sari, who specializes in child and adolescent psychiatry at Cape Cod Healthcare Centers for Behavioral Health in Hyannis. “Younger children have no concept of what a virus is and no experience coping with this type of stress. They’re asking, ‘What does the coronavirus pandemic mean?’ The source of this stress is totally alien to children.”

For instance, she recently talked with the parent of a 5-year-old patient who never had sleeping problems. Now, that patient is waking up late at night and turning every light on in the house. Dr. Sari suggested the child is scared that the virus is coming, which she thinks of in concrete terms as the bogeyman.

Explaining COVID-19 to Children

The best thing parents can do is try to explain concepts like viruses and social distancing at levels their children can understand, Dr. Sari said. She recommended using words children know, using upbeat (as opposed to ominous or frightening) voice inflections.

A 5-year-old and an 8-year-old child’s thoughts are pretty concrete, Dr. Sari said, so you have to use words like ‘very, very’ with the right inflection.

“Tell children we have to keep ourselves from other people so we can’t make them sick and they can’t make us sick.

“We’re just being very, very safe. We’re keeping the bogeyman out,” she said. “Many children understand the flu, so you can say, ‘This is like getting the flu. Most people get a little sick when they have the flu. And sometimes people get really sick when they have the flu.’

“I hesitate to tell young children people could die, but you could add that some people are really sick, but very few die.”

How to Deal With Stay-at-Home Stress

Now that schools are closed, physical distancing is the new norm and many parents are working from home due to the COVID-19 pandemic, Dr. Sari offered the following advice for helping children cope.

Provide structure

Develop a schedule and follow it. Children are used to routines, and routines will help them feel safe. Keep daytime rituals and nighttime rituals. Go to bed and wake up at regular times. You don’t have to have a rigid schedule right now, but it’s best not to go to extremes.

For example, one of Dr. Sari’s patients told her mom she always had math class after lunch at school. Letting the child do her math homework after lunch at home made the child comfortable. Giving her a familiar, structured schedule eased her anxiety.

Practice self-care

A mother phoned Dr. Sari saying she was stressed out because her children were vying for her time and energy now that she had to work from home. She was getting up early to start her work because the kids always wanted her attention. She was afraid she was going to lose her job if she had to stop working to home-school the kids.

Dr. Sari told the mom it was good to practice self-care, making sure she ate right, slept right and exercised. She needed to keep her job to provide an income for her family, so her work needed to come first. She also needed to prioritize, provide structure for the family, and communicate the schedule clearly.

Here’s where a schedule helps reduce stress, Dr. Sari said. The mother in this case needs to explain to her family that she has a specific time to work, then she will stop and spend time with the children. In the meantime, kids have scheduled times for reading, play, meals, homework, social networking and exercise.

Keep exercising

Kids and adults need to work off this anxiety with physical activity. Physicians are encouraging everyone to step up and exercise. Don’t forget exercise now that you can’t play soccer, lacrosse, or your sport of choice. You still need to get out and exercise, practicing social distancing, of course.

Limit information

Children and adults can reduce anxiety by limiting their news to what they can read. We can control the rate of reading and are not overwhelmed.

If you are anxious, don’t watch the news. Read about it.

A 5-year-old doesn’t need to hear about respirators or masks. They just need to be told they need to stay home to be healthy. Children just need to be told what they can understand.

Getting help

Dr. Sari and other physicians and therapists are using tele-medicine to keep patient appointments. Providers at the CCHC Centers for Behavioral Health are accepting new patients, she said.