Caregiving amidst coronavirus: How do we support our children during a pandemic?

As the coronavirus has spread in communities around the country and school closures have necessitated a significant change in families’ routines, parents may be wondering how to talk with their children about the impact of this change to their daily lives. Since 1979, the New York Life Foundation has focused its support on times of transition for young people: following the loss of a loved one and during the shift from middle to high school. As part of this work, the New York Life Foundation has invested in and partnered with the Trauma and Grief (TAG) Center, which aims to foster resiliency in children exposed to traumas or losses. The following is a conversation with New York Life Foundation President Heather Nesle and Julie Kaplow, Ph.D., ABPP, Associate Professor of Psychology, Department of Pediatrics, Baylor College of Medicine and Founder of the TAG Center.

Heather Nesle: How do we help our children navigate these new and unfamiliar circumstances, while ensuring that we are being honest about the reality of the situation?

Julie Kaplow: As parents, we are often faced with the very difficult challenge of reassuring our children during times of stress, while acknowledging that bad things can and do happen in this world. This is the challenge we are now confronted with during the COVID-19 pandemic. Based on existing research and clinical work in the overlapping fields of trauma and disaster response, we have some idea of how children are likely to react to the pandemic and what we, as caregivers and parents, can do to support them.

Heather Nesle: What should we expect from our kids?

Julie Kaplow: Children and adolescents are likely to respond in different ways to the pandemic as a function of their age, developmental stage, and cues from their social environment. Young children in particular are extremely attuned to their parents’ reactions, and their own anxiety is often a reflection of what they are seeing in their caregivers.

Heather Nesle: Are there different responses to the pandemic that are associated with different age groups besides young children?

Julie Kaplow: Yes, there are. Preschool-aged children, school-aged children and adolescents are likely to show developmental differences in how they react to environmental stress associated with the pandemic.

Preschool-aged children may show distress upon separation from caregivers (e.g., being afraid to go in certain rooms by themselves, wanting to sleep with parents, not wanting to be left with a babysitter), developmental regressions (e.g., eating, toileting, speech/language difficulties), increased oppositional behavior or temper tantrums and increased tearfulness.

School-aged children may develop new fears or worries that may or may not be related to the virus (e.g., fear of the dark, fear of loud noises), difficulty sleeping, increased nightmares, aggression or irritability, somatic complaints (headaches, stomach aches) and increased clinginess toward caregivers.

Adolescents may experience lethargy or apathy, social withdrawal (beyond “normal” social distancing), difficulties sleeping or changes in eating habits, irritability or increased moodiness or hopelessness about the future

Heather Nesle: How can we help our children to cope?

Julie Kaplow: Caregivers can help their children to cope with the pandemic by remembering the “Six S’s”:

• Safety and security: During uncertain times, the ability to provide a sense of safety and security to our children becomes even more critical, albeit more challenging. It is helpful to make sure our kids are aware of what the adults in their lives are doing to protect them and keep them safe. For example, you might say, “The reason you are not in school right now is because the government wants to make sure to keep you and all of your classmates healthy.” Or “Experts and doctors across the country are helping to make good decisions about what we can do to make sure the virus doesn’t spread.” Giving children choices and helping them to feel empowered to keep themselves safe can also alleviate some of their anxiety. For example, you might say, “Let’s talk about all the things you can do to keep yourself and our family healthy, like washing your hands or using hand sanitizer after you play outside.”
• Simple language: As parents, we tend to either err on the side of providing too much information, which can be overwhelming to our kids, or providing very little information at all, which sends the message that it’s not ok to talk about what’s happening or it will be too distressing for kids to hear. Meeting children where they are at and making sure you are using language they can understand is especially helpful and allows them to take in as much information as they need. For example, you might say, “I know you’ve been hearing about the coronavirus, and you may have heard some things that are making you feel worried or upset. What questions do you have for me?” Or “Even though we don’t know very much about the virus since it’s new, there are still some facts I can share with you. What would you like to know about it?” From there, you can let your child guide the conversation, as they often intuitively know what information they can or cannot handle.
• Supervision: As much as it’s helpful to provide children with factual, simple information on a “need-to-know” basis, media outlets and the news can be overwhelming and/or frightening to adults and children alike. It is important to monitor the type and quantity of information your child is receiving and try as much as possible to keep it to a minimum. You can also watch the news with them, answer questions they may have, and turn it off if it becomes unhelpful or too detailed/distressing.
• Structure: When the world outside feels chaotic and out of control, children benefit from having a familiar routine or structure to their day. It is obviously more difficult to do this when children are not in school, but families can create schedules together so that kids know what to expect each day. Allowing children to build in time for playing outside or taking a “tv or video break” can also be helpful.
• Social support: We know that social support is a very powerful protective factor during times of stress, but with the need for social distancing during a pandemic, exposure to adequate social support can be much more challenging. Helping kids find ways of connecting with friends, whether through phone calls, texting, email, or Facetime, will be especially important right now. In addition, reminding adolescents, who are particularly invested in their friends at this age, that this is a temporary situation can help to alleviate fears or concerns about “losing friendships”.
• Self-care: As caregivers, we are often consumed with ensuring that our children are healthy, happy, and safe, but that can come at a cost when it involves putting our own health and well-being aside. The best thing we can do for our children is make sure that we are getting the support we need and taking care of ourselves. This can include making time to reach out to our own friends and family, exercising, eating healthy, and getting enough sleep.

Heather Nesle: Is there anything else parents can do during this difficult time?

Julie Kaplow: The only predictable part of life is change. The ability to adapt to a “new normal” in the face of a pandemic will require accepting the ambiguity of life, knowing that we can only control our own reactions (and not necessarily the environment itself), and doing our best to be present for our children when they need us the most. The coming months can be filled with “teachable moments” for our children, including how to effectively cope with stress and how to focus on the things that really matter such as health, relationships, and doing our part to keep our community safe from harm.

Parents can also look into resources from the National Child Traumatic Stress Center, UNICEF, the National Association of School Psychologists and the Child Mind Institute.

Julie Kaplow, PhD, ABPP, is a licensed clinical psychologist and board certified in Clinical Child and Adolescent Psychology. In 2012, Dr. Kaplow founded the Trauma and Grief (TAG) Center, a designated Treatment and Service Adaptation Center of the National Child Traumatic Stress Network, specializing in childhood trauma and bereavement. This role involved providing oversight of evidence-based assessment, treatment, and research with traumatized and bereaved youth and families, and developing and disseminating trauma- and bereavement-informed “best practices” to community providers nationwide. A portion of her work is funded by the New York Life Foundation.

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