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The Altamont Enterprise Regional

‘Reassurance, routines, and regulation’ critical for children in isolation, expert says
Monday, March 23, 2020 - 20:36

COVID pic.jpg
- Photo by Tim Wiles

The empty parking lot at the Guilderland Public Library was the perfect spot on March 21 — a sunny Saturday — for Andy Choens to teach his 4-year-old daughter, Leila, how to ride a bike. Jessica Griffin, a professor of psychiatry and pediatrics at the University of Massachusetts Medical School, told The Enterprise this week that children require some degree social contact to develop resilience to trauma and stress, and that one supportive guardian can make a world of difference during this troubling time. “She had a great time riding in the parking lot,” said Andy Choens. “Maybe, when this is all over, we could do a skills day and invite the community!”

In recent weeks, daily life has been upended by what writer Geoffrey Dyer describes as an “existential inconvenience.” Many people are not under a mortal threat from the coronavirus and its accompanying disease, COVID-19 but, in order to protect those who are vulnerable and to prevent the collapse of the medical system with its spread, everyone must remain in their homes and restrict social contact. 

Children, now home from school until at least April 1 — but probably longer —  are especially vulnerable to the psychic tolls of the global response of social distancing.

“Socialization is key to children’s healthy development, impacting their emotional, psychological, and cognitive functioning,” Jessica Griffin, PsyD, told The Enterprise in an email this week. 

Griffin is an associate professor of psychiatry and pediatrics at the University of Massachusetts Medical School. 

“We are in an unprecedented and frightening time for children and families,” Griffin said. “Social distancing, coupled with the stress on families (e.g., heightened anxiety, fears regarding finances, etc.) could mean stress on children. We know that stress, without the buffering impact of social support, can become toxic on children – negatively impacting their emotional health as well as their physical health.

“The good news is that although stress can become toxic to children’s well-being,” Griffin continued, “the number-one factor in preventing that stress from becoming toxic is the presence of a supportive and nurturing caregiver. Supportive relationships promote our resilience to stressful events  — so it is critical that we maintain our social connections with one another, however we can, while remaining physically safe.” 

Griffin said that, while many people are fortunate to have technologies that allow them to communicate across a distance, children in families that are not able to afford these technologies are not necessarily going to be crushed by the impacts of isolation.

“Science supports that children who have adequate supports in place, even if it is just one supportive, nurturing and available caregiver,” Griffin said, “will bounce back after a traumatic or stressful situation.”

In psychology, the ability to recover from stress or trauma is called resilience. Griffin detailed her basic strategy for developing resilience in children during this difficult and often scary time: Reassure them, keep them on a routine, and help them with self-regulation.

Reassure

One of the challenging aspects of social distancing — for anyone — is internalizing the reason it’s necessary despite its difficulty. This can be hard for children, who may be frightfully paralyzed by the gravity of the situation rather than motivated, which may leave parents feeling uncertain how to explain the drastic changes in behavior that are required. 

“In my opinion,” said Griffin, “it is not the premature closing of schools that will negatively impact them (in fact, they are used to having breaks in the summer, albeit this is entirely different), but how the adults around them respond to this pandemic.” 

Griffin said that it’s important for adults to “put on their own emotional ‘oxygen masks’” before providing support to children, who will be looking for adult cues as they develop an emotional response to the crisis.

This idea threads into Griffin’s first social strategy of providing children reassurance.

“Children need to be repeatedly reassured about their safety,” Griffin said. “Parents can offer reassurance about children’s safety and the safety of loved ones. Children can be told that there are few children affected and that when children do get sick, it is usually quite mild.”

However caregivers decide to reinforce their childrens’ sense of security, it’s important, Griffin said, to not do so by simply leaving them in the dark. 

“Children have a tendency to ‘fill in the blanks’ when they are not provided with adequate information,” Griffin explained. “These are uncertain times; however, not providing any information may be more stressful or anxiety-provoking than providing basic information.”

“At the same time,” Griffin said later, “families need to monitor how much children are exposed to online or on television. Although it is natural to want more information, ongoing access to news programming about the pandemic as well as constant conversation among adults about their fear, anxieties, or threats to others’ safety can be stress-inducing. Children are like sponges, or miniature detectives in times of uncertainty and will tune in keenly to adult responses.”

In order to provide critical information to children without overbearing them, Griffin recommended that digital and cable activity be monitored, and that conversations between adults that deal with “concerns, fears, and worries” be held where children won’t be exposed to adult uncertainty.

Adults should also refrain from openly engaging in unhealthy coping strategies, like excessive drinking or drug use, because that can damage their own sense of resilience and control in the situation. Instead, adults should maintain social contact through technology and ensure a healthy sleep schedule and diet, along with outdoor exposure, if possible, and exercise.

Routines

Routine-building aids resilience in children by giving them predictability and a sense of safety, Griffin said, and that routines are especially important when school is not in session. 

This means regular bedtimes and meal schedules, along with blocks of time dedicated to learning and playing.  

And much like late-night talk-show hosts who have been recording monologues from their living rooms and bathtubs while their shows are suspended to provide normalcy to viewers, children can replicate some of their normal practices while home-bound.

WMHT, the like PBS stations across the state, is offering educational programming for children in fourth grade through 12th, from 8 a.m. to 6 p.m. Monday through Friday, alongside its normal daytime educational programming geared toward kids in preschool through the third grade.

Regulating

Regardless of how well caregivers prepare their children for the reality of the pandemic and maintain normalcy within the bounds of the home, children are likely to endure stress. Teaching kids how to respond to that stress — or “self-regulate” — will ensure that they “bounce back” from it later on.

“When children are stressed out,” Griffin said, “their bodies respond accordingly, releasing stress chemicals in their brains. To help with this, we can encourage youth to practice activities to help calm their bodies down such as exercise, deep-breathing, age-appropriate mindfulness or meditation activities, [and] ensuring they get adequate sleep.”

Griffin also suggested that parents give children vocabulary words, like “scary,” “overwhelming,” “anxious,” and “worried,” to help them communicate their emotions, which will provide relief for the child while helping caregivers understand the emotional state of the child and develop a response.

It’s also important for caregivers to be able to determine what a healthy level of stress is in a child and what amount can be potentially toxic.

“It is normal to expect you may see some emotional or behavioral changes in your child as they and you adjust to the changing landscape,” Griffin said. “However, if your child begins to show an ongoing pattern of emotional or behavioral concerns (e.g. nightmares, focusing excessively on anxieties, increased aggression, regressive behaviors, or self-harm), reach out to professionals. 

“Caregivers can contact their pediatrician or family doctor to assist in referrals or their local mental health agencies,” Griffin continued. “Many providers now have the capacity to provide their services via ‘telehealth’ are able to communicate through the telephone or video-conferencing platform.”

Going forward

In discussing the impacts of the virus on children at large, Griffin was stark but optimistic.

“The narrative of our children’s lives will be forever changed,” Griffin said, “but that does not mean that the change will be entirely negative. We will get through this, inevitably. We have learned so much about trauma and resilience in the last two decades and I know that we will learn even more as we experience and study the individual and societal response to this pandemic.”

Griffin said that, in the long run, an intense national focus on gratitude in times of hardship — a gratitude for technologies that bring us closer together and what it means to support a family member and seven billion strangers all at once — can have a positive impact on this generation of children.

“Children will never forget this time in their lives,” Griffin said. “If we can show them the stories of helpers, the stories of resilience, and can increase their coping skills, this stressful experience may be the stress that is tolerable and stress that can actually promote their resilience in the future as adults.”

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