The disruption in the lives of children during this pandemic has been vast. Loss of family members, school, and routines as well as increased stress in the home from altered work life balance and uncertainty can affect the safe space and reassurance that children need.
Q & A Today:
Dr. Adelaide Robb, Distinguished Endowed Professor and Chair of Psychiatry and Behavioral Sciences at Children's National Medical Center
Q: What are the most common symptoms that you are seeing present in children & adolescents?
1. Online schooling has been difficult and affected children both with their academics and peers.
Increased difficulty in academics. For kids with an IEP (such as ADHD, autism, learning differences), a small percentage are getting the services they need such as speech therapy. For many schools, students have been given packets and video instruction, but accessibility of these resources can be intermittent and difficult. The flexible grading systems, though well-intentioned, have resulted in less learning and disengagement by students.
Decreased peer support. Many children are reporting, "I miss school and I miss my friends." Not all children have cell phones and technology so some have no contact with other children who are a big part of their normal lives, and that has been very hard.
2. Anxiety and Mood Disorders
Children are fearful, and the news is contributing to that right now. Some are having trouble getting food and that is very scary for them. Worsening symptoms, nightmares, difficulty functioning. We can deliver medications and therapy to help, but a part of the treatment of anxiety disorders is practice. If you are having anxiety over going to the store, you may not be able to go to the store right now and do your homework practice from your therapist.
3. Eating Disorders
Adolescents have been stuck at home instead of in an organized setting such as school. For those with an eating disorder, without that organized routine and setting, the struggle with food and constant accessibility to it has been very difficultA. The current lack of structure can also make it harder to exercise.
4. Substance Abuse
Substance abuse is a problem right now also because adolescents are isolated, not getting to 12 step meetings they might need, and yet drug suppliers are making accessibility very convenient with at home deliveries.
5. Acute Stress Disorder
In children of parents who have been ill with Covid during this pandemic, we are seeing PTSD symptoms.
Q: Any recommendations for families around discussing racism?
The American Academy of Child & Adolescent Psychiatry (AACAP) website has some good resources on racism and the protests. As families, you can have an open and honest conversation with your children. We live in a multicultural place with people from all over the world. There are so many natural ways to have these important conversations.
Q: Tips for summer?
This is a time with no homework and no school. It is not going to be the same summer, but it is an opportunity to spend time as a family. Think about this summer as a time to do new things. Bike with friends, learn to fish, go explore and hike. All these things can be done while still socially distancing. Play family board games, have family movie night. Support local restaurants by ordering food and discuss with your children why this is important. Because many students have missed so much school, do some summer packets of reading and math skills. Strengthen bonds this summer.
Many people are incredibly frightened that they will get Covid. Wear a mask, avoid touching your face, wash your hands. We wear eye protection in the hospitals not only to protect against fluid absorption but also to protect us against touching our faces. Yes, it might be a little harder to breathe and may be slightly irritating to wear a mask, but this is a public health measure like vaccinations and wearing seatbelts.
Q: What is being done for mental health for frontline workers at your hospital because without them, we can't deliver care to the children?
The psychology division is available for call in therapy for staff. There are employee programs that cover mental health. There are opportunities for child care for employees. Health care providers are also coping with their own fears and anxieties. I have been encouraging staff to take 5 minutes out from the day to think about what they are grateful for. Also, it is important they talk to co-workers for support as this is a shared experience and connection is important. I am touching base with staff in our department every morning and every evening to give them an opportunity to discuss what is on their mind. These are helpful practices for employers in general. In addition, gratitude and connection and conversation are important for families also fighting to understand this pandemic. Turn off the news. Children are getting frightened because they do not have developed rational thinking skills to process it.
Thank you to Dr. Robb for the inspiration!
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