15 Recommendations for Children and Adolescents during COVID-19

15 Recommendations – Children and Adolescents during COVID-19

By Naina Arora (Trainee Clinical Psychologist)

 On March 11th, 2020, World Health Organisation announced COVID-19 as a global pandemic. Masking up, sanitising and social distancing became the need of the hour. The COVID-19 pandemic is not only a medical pandemic but also a psychological one. The pandemic has affected people physically, mentally, socially and spiritually. The current challenges brought about by COVID-19 are unparalleled and caused fear, anxiety, stress and uncertainty to so many of us. Its far reaching debilitating effects have spared none ranging from children to older population. The children and adolescents especially have been impacted adversely by the pandemic.

A child can experience stress even when he is in the womb. A mother experiencing high stress during pregnancy can lead to the child developing various behaviours like inattentively, hyperactivity, temper tantrums, separation anxiety, etc after being born (Biaggi et al, 2016; Kinsella & Monk, 2009). So, during these unprecedented times, when the stakes of getting infected are high, both the emotional as well as social development of children are getting affected.

Children have been seen to show signs like clinginess to the primary care takers, fear of the care takers getting affected, irritability, inattention and acquiring more information about what the pandemic exactly is about (Singh et al, 2020). Other symptoms that the children display are disturbed pattern of sleep, separation related anxiety, nightmares, poor appetite as well as anger outbursts (Jiao et al, 2020).

Due to the lockdown, the schools have also shut down making the education system more virtual. This too has impacted children adversely as this has led to a breakdown of the routine, monotony, boredom, decrease in creative ideas and physical confinement within four walls (Jiao et al, 2020). Children, too have displayed a longing for playing with their friends outdoors as it was a medium of bonding for them. Due to not being able to do so they cling more to their care takers and often show behavioural disturbances (Lie, 2020; Liu et al, 2020; Zhai & Du, 2020).

Also, due to more time spent indoors and educational system becoming virtual, the screen time of children has increased. This puts them at at a risk of compulsive internet usage, viewing content that is objectionable as well as getting abused (Cooper, 2020; UNICEF, 2020b). In teenagers, high level of anxiety and hoarding behaviour has been observed (Lee, 2020; Oosterhoff et al, 2020).

As far as children and adolescents with special needs are concerned, the pandemic and the lockdown has only worsened their condition. It has led to development to uncertainty in their life due to unstructured routine. This has aggravated their symptoms as children with special needs, like autism, have a low tolerance for uncertainty. They also have a hard time in understanding what exactly the pandemic is and following instructions. Closure of the special schools too has led to a regression in the progress made by the children as there is lack of social interaction as well as skill training (Lee, 2020). In adolescents with special needs, anger outbursts, self harm and conflict with parents have been witnessed.

The underprivileged children are having it worse. They already struggled to earn their bread and butter. But due to the lockdown they aren’t able to afford even the bare minimum things required for survival which puts them at a greater risk of showcasing behavioural and emotional disturbances (Singh et al, 2020).

Recommendations during Covid 19

Though these tough times have raised innumerable problems for the children as well as their caregivers, steps can be taken to make the situation better. Following are some of the steps that can be taken by the parents of the children:

  • The younger children as compared to the adolescents require more attention from their parents. So the parents should try to give them undivided attention, warmth and unconditional positive regard.
  • The parents should try to communicate the depth of the situation to children in as simple terminologies as possible according to the developmental level of the child. They can even use the videos and diagrams tailor made for children by UNICEF and WHO to explain about the pandemic.
  • Exposure to news should be cut down and only fact based neutral news channels should be shown to children.
  • Parents are role models for their children. So they should model proper preventive measures in order for the children to lean.
  • Manage your child’s anxiety. Try to look for emotion cues in the child and address them. Try answering all their queries related to the pandemic and don’t avoid them. Also don’t be harsh on them for not acting in accordance to the situation. Rather try to tackle them calmly and reassure them that things will get better if they take proper precautions.
  • A routine should be built for the child and be adhered to. We can set up a time for waking up and going to bed. Screen time needs to be monitored and child lock can be put on certain websites which the parents find objectionable. Child can be engaged in household chores. He/she can be involved in indoor games like mazes, puzzles or maybe board games. Study time should be set and the child can be given small study assignments related to their lessons. Also, physical activities should be a part of the routine .
  • Children can be made to meet their playmates virtually. Parents can also organise activities for the children which can be done virtually. However, their meetings should be carefully supervised by the parents to avoid any objectionable activity taking place.
  • Responsibility, collaboration and accountability should be taught to children by engaging them in household chores and making them feel like an equal member of the family.
  • Engagement in creative activities like art, music or dance should be promoted as it acts as an outlet for all the pent up energy and negative emotions. Building up new hobbies like creative art, stretching, cooking, etc should also be promoted.
  • Adolescents often indulge in risk taking behaviours and might break COVID-19 protocols. Such issues need to be assertively addressed by the parents.
  • Adolescents who are shy should be encouraged by their parents to stay in touch with their peer group, express themselves and not restrict themselves to their rooms.
  • For children with special needs, parents need to actively participate in managing the behavioural difficulties of the child, maintaining their routine and promoting health-related behaviours.
  • For underprivileged children, the parents need to be supportive of their children, maintain healthy parenting, and indulge in solving the problems of their children.
  • Practicing open communication is also very important and whenever necessary, parents should provide reassurance to their children about the whole scenario. They should listen to their child’s concerns and try answering them. Small boding exercises like reading stories to the children and putting them to sleep can make them feel secure and loved.
  • At last but not least, parents need to take care of their own mental well-being and try to cope with the stress adaptively.

Hope you find this article interesting and are able to relate to it.

References

Biaggi A., Conroy S., Pawlby S., &Pariante C.M. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J. Affect. Disord. 2016;191:62–77. doi: 10.1016/j.jad.2015.11.014

Cooper, K. (2020, September 4). Don’t let children be the hidden victims of COVID-19 pandemic. https://www.unicef.org/press-releases/dont-let-children-be-hidden-victims-covid-19-pandemic.

Jiao W.Y., Wang L.N., Liu J., Fang S.F., Jiao F.Y., Pettoello-Mantovani M., Somekh E. Behavioral and emotional disorders in children during the COVID-19 epidemic. J. Pediatr., S0022-3476(20)30336-X. 2020 doi: 10.1016/j.jpeds.2020.03.013.

Kinsella M.T., Monk C. Impact of maternal stress, depression and anxiety on fetal neurobehavioral development. Clin. obstet. Gynecol. 2009;52(3):425–440. doi: 10.1097/GRF.0b013e3181b52df1.

Lee J. Mental health effects of school closures during COVID-19. Lancet. Child Adolesc. Health, S2352-4642(20)30109-7. 2020 doi: 10.1016/S2352-4642(20)30109-7.

Liu J.J., Bao Y., Huang X., Shi J., Lu L. Mental health considerations for children quarantined because of COVID-19. Lancet. Child Adolesc. Health. 2020;4(5):347–349. doi: 10.1016/S2352-4642(20)30096-1.

Oosterhoff B., Palmer C.A., Wilson J., Shook N. Adolescents’ motivations to engage in social distancing during the covid-19 pandemic: associations with mental and social health. J. Adolesc. Health. PMC. 2020 doi: 10.1016/j.jadohealth.2020.05.004.

Singh S, Roy D, Sinha K, Parveen S, Sharma G, Joshi G. Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations. Psychiatry Res. 2020;293:113429. doi:10.1016/j.psychres.2020.113429

UNICEF. (2020b, April 14). UNICEF. UN News. https://news.un.org/en/tags/unicef.

Zhai Y., Du X. Mental health care for international Chinese students affected by the COVID-19 outbreak. Lancet Psychiatry. 2020;7(4):e22. doi: 10.1016/S2215-0366(20)30089-4.

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