{"id":47161,"date":"2020-04-14T11:10:55","date_gmt":"2020-04-14T10:10:55","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=47161"},"modified":"2020-04-21T09:30:35","modified_gmt":"2020-04-21T08:30:35","slug":"elizabeth-rider-keeping-children-emotionally-healthy-covid-19-pandemic","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/04\/14\/elizabeth-rider-keeping-children-emotionally-healthy-covid-19-pandemic\/","title":{"rendered":"Elizabeth A Rider: Keeping children emotionally healthy during the covid-19 pandemic\u00a0"},"content":{"rendered":"

We must not lose sight of children and adolescents during and after the covid-19 pandemic, says Elizabeth A Rider<\/p>\n

\"\"The rapidly evolving covid-19 pandemic, now with <\/span>confirmed cases in 213 countries<\/span><\/a>, has caused worldwide fear, anxiety, and confusion in adults, and major disruptions in almost all aspects of daily life. The primary focus of healthcare leaders is necessarily containment of the epidemic. What about the pandemic\u2019s effects on children?\u00a0<\/span><\/p>\n

Although covid-19 currently appears to be <\/span>less frequent and less severe among children and adolescents<\/span><\/a>, they remain significantly impacted by concomitant disruptions, including separation, social isolation, illness of caregivers and family members, uncertainty, and increasing stresses on families and living situations. Quarantines, school closings, <\/span>home confinement<\/span><\/a>, and other containment approaches mandated in a rapidly growing number of countries pose additional challenges.\u00a0<\/span><\/p>\n

Children are especially vulnerable to the emotional and psychological impact of covid-19 given their need for security and comfort in the world, and their difficulty conceptualizing the real impact of a health or other disaster. <\/span>Sprang and Silman studied<\/span><\/a> the reactions of children and their parents to pandemic disasters and found that 30% of isolated or quarantined children and 25% of their parents met criteria for post-traumatic stress disorder (PTSD). PTSD was found to be four times higher in quarantined children compared to those who were not quarantined. Quarantined individuals often experience post-traumatic stress, detachment, anger, and insomnia, <\/span>even years later<\/span><\/a>.<\/span><\/p>\n

Healthcare systems and clinicians worldwide are stretched thin looking after people who require acute care due to covid-19 in numbers that are unprecedented for non-wartime events. Children and parents are sheltering at home, with the primary burden of childcare and teaching now resting on at-home parents and other caregivers. Many parents do not have training in understanding child development, nor knowledge of age appropriate responses and interventions when their children articulate or exhibit behavioral, and sometimes physical, reactions to the covid-19 pandemic.\u00a0<\/span><\/p>\n

Increasing the capacity of parents, families, teachers, and other frontline child caregivers to recognize and respond to children\u2019s and adolescents\u2019 emotional and behavioral reactions to the covid-19 pandemic may help to prevent some of the negative sequelae of childhood emotional trauma from the pandemic. Consequently, understanding the impact of the covid-19 pandemic on children and adolescents, and <\/span>its relationship to their developmental stage<\/span><\/a>, is vital.\u00a0<\/span><\/p>\n

Children and adolescents are acutely aware of their parents\u2019 and caregivers\u2019 stress and anxiety. Those also experiencing the life threatening illness or loss of family members or friends will be especially impacted. Practical interventions include giving parents and children permission to talk about their feelings and reactions. Avoidance makes the pandemic scarier in children\u2019s minds\u2013\u2013seemingly so dangerous that it cannot be discussed. Healthcare workers can help parents to understand how children may communicate through their reactions, behaviors, and symptoms, and <\/span>guide parents to label and validate feelings and offer constructive ways to manage emotions<\/span><\/a>. Common reactions and supportive interventions by developmental stage include:\u00a0<\/span><\/p>\n

Infants and Toddlers <\/b>(0 \u2013 3 years):\u00a0<\/span>
\nReactions:\u00a0<\/span><\/i><\/p>\n