Helping Kids and Families Cope with COVID-19

Original article updated on April 20, 2020 to accurately represent the evolving situation.

Families are continuing to adapt to the new normal of sheltering in place, social distancing, remote learning and work, to help slow the spread of the novel coronavirus (which causes COVID-19). Experts at Stanford Medicine Children’s Health have advice about how families can continue to help their children cope throughout this challenging period of time.

Communicating openly about what is going on is key, and parents and caregivers should communicate in an age-appropriate way that addresses children’s questions without stoking anxiety, says Stanford Medicine Children’s Health psychiatrist Victor Carrion, MD, who also directs the Stanford Early Life Stress and Resilience Program. It’s important for children to understand that worry is a normal response to news about the disease. But children should not be put in the position of helping parents handle their own worries. It is the parent’s or caregiver’s job to help children feel safe.

Dealing with the ongoing challenges of prolonged shelter-in-place orders:

All children and teens need to be reassured that physical distancing does not mean we want them to lack social or emotional connectedness. Families should help kids stay connected to friends and loved ones using technology.

Structure is beneficial for everyone as a way of mitigating the stress of having to stay home. Families can develop daily routines with consistent times for eating, sleeping, learning, working, and socializing.

Kids and teens can gain a sense of control by sharing in family decision-making, such as by choosing a movie, game or activity for everyone to enjoy.

Adolescents especially need opportunities to socialize with peers online or by phone, and they need privacy from parents while doing so. It is also helpful if families are able to set aside a “teen cave,” a space in their home that is just for their teens.

It’s important to talk with children and teens about their sadness related to missing milestone events, such as birthday celebrations, graduation ceremonies, or long-planned family vacations.

Parents can help reframe negative truths by acknowledging disappointment and also by talking about how good it will feel when we are able to see loved ones again, as well as how we will come up with new and special celebrations.

Parents can model good self-care behaviors and help everyone in their families follow them. These include healthy eating, maintaining good sleep habits, avoiding use of alcohol and drugs, and getting exercise and time outdoors. Yoga and mindfulness techniques can be particularly helpful because they address physical and mental well-being together.

Children or teens receiving regular mental health care for previously diagnosed conditions should not discontinue treatment now. Most mental health providers are continuing to see patients using telemedicine.

Tips for how to share information about the spread of the virus with children and teens:

Parents can reassure their kids that COVID-19 appears to be mild in children. Remind children and teens of important preventive steps, such as proper handwashing, and discuss how community and national experts are helping us understand the virus and how to limit its spread.

Kids need information tailored to their age and comprehension level. A preschooler can handle less detail than a teenager, for instance, and children of different ages process their reactions to challenging news differently.

Parents should maintain open communication, recognizing that their children will continue to ask new questions about COVID-19 as time passes. Each conversation can be short, and Dr. Carrion recommends answering a child’s specific question without providing a lot of extra information. “Often, kids just want to know what they’re asking,” he said.

Playing games or drawing pictures about the news is the best approach for the very young, while engaging in conversation is appropriate for older kids. “Play is more than fun,” Dr. Carrion said. “Play is very important developmentally.”

There are multiple benefits to teaching children basic infection-control measures, including coughing into their elbow or singing “Happy Birthday” twice while washing their hands to ensure thorough handwashing. In addition to reducing their risk of illness, these actions provide kids with a sense of control over something they may not completely understand. Similarly, parents can emphasize that social distancing is a positive action that helps protect vulnerable community members.

It’s appropriate to limit children’s exposure to news reports, while recognizing that older kids may come across these on their own and want to discuss them. Parents can also ask what their children have heard about the coronavirus from other sources. For older kids on social media, parents can discuss how to spot reliable versus unreliable news sources and can point to reliable information sources.

Parents should be alert for behavior changes that signal distress, such as increased clingy behavior in a preschooler, unexplained complaints of headaches or stomachaches in a youngster, or sudden withdrawal in a teenager. These behaviors are often a clue that a child needs help.

More of Dr. Carrion’s discussions of these issues are available in a recent Stanford Medicine podcast interview with him. View a video presentation on ‘Talking to Young People About COVID-19’ with Dr. Carrion and experts from Stanford’s Department of Psychiatry and Behavioral Sciences.

For more information for families on coping with COVID-19, see the National Child Traumatic Stress Network’s fact sheet.

For the latest information about COVID-19, please visit http://coronavirus.stanfordchildrens.org.