: Hoe ouders de geestelijke gezondheid van kinderen tijdens COVID-19 in de gaten kunnen houden – en indien nodig hulp kunnen krijgenseptember 10, 2020
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As schools reopen six months into the pandemic, many children are worried for their families’ safety and stability, bummed they can’t see friends or play sports, struggling with distance learning or worse.
Two recent studies published in the journal Pediatrics shed light on how the COVID-19 crisis has impacted children’s and parents’ mental health: One, which analyzed surveys taken from February to April of hourly service workers with a child aged 2 to 7, concluded that “in families that have experienced multiple hardships related to the [COVID-19] crisis, both parents’ and children’s mental health is worse.”
“As the crisis continues to unfold, pediatricians should screen for mental health, with particular attention to children whose families are especially vulnerable to economic and disease aspects of the crisis,” the authors wrote.
The other, a June survey of parents with kids under 18, reported that “27% of parents reported worsening mental health for themselves, and 14% reported worsening behavioral health for their children” since March, among other findings.
Children and adolescents “may begin to worry about things that perhaps in the past they didn’t have to worry about as much, and/or are stressed out by listening to the news [or] trying to figure out how to make the next academic year work for them,” said Tyish Hall Brown, a child psychologist and associate professor at the Howard University College of Medicine. Household issues such as financial stressors or food insecurity may also weigh on kids, she added.
As for children who were living with mental-health conditions prior to the pandemic, some may already have learned coping skills that are helping them push through the pandemic’s added stressors, Hall Brown said — while others are now experiencing anxiety or depression with greater frequency.
“For kids already struggling with things like depression or anxiety or ADHD, I think we’re seeing that for some kids that’s been really heightened,” said clinical psychologist Garica Sanford, the training director at the Momentous Institute, a Dallas, Texas nonprofit that works with kids and families to promote social-emotional health.
Compounding pandemic-related concerns, of course, is stress and worry related to the ongoing national reckoning on racial justice and police brutality. “It’s almost like having another pandemic in and of itself,” Sanford said. “For some of our families this is not new, but it’s now heightened and it’s intersecting with the global pandemic.”
Here’s how to gauge whether your child is having mental-health difficulties during the pandemic — and what to do if they are:
“ ‘If that’s long-lasting or really severe and different from the way a kid was behaving before, that’s where we really want to lean in and get curious.’ ”
— Garica Sanford, training director at the Momentous Institute
Monitor your child — and know when to actually be concerned
“We should expect that some kids likely will have some changes in their behaviors and their moods,” Sanford said. “But we really want to look at severity, frequency and duration of changes.”
You might see changes in children’s sleep, appetite and increased or decreased desire to be around parents, Sanford said. Young kids might show behavioral changes such as increased tantrums or heightened energy right now, Hall Brown added. Teens might show greater irritability or avoidance of certain situations.
It’s most important to notice any major changes in behavior, Hall Brown said: Were they previously outgoing, but now don’t even want to talk to friends via Zoom ZM,
“If that’s long-lasting or really severe and different from the way a kid was behaving before, that’s where we really want to lean in and get curious,” Sanford added. “What we really want to look at is what’s the impact on their overall functioning.”
Contact a health-care provider if your child’s change in behavior starts interfering with their finding pleasure in activities or doing what you think they should be doing, said psychologist Mary Alvord: “They’re pulling away more, or they’re not getting any of their work done, or they’re not wanting to talk to friends or to you,” she said. You can speak with a school counselor, psychologist, pediatrician, school nurse or other mental-health professional.
Avoid trying to diagnose your child on your own, especially when it comes to anxiety and depression, said Donna Hallas, the director of the pediatric nurse practitioner program at the NYU Rory Meyers College of Nursing. Instead, take note of any changes in your child’s behavior — filling out a screening tool like the Pediatric Symptom Checklist can help — and relay your observations to a health-care provider if you’re concerned, she said.
“What we ask parents to do is describe the behaviors, and then we talk to them and we make the diagnosis based on everything we see,” Hallas said. If your child has a previously diagnosed mental-health condition, be sure to stay connected with their provider, she added.
“ ‘Don’t think just because you had a conversation today that tomorrow they’re going to be in the same place.’ Try to budget a daily check-in during a mutually convenient time. ”
— Tyish Hall Brown, a child psychologist and associate professor at the Howard University College of Medicine
Keep an open line of communication
“When you’re not sure what to do, prioritize the relationship” between yourself and your child, Sanford said. Hall Brown urged parents to “continuously have conversations with your children” and let them speak their mind. “Don’t think just because you had a conversation today that tomorrow they’re going to be in the same place,” she said. Try to budget a regular check-in at a mutually convenient time.
Parenting a sullen teen who wants nothing to do with you? Be persistent and think up creative ways to communicate, said Sanford, who recalled hearing of a parent who leaves a journal open for her and her daughter to write in throughout the day. Brainstorm ways to converse while allowing for some distance, whether that’s going for a walk or allowing a conversation to unfold in smaller moments over time. Let them know you’re there for them, Alvord added, and make sure they know how to reach other trusted people such as a favorite aunt, friend or sibling.
If you’re an essential worker who isn’t at home with your child 24/7, you can still find “intentional times to connect,” Sanford said, whether they’re through text messaging, leaving notes, or making a quick call on your break.
Validate their feelings. “If they say they’re anxious or nervous about something, don’t be dismissive about it — hear them out,” Hall Brown said. It’s important for parents to tell their kids, “It’s OK if you’re not totally OK,” Alvord added.
Help your kid troubleshoot
“Coping mechanisms could be figuring out a little bit of what the problem is,” Hallas said. If the problem is that they miss seeing their friends, for example, you could engineer a COVID-safe playdate and help them adjust.
Encourage your child to refocus on what they can do to make themselves feel better, help their community, and be productive in spite of the challenges they’re facing, Hall Brown said. Help your kid push back on negative thoughts, she added, like the belief that they’ll “never” see their friends again.
“Every time we hear ‘never, ever,’ we have to stop and pause, because that’s not the case,” she said. “If a parent can help a child narrow down exactly what that worry is, which is ‘[I] can’t see my friend today,’ they can help them move past that.”
“ ‘Would they like to draw, paint, read a story, listen to music, run around, bike-ride? They need even more to look forward to, because there’s just not a lot of variability in activity during the day.’ ”
— child psychologist Mary Alvord
Provide some structure and routine
“I find that when kids are just in their rooms, when they’re just leisurely doing whatever they want to do throughout the day, they get bored or start to focus on things that are a challenge for them,” Hall Brown said. A bit of structure — designated times for waking up, exercising, reading and having time to themselves, for instance — can help them stay active and avoid dwelling on the negative, she said.
Work with your kid to create a “menu” of activities they’d like to do during free time built into the school day or after school, Alvord said. “Would they like to draw, paint, read a story, listen to music, run around, bike-ride?” she said. “They need even more to look forward to, because there’s just not a lot of variability in activity during the day.” Get outdoors.
Allow kids opportunities to exert some control, even on decisions as simple as what to eat for dinner or what to wear to school. This can give them a sense of agency, “given that right now things feel so out of control and unpredictable,” Sanford said.
Limit media exposure
“We’ve often recommended that parents limit the amount of exposure to the news outlets, to social media and to other ways where they’re being exposed to a lot of the graphic images and a lot of the challenges that we’re currently facing,” Hall Brown said. “By limiting, we give parents the power to help the kids to digest information and have conversations with them that are appropriate for their developmental age.”
Take care of yourself
Sanford and Hall Brown both drew parallels to the familiar airplane-safety protocol of putting on your own oxygen mask before helping others.
“During this time, [kids] really need the ability to know that somebody is there — that even if they don’t know what’s going on in the world or what to predict next, they know who’s there to help them or sit with them when there’s not a clear solution,” Sanford said. “In order to do that, parents first need to make sure we’re taking care of ourselves.”
Remember that asking for help can be a strength, Alvord added. “It makes you stronger. It helps you do better. You don’t have to do it all alone.”