How does the coronavirus pandemic affect children's mental health?

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With an increasing number of states issuing shelter-in-place ordinances in response to the coronavirus pandemic, more and more Americans are following self-isolation and social distancing practices in an attempt to help flatten the curve. As a result, some may notice an impact on their mental health, with one psychotherapist saying, “The unprecedented stress of what we’re all going through right now is felt by all.”

And that stress can be felt by children, too.

Fox News spoke with Dr. Tali Raviv, the associate director of the Center for Childhood Resilience at the Ann & Robert H. Lurie Children’s Hospital of Chicago, about how the pandemic could affect children's mental health. Read on for a look at the signs a child may be mentally distressed and how to help them.

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Fox News:  What are the signs a child’s mental health may be suffering? 
Dr. Tali Raviv: In times of stress and disrupted routines, it is normal for people of all ages to experience signs of distress. For young children, this may include increased clinginess, tearfulness, nightmares or temper tantrums. You may also see children returning to behaviors they had previously “outgrown,” such as thumb-sucking or bed-wetting.

For older children and teens, you may see physiological changes, such as changes in sleep or appetite, reduced energy, or increased physical symptoms such as headaches or stomach-aches. Cognitive, or thinking changes, are also common and can include forgetfulness and distraction.  Some children or adolescents might become more withdrawn or socially isolated. Finally, increased worries about health and about the future are also common. While all these are normal reactions, parents should be observing their child’s behavior and noticing changes so that they can support their coping.

Fox News: If a child has a preexisting mental health condition, what extra precautions should a parent or guardian take during this time?
Raviv: All children may experience temporary increases in distress due to the COVID-19 situation.  However, children with preexisting mental health needs may be particularly vulnerable. The most important thing for parents to do is to monitor their child and take note of any increase in symptoms.

To the extent possible, families should try to maintain elements of their child’s treatment plan, including continuing taking any prescribed medication and maintaining remote contact with their child’s mental health team. Many therapists and psychiatrists have moved to telehealth operations, and scheduling remote check-ins with these providers can help support positive coping strategies and monitor for signs of worsening mental health.

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"In times of stress and disrupted routines, it is normal for people of all ages to experience signs of distress. For young children, this may include increased clinginess, tearfulness, nightmares, or temper tantrums," Dr. Raviv said. (iStock)

Fox News: Could the pandemic have lasting effects on children’s mental health even after it’s over?
Raviv: The vast majority of youth will be resilient in the face of even severe stress or trauma.  However, there are some children that may experience some lasting mental health effects. This becomes more likely if they have experienced a direct threat to their own safety (such as not having enough food or stable shelter, being very ill themselves or seeing a loved one who is very ill) or experience a death or loss due to the coronavirus.  Children with pre-existing mental health problems are also at higher risk for more lasting mental health concerns.

Fox News: How can you help your child during this time?
Raviv: There are three key pieces to supporting children’s resilience in the face of stressful circumstances.  First is ensuring physical and emotional safety.  This includes ensuring their physical needs are met (food, shelter, healthcare) as well as providing emotional safety by providing accurate information in age-appropriate language, limiting exposure to media coverage, and creating or re-establishing a familiar structure and predictable routines.

Second is building and maintaining healthy relationships.  This includes building and strengthening connections with supportive adults such as caregivers, family members, teachers, and coaches as well as peers.  Also, connecting to a larger community, such as faith-based groups or schools, can also help children build resilience.

Third, supporting and teaching skills for coping and emotion regulation is important to building resilience in the face of this and other stressors.  This includes helping children learn how to express emotions in words, engage in positive activities, use relaxation strategies such as deep breathing, access social support, and solve problems.  Keeping in mind these three key components can help children not only get through this stressful time but also grow and thrive.

Fox News: At what point should a parent or guardian seek help from a pediatric psychologist?
Raviv: Signs that a child might need professional help include changes in behavior that last more than one month.  If more urgent concerns arise, such as thoughts of death or suicide, self-harming behaviors, panic attacks, or serious physical or verbal aggression that threatens their safety or that of those around them, families should contact their pediatrician or mental health provider for advice.  In cases where behaviors are urgent or potentially life-threatening, families should contact 911 or go to their nearest emergency room.

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Fox News:  How should you help a child cope with isolation?
Raviv: Humans are social creatures, and social connection is critical to maintain. Consider including a daily “family meeting” in your schedule, which could also include time to connect remotely via phone or video call with distant family members. Maintaining a connection with peers, classmates, teachers, faith groups and neighbors is also important. Text, email, letter writing, telephone, or video-calls are all great for this purpose.

Neighborhood activities such as chalking the sidewalk with messages or going on a neighborhood scavenger hunt and posting pictures can also be creative ways to maintain connections while remaining socially distant.