Pandemic Anxiety in Children

The coronavirus pandemic has been a long, stressful time for most, but especially for young children. While we are hopefully moving in the right direction about transitioning toward more pre-pandemic routines and activities, there is still much cause for anxiety in children.

Uncertainty, fear and staying at home has made changed routines difficult. Children don’t always understand why they can’t go to school, see their families, or play with their friends. Remote learning, while a way to attempt to keep children current with their studies, can be another cause of anxiety. For children with special needs, the disruptions are amplified. Services that have moved to teletherapy are additionally challenging, and maintaining a calm, albeit new routine is difficult as well.

We are sharing the following information from Boston Children’s Hospital: 

Some kids hide in their rooms. Others turn their cameras off during remote learning and don’t want to talk to anyone. Still others feel panicky when they do go out in public. As the COVID-19 pandemic wears on, its effects on our mental health may have become increasingly noticeable — especially in children and teens. “My daughter used to be really energetic and motivated,” says one mother. “She was happy and light. Now, she’s just folded into herself.”

She’s not alone. Families are reporting troubling changes in their children’s emotional well-being, particularly when it comes to anxiety. To better understand the problem — and learn what parents can do to help — we spoke with Allison Scobie-Carroll, senior director of social work and family services at Boston Children’s Hospital.

A lot of kids seem to be experiencing increased anxiety. Why?

Like adults, children and teens are missing being around their peers. They need those relationships not just to feel good, but also to practice social skills. Now that we’ve been in this for a year, we’re seeing the effects of what happens when children are separated from regular social interaction for long periods of time.

What are some aspects of the pandemic that can cause or worsen anxiety in kids?

Our “new normal” means that the way we interact with each other has changed. Things that once came naturally — like just being out in the world — are now fraught with concern. If a child is already prone to anxiety, the rejection they might feel when someone steers away from them may be amplified, even if that person is simply trying to physically distance.

Then add in masks, which can contribute to anxiety in a couple of different ways. First, they block our ability to read social cues, like smiles or frowns. They can also impede the ability to practice deep breathing, which is a natural way to counteract anxiety and for some people contributes to feelings of claustrophobia. That said, masks are critical to protecting against COVID-19, and most kids have adapted well to wearing them.

Can kids “catch” anxiety from their parents and other adults?

Collectively, we’re transmitting a lot of worry and kids absolutely pick up on that, particularly if they’re already sensitive or prone to anxiety.

What can parents do to help their children cope with anxiety?

The most important thing you can do is to let your child know you’ll be there for them — it’s so simple but so fundamental. You can also try the following tips:

Listen to them. Children experience and navigate the world through a different lens than adults. Their worries need not be rational or fact based, but they are still valid.

Teach them coping skills. Regular exercise, turning off screens at least an hour before bed, and using apps like Calm to practice deep breathing and other relaxation techniques can all help kids (and parents) ease anxiety.

Schedule safe playdates. There’s no substitute for being around friends — kids relate to each other in ways that adults just can’t. Ask your child if they’d be interested in seeing the friends in their circle, as long as they follow safe precautions like wearing masks and practicing physical distancing.

Connect with other parents. The pressures of life right now might make you feel something is very wrong with your child — but many families are experiencing the same thing. Situational anxiety can be a natural response to chronic stress. It can help to know that it’s not a failure on your part and that you aren’t alone.

Know your child. A lot of kids and adults are experiencing panic attacks, having night terrors, or developing phobias for the first time during the pandemic.  If you’re concerned about new or worsened symptoms in your child, contact your primary care provider for help.

The Mayo Clinic offers additional suggestions for helping children with special needs during this time:

Kids with special needs and their parents may feel anxious, just like any family. At the same time, families with complex needs have a hidden strength: They’re resilient, and they know what it takes to adapt to the unexpected. If you’re in this situation during the COVID-19 pandemic, know that you can navigate uncertain times successfully. Here are some suggestions:

Rely on your experience

Think back to strategies that have worked for you in the past. Go back to the basics. This might include:

  • Keeping a consistent schedule for meals, medications, exercise and bedtime
  • Planning gradual transitions that suit your child’s pace
  • Using visual cues to illustrate schedules and activities
  • Scheduling quiet time to reduce sensory input and de-stress
  • Offering warm praise for a job well done
  • Promptly correcting or redirecting negative behavior and offering a chance for a redo

Help your child feel in control

Explain that everyone is working together to keep the virus that causes COVID-19 from spreading and making people sick. This is why some schools and playgrounds may be closed. Likewise, having a playdate or going to a friend’s house may not be an option. Explain that kids can be a big help, too, by following such practices as:

  • Washing hands with soap and water often, or clean hands with sanitizer
  • Sneezing or coughing into a tissue or a bent elbow, not hands, and throwing used tissues in the trash
  • Keeping 6 feet of space between themselves and others outside of the house
  • Waving or giving smiles instead of hugs, fist bumps and high-fives
  • Wearing a face mask at grocery stores and in other public places

Revisit your child’s treatment plan and care needs

If your child has a treatment plan — which might include things such as a list of prescription medicines, therapy instructions, and emergency and medical contacts — make sure that it’s up to date and accessible. It may help to have it in the form of an electronic document that you can easily share. In addition:

  • Identify potential alternative caregivers, in case you or your child’s regular caregiver is sick.
  • Gather specific instructions for caregivers, including information on your child’s medical conditions, doctors and therapists, daily schedules, and preferences.
  • Visit websites of support groups and organizations you’ve typically relied on in the past.

Manage stress

During the pandemic, everyone feels added stress. But it’s possible to manage stress so it doesn’t get overwhelming. Consider these tips:

  • Take breaks.Remember to make some time for yourself. Wake up a few minutes early to gather your thoughts. Pause a minute or two before bedtime to do some stretches or deep breathing. Take time to gather your mental reserves.
  • Limit access to the news.Being informed is good. But information overload can heighten anxiety about the disease.
  • Stay healthy.Even though schedules feel off, prioritize getting enough sleep, eating balanced meals and staying active. These fundamentals will reduce stress and improve everyone’s state of mind.
  • Connect with loved ones.Stay connected with grandparents and friends via phone or video chat. Or write a letter. Maintaining your family’s support network is a key coping strategy.
  • Have some fun.Share relaxed moments with your family, when you’re not focusing on work or school. Play games with your kids, go for sunset walks, do cooking projects together and enjoy home movie nights.

 

It’s a challenging time for sure. Children experience their own anxiety, but also feed off the environment within their home. To handle both yours and your child’s anxiety it is important to find ways to enjoy the time together with your family. The weather is changing; get outside and play, take a walk, create a scavenger hunt…just be together and soak up some fresh air. We’ll all get through this together.

Stay safe and be well.

 

Note: The information in this article is for informational purposes only. It is not an attempt to diagnose or treat any medical condition. Always consult your child’s pediatrician with any specific medical questions. MKSA is also available to answer questions about child development. Contact us at 516-731-5588 or www.mksallc.com.

Sources:
https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/special-needs-parenting-covid-19/art-20487665
https://answers.childrenshospital.org/covid-anxiety-kids/

It’s Our Outdoor Play and Safety Issue!

School is over and summer vacation is upon us. Time for…indoor screen time? That doesn’t sound right. But for many children, sitting in front of screens will be their primary summer activity. Children should be active for at least an hour every day, but on average, children spend four to seven minutes daily in unstructured outdoor play, compared to seven or more hours in front of a screen. Like everything, there is a time and place when some screen time is not a bad thing.

But—it’s summer! Sunshine! Fresh air! Playgrounds! Beaches! There are many reasons children need to play outside including physical, social and emotional factors. It’s fun, it’s healthy and it’s important.

Below are some benefits children experience from playing outside:

Practice Emerging Skills
Outdoors is the best place for young children to practice and master developing physical skills. While outdoors, children can practice motor skills such as running, jumping and leaping. For children with special needs, outdoor play can improve flexibility, muscle strength and coordination. Children can perform manipulative skills such as pushing a swing, pulling a wagon and carrying moveable objects. Being outside also helps children to improve body awareness, balance and motor skills.

Health Benefits
Sun exposure helps our bodies produce vitamin D, which plays a critical role in body processes including bone development. Immune systems get a boost as well from time spent in sunshine. Playing outdoors helps children get exercise and burn calories, which may help counter risk factors for obesity, hypertension and arteriosclerosis (which can show as early as age 5). Outdoor light also stimulates the pineal gland, the part of the brain that regulates the ‘biological clock’ which is critical for the immune system.

Cognitive and Social/Emotional Development
Unstructured outdoor play is the best way children learn to take turns and share. As they invent and play games, they improve communication, cooperation and organizational skills. The best way for children to learn how to plan, troubleshoot and multitask is though playing with other children. When they make up their own games, figure things out and amuse themselves, these important life skills are learned and practiced. When outdoor play is used as a teaching skill, children with communication challenges, problems with social skills, and sensory issues can reap many benefits.

Physical Benefits
For children with special needs, outdoor play provides a boost in self-confidence. As they overcome obstacles and improve physical skills, their self-esteem increases as well. When they experience personal satisfaction and accomplishment, that increase in confidence carries over into other areas of their lives. Physical play also helps reduce stress, which contributes to depression and anxiety.

Social Benefits
Children need to learn how to work together. Children with special needs often have problems with social skills, but outdoor play provides some additional social benefits. Behavior may improve and make it easier for these children to build friendships. They learn how to share, how to deal with conflict and how to work in groups, all while having fun in an outdoor, low-stress environment.

Appreciation for Nature/Sensory Skills Development
Aesthetic Awareness refers to a heightened sensitivity to beauty in the world around us. Outdoors is full of beautiful sights, sounds, smells and textures, all to be experienced through all senses. Seeing animals and birds, hearing wind moving through leaves, smelling fragrant flowers and earth, touching grass and trees, and even tasting a raindrop all provide opportunities for children to appreciate the world around them. Playing on screens uses only two senses—hearing and sight—which can negatively affect children’s perceptual abilities.

While free play is important and beneficial, planning or creating specific activities has much value too. Here are some fun ideas for outdoor time:

 -Nature walk: ask children to tell you what they are seeing, smelling and hearing; touch a rock or a leaf

-Obstacle course: set one up in your yard using old tires, cardboard boxes and more

-“Listening” walk: walk with your children and point out as many sounds as you can; bring along a tape recorder (or record on your phone) so they can identify sounds at a later time

-Parachute or sheet time: bring a parachute or old sheet outside and play games with it (shaking it, circling with it, bouncing foam balls on it)

-Music: bring music outside and dance with your kids in a natural environment

-“Water painting”: have children paint the side of building or wood fence with a brush and a bucket of water; get exercise while teaching about wet and dry, light and dark and evaporation

-Bubbles: chasing bubbles gives kids another chance to run

-Outdoor sensory table: create a toy car wash

-Swings: many local parks have adaptive swings for children with special needs

-Chalk: for children who love to color, outdoor chalk is a fun way to color; large chalk is good for children who have difficulty grasping

-Biking: even if your child cannot ride a bike, a tandem bike or bike with car seat or trailer is a great way to experience the outdoors

-Sandbox: like a large sensory bin, in this you can make castles, mud pies and more

-Picnic: have your child help prepare and pack the food; spread a blanket in the backyard and have fun

-Quiet time: even reading a book or napping can be enjoyed outside

-Playgrounds: these are a great place for kids to work on balance, motor planning, confidence and social skills

-Water (rain) therapy: for a wonderful sensory integration experience, let your children play outside in the rain—in clothes or swimsuits, with or without an umbrella; give them buckets to collect water and brooms to slosh it up with

 

With lots of outdoor play ahead, it’s also important to be safe. We’ve incorporated our list of safety tips, which includes information on topics such as sunscreen, dry drowning and more. With a summer full of beach and pool visits as well as time spent on the playground in the heat, we’ve put together a list of summer safety tips to be sure you enjoy the season safely. These tips apply to both children and adults; no one can have a good time if they’re sunburned or injured.

1.Lather on the sunscreen
Sunscreen should be applied right after children are up and dressed. Since sunscreen takes at least 15 minutes to get absorbed and start protecting you, if you wait until your children (and you!) are already in the sun, you’re behind the eight ball. Remember to re-apply after swimming and throughout the day, even if it’s cloudy out. UV rays can penetrate through fog and haze. If your child is going to camp, be sure to pack extra sunscreen (spray sunscreen is easier for little hands to use) and show your child how to use it. And be sure to use enough. Most of us don’t; a good rule of thumb is we need about a shot-glass full to protect our whole body. Less is definitely not more here.

2.Drink that water!
The importance of drinking fluids (preferably water) cannot be overstated. During warm weather, and especially when we sweat, our bodies lose fluid rapidly. Children often can’t tell if they need water, and by the time they are thirsty they are likely already a bit dehydrated. Teach them the importance of drinking fluids and be sure they take adequate breaks during outdoor activities.

3.Watch for heat illness
When our body is exposed to more heat than it can handle, several heat related illnesses may occur. Heat exhaustion and heatstroke are two such illnesses, and both can be very dangerous especially in infants and young children. For heat-related illness, the best defense is prevention:

-Never leave infants, children or pets in a parked car—ever

-Dress infants and children in loose, lightweight, light-colored clothing

-Schedule outdoor activities carefully, for morning and evening hours (avoiding heat of day)

-Stay cool with cool showers or baths

-Seek medical attention immediately if someone you know has symptoms of heat illness

When we lose excessive amounts of salt and water and the result can be heat exhaustion. Symptoms include severe thirst, fatigue, headaches, nausea, vomiting and sometimes, diarrhea. Other symptoms include profuse sweating, clammy/pale skin, dizziness, rapid pulse and slightly elevated temperature. Anyone experiencing heat exhaustion should be moved to a shaded or air-conditioned area, given water or other cool (non-alcoholic) beverages, and apply wet towels or take a cool shower.

Heat exhaustion can turn into heatstroke if not treated. When our body is having difficulty sweating and our temperature rises quickly, you may experience heatstroke. This happens when our body cannot get rid of excess heat. Having very hot skin and being confused are two symptoms. Getting rid of excess body heat is critical. Call for emergency help immediately. The person should be moved into the shade into a half-sitting position. Spray the victim with water and fan them vigorously; if humidity is higher than 75%, apply ice to their neck, armpits or groin.

4.Be safe in the water
According to Injury Facts 2017 (nsc.org), an average of nine people die from drowning in the U.S. every day. Drowning is a concern for young children, and teens and young adults too. Some basic water safety precautions for young children include:
-Never leave your child alone near water; if you must leave, take your child with you

-Find age-appropriate swim lessons for your child (remember that lessons do not make a child “drown-proof”)

-Always keep your eyes on your child; never rely on a lifeguard to watch your child

-Don’t let children play near pool drains and suction fittings; hair, fingers/toes, and swimsuits can get caught and become part of the suction

-Remember that even rivers and lakes have undertows

-Always keep a first aid kit handy

-Get trained in CPR

-If a child is missing, check the water first

5.Know about dry drowning/secondary drowning
Many parents think once their children are finished swimming and away from water they can relax. Not necessarily so. There is a term that should be in every parent’s vocabulary. The following are excerpts from an article from ChildrensMD.org, by Dr. Kathleen Berchelmann explaining the term “dry drowning” and what you need to know:

“There is some debate about the definition of the term “dry drowning.” Usually this term refers to situations where some water got in a child’s lungs and the child has a severe inflammatory reaction to the water hours after the incident. This phenomenon is also called “secondary drowning” or “near drowning.” There is another phenomenon, also sometimes called “dry drowning” in which suffocation occurs but no water ever entered the lungs. In these rare situations the larynx (voice box) spasms and stays shut, causing involuntary suffocation. Sometimes this spasm is triggered by water droplets hitting the larynx, or a sudden high-speed submersion under water such as off a high-dive or a high-speed water slide. This latter form of dry drowning generally doesn’t occur when kids are simply swimming or playing in the pool.”

Symptoms and warning signs of “dry drowning”:

Coughing: Any person who has persistent coughing after playing in the water is at risk for water in their lungs. Don’t go to bed worrying; take your child in for a medical evaluation.

Water rescue: Any person who was submerged in water and came up struggling, especially if he/she had to be retrieved from the water, needs medical evaluation.

Amnesia: Any person who was unconscious underwater or has limited memory of an incident that occurred in water needs immediate medical care.

Behavior change: If your child feels sick, acts too sleepy, or has a change in mental behavior after a day at the pool, take it seriously. The worst thing that can be done with a child who may have inhaled water is to put them to bed. They need immediate medical care.

Vomiting: Vomiting after a day of swimming can be due to waterborne infectious disease but can also be a sign of severe illness due to dry drowning. This is a sign stress from the body due inflammation. While dry drowning is extremely rare, it is important to know the signs and get immediate medical attention if someone is not behaving normally after swimming.

6.Keep mosquitos and ticks away
Outside time is fun time—that is until the bugs start biting, or your find a tick on your child. Some easy precautions can keep you and your children safe this summer. Use a good bug repellant with one of these ingredients: DEET, Picaridin, IR 3535 or oil of lemon eucalyptus. Many pediatricians advise using products that contain less than 30% of these ingredients on children. Ticks can live in backyards, as well as deep in the woods; be mindful of where you set up patios and playground equipment. Keep these areas a distance away from shrubs and bushes and consider professional tick control applied by a pest control expert. After a day outside, make it a practice to check for ticks on children, adults and pets. If you find one, use a fine-tipped tweezer to remove it. Call your doctor with any questions.

7.Have fun but be safe
Playground-related mishaps are common causes of injuries and visits to the emergency room. To keep children safe while playing outside, take adequate precautions and always have adult supervision when young children are playing outside.

Ensure that surfaces under playground equipment are safe and well-maintained. Watch young children around stairs and playground equipment. Gates on stairs can prevent a young child from falling down the stairs. Be sure children wear protective equipment for the sport of their choice and watch for signs of a concussion (including can’t recall events before or after a hit/fall; appearing confused; moves awkwardly; demonstrates behavior changes; headache/head pressure; nausea/vomiting; dizziness; sensitive to noise or light; feeling sluggish; feeling ‘off’). Symptoms usually appear shortly after an injury but can also take hours or days to show up. Consult your child’s doctor if you suspect or have been advised that your child has a concussion.

 

We are all looking forward to a summer full of beautiful weather with lots of fun time spent outdoors. With a little planning and precaution, you and your children will be safe and have a wonderful time! Remember, if you have an emergency or any serious concerns, contact your child’s doctor immediately.

Note: The information in this article is for informational purposes only. It is not an attempt to diagnose or treat any medical condition. Always consult your child’s pediatrician with any specific medical questions. MKSA is also available to answer questions about child development. Contact us at 516-731-5588 or www.mksallc.com.

Sources:
http://www.earlychildhoodnews.com/earlychildhood/article_view.aspx?ArticleID=275
https://news.sanfordhealth.org/childrens/play-outside/
https://www.health.harvard.edu/blog/6-reasons-children-need-to-play-outside-2018052213880
https://www.cerebralpalsy.org/blog/outdoor-activities-for-children-with-special-needs

Are You and Your Children Washing Your Hands Properly?

Kids are back to school, cold weather is coming and we’ll be spending more time indoors. It seems like a perfect time to review handwashing practices to keep everyone clean and healthy. Did you know that frequent handwashing is one of the best ways to protect yourself, your family and others from getting sick?

While it seems simple enough, there are some dos and donts for washing your hands, including how and how often. If you’re not washing properly, you’re missing out on its benefits. Did you know the Centers for Disease Control and Prevention calls handwashing a “do-it-yourself” vaccine?  Studies show that frequent handwashing helps prevent the spread of certain illnesses, including stomach bugs, strep and the flu. With most children picking up 6-10 colds each year, handwashing is an easy preventive measure.

Some handwashing facts:
-For every 15 seconds of handwashing, 10 times more bacteria are removed.
-A research study showed that school children who washed their hands had 51% fewer sick days due to stomach bugs and 24% fewer sick days due to colds.
-Compared to dry hands, damp hands are 1,000 times more likely to spread bacteria.
-Hands spread approximately 80% of common infectious diseases.
-Only 1 out of 5 people wash their hands before preparing food.
-95% of people either don’t wash their hands, or don’t wash properly after using a public restroom.

It’s also worth noting that antibacterial soaps, such as those containing triclosan, are no more effective at killing germs than is regular soap, and they may lead to antimicrobial-resistant bacteria. As of 2016, liquid, foam and gel hand soaps, bar soaps and body washes containing antibacterial ingredients can no longer be marketed to consumers. If you or your child are not near running water, hand sanitizer can be used in a pinch. Be sure the sanitizer contains at least 60% alcohol and is used properly: apply gel to the palm of one hand, rub your hands together, covering all surfaces, until hands are dry. Be sure to supervise young children using sanitizer; swallowing these products can cause alcohol poisoning.

When should you wash your hands?

Always wash:
Before, during and after preparing food, especially raw meat, poultry or fish
Before eating food
Before treating wounds or caring for a sick person
Before inserting or removing contact lenses
After using the bathroom
After changing diapers or helping a child use the bathroom
After contact with bodily fluids
After treating a cut or wound
After touching an animal, animal food or treats, animal cages or animal feces
After touching garbage or outdoor garbage pails
After blowing your nose, coughing or sneezing (try to cough or sneeze into your elbow or shoulder)

It’s also a good habit to teach children to wash hands when they come home from school. This is especially important if they are going to eat a snack as soon as they come home. You can teach children to Wet-Lather-Scrub-Rinse-and-Dry. Those five simple steps are all it takes.

How to wash your hands properly:
-Turn on water and wet your hands, preferably with warm water.
-Apply soap and lather well.
-Rub hands together, palm to palm; clean all surfaces including fronts and backs of hands, wrists, fingers, between fingers and under fingernails.
-Scrub your hands for at least 20 seconds. You can hum the “Happy Birthday” song from beginning to end twice, and that about covers it.
-Rinse your hands well under clean, running water.
-Dry your hands with a clean towel or paper towel and use the towel to turn off the faucet.
-If you’re in a public place, use the paper towel to open the (dirty!) bathroom door as well.

It’s important to teach children how to wash their hands, and to encourage them to wash frequently. If a child can’t reach the sink, explore keeping a step stool handy. Make handwashing an important and fun part of your day to keep you and your family as healthy as possible! For more resources, including handwashing videos, and some additional hygiene tips, read more here.

Note: The information in this article is for informational purposes only. It is not an attempt to diagnose or treat any medical condition. Always consult your child’s pediatrician with any specific medical questions. MKSA is also available to answer questions about child development. Contact us at 516-731-5588 or www.mksallc.com.

  

Sources:
Centers for Disease Control and Prevention Handwashing
Mayo Clinic Handwashing Dos and Donts
Duquesne University School of Nursing Proper Handwashing Techniques and Hygiene Tips: Guide for Teachers and Parents
Fastmed Back to School Checklist: A Handwashing Lesson