TIPS FOR CAREGIVERS, PARENTS, AND TEACHERS DURING INFECTIOUS DISEASE OUTBREAKS
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What You Should Know
*Note: I am not a child therapist. My expertise is with those 16 years of age through adult. The following information is from SAMHSA.gov.
How do you feel right now? For some of you, there may be a sense of anxiousness. For others, fear. Perhaps even sadness, guilt, anger, or numbness. If you have a news app on your phone, do you get updates? What is your initial reaction when you hear the alert tone from your news app? These and many more responses are normal within a time such as this when things are changing daily and there seems no certainty is coming.
But what about the children and youth in your life? How are they feeling? What are they experiencing? When children and youth are exposed constantly about an infectious disease outbreak they can feel scared, confused, or anxious—as much as adults. This is true even if they live far from where the outbreak is taking place and are at little to no actual risk of getting sick. But when it seems to be in your own backyard, the resulting fear can be overwhelming for children and youth. Young people react to anxiety and stress differently than adults. Some may react right away; others may show signs that they are having a difficult time much later. As such, adults do not always know when a child needs help.
Possible Reactions to an Infectious Disease Outbreak
Many of the reactions noted below are normal when children and youth are handling stress. If any of these behaviors last for more than 2 to 4 weeks, or if they suddenly appear later on, then children may need more help coping.
PRESCHOOL CHILDREN, 0–5 YEARS OLD
The first thing to remember is that no one is exactly the same. But there are some more common responses in very young children to stress. These little ones do not have the ability to express themselves in the same way adults do. They have the words or even the understanding of what is happening within their minds. Because of this, very young children may express anxiety and stress by going back to thumb-sucking or wetting the bed at night. They may fear sickness, strangers, darkness, or monsters. It is fairly common for preschool children to become clingy with a parent, caregiver, or teacher or to want to stay in a place where they feel safe, even if they have never acted this way before. They may express their understanding of the outbreak repeatedly in their play or tell exaggerated stories about it. Some children’s eating and sleeping habits may change. They also may have aches and pains that cannot be explained. Other symptoms to watch for are aggressive or withdrawn behavior, hyperactivity, speech difficulties, and disobedience.
Infants and Toddlers, 0–2 years old, cannot understand that something bad in the world is happening, but they know when their caregiver is upset. They may start to show the same emotions as their caregivers, or they may act differently, like crying for no reason or withdrawing from people and not playing with their toys.
Children, 3–5 years old, may be able to understand the effects of an outbreak. If they are very upset by the news of the outbreak, they may have trouble adjusting to change and loss. They may depend on the adults around them to help them feel better.
EARLY CHILDHOOD TO ADOLESCENCE, 6–19 YEARS OLD
Children and youth in this age range may have some of the same reactions to anxiety and stress linked to infectious disease outbreaks as younger children. Often younger children within this age range want much more attention from parents or caregivers. They may stop doing their schoolwork or chores at home.
Children, 6–10 years old, may fear going to school and stop spending time with friends. They may have trouble paying attention and do poorly in school overall. Some may become aggressive for no clear reason. Or they may act younger than their age by asking to be fed or dressed by their parent or caregiver.
Youth and Adolescents, 11–19 years old, go through a lot of physical and emotional changes because of their developmental stage. So it may be even harder for them to cope with the anxiety that may be associated with hearing and reading news of an infectious disease outbreak. Older teens may deny their reactions to themselves and their caregivers. They may respond with a routine “I’m okay” or even silence when they are upset. Or they may complain about physical aches or pains because they cannot identify what is really bothering them emotionally. They may also experience some physical symptoms because of anxiety about the outbreak. Some may start arguments at home and/or at school, resisting any structure or authority. They also may engage in risky behaviors such as using alcohol or drugs.
How Parents, Caregivers, and Teachers Can Support Children in Managing Their Responses to Infectious Disease Outbreaks
With the right support from the adults around them, children and youth can manage their stress in response to infectious disease outbreaks and take steps to keep themselves emotionally and physically healthy. The most important ways to help are to make sure children feel connected, cared about, and loved.
Pay attention and be a good listener. Parents, teachers, and other caregivers can help children express their emotions through conversation, writing, drawing, playing, and singing. Most children want to talk about things that make them anxious and cause them stress—so let them. Accept their feelings and tell them it is okay to feel sad, upset, or stressed. Do not make them feel that their feelings are unimportant. Crying is often a way to relieve stress and grief.
Allow them to ask questions. Ask your teens what they know about the outbreak. What are they hearing in school or reading on social media? Try to watch news coverage on TV or the Internet with them. Also, limit access so they have time away from reminders about the outbreak. Don’t let talking about the outbreak take over the family or classroom discussion for long periods of time. Instead, discuss other things that are important in the world, in the community, and in the family.
Encourage positive activities. Adults can help children and youth see the good that can come out of an outbreak. Heroic actions, families, and friends who assist with the response to the outbreak, and people who take steps to prevent the spread of all types of illness, such as hand washing, are examples. Children may better cope with an outbreak by helping others. They can write caring letters to those who have been sick or lost family members to illness; they can organize a drive to collect needed medical supplies to send to affected areas. There are a number of ways they can be proactive which will encourage a sense of well-being.
Model self-care, set routines, eat healthy meals, get enough sleep, exercise, and take deep breaths to handle stress. Adults can show children and youth how to take care of themselves. If you are in good physical and emotional health, you are more likely to be readily available to support the children you care about.
Include faith. Children and youth need to understand that hope still exists in the midst of bad things. If you suddenly stop attending church or stop praying as a family, they are going to be confused and have doubts about the goodness of God. Set a time for prayer as a family every day. Give each person a chance to lift up prayer concerns, as well as something to be joyful about. Talk about God and the hope He has promised in your everyday conversations. Find a good family Bible study or devotional and make it a priority. Encourage your children to talk to God about their feelings and give them room to do so in their own way. And if they express and anger toward God, help them see that throughout scripture, God’s chosen people had moments of anger, too.
A NOTE OF CAUTION! Be careful not to pressure children to talk about an outbreak or join in expressive activities. While most children will easily talk about the outbreak, some may become frightened. Some may even feel more anxiety and stress if they talk about it, listen to others talk about it, or look at artwork related to the outbreak. Allow children to remove themselves from these activities, and monitor them for signs of distress.
PRESCHOOL CHILDREN, 0–5 YEARS OLD
Give these very young children a lot of emotional and verbal support.
Get down to their eye level and speak in a calm, gentle voice using words they can understand.
Tell them that you always care for them and will continue to take care of them so they feel safe.
Keep normal routines, such as eating dinner together, prayer and devotion time, and having a consistent bedtime.
EARLY CHILDHOOD TO ADOLESCENCE, 6– 19 YEARS OLD
Nurture children and youth in this age group:
Ask your child or the children in your care what worries them and what might help them cope.
Offer comfort with gentle words or just being present with them.
Spend more time with the children than usual, even for a short while.
If your child is very distressed, excuse him or her from chores for a day or two.
Encourage children to have quiet time or to express their feelings through writing or art. Encourage children to participate in recreational activities so they can move around and play with others.
Address your own anxiety and stress in a healthy way.
Let children know that you care about them— spend time doing something special; make sure to check on them in a nonintrusive way.
Maintain consistent routines, such as completing homework and playing games together.
When To Get More Help
In some instances, children may have trouble getting past their responses to an outbreak, particularly if a loved one is living or helping with the response in an area where many people are sick. Consider arranging for the child to talk with a mental health professional to help identify the areas of difficulty. If a child has lost a loved one, consider working with someone who knows how to support children who are grieving.
Helpful Resources
Substance Abuse and Mental Health Services Administration (SAMHSA) 5600 Fishers Lane — Rockville, MD 20857 Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727)
SAMHSA’s Disaster Distress Helpline
Toll-Free: -877-SAMHSA-7 (1-877-726-4727) (English and español) SMS: Text TalkWithUs to 66746 SMS (español): “Hablanos” al 66746
TTY: 1-800-846-8517 Website (English): https://www.disasterdistress.samhsa.gov Website (español): https://www.samhsa.gov/find-help/disaster- distress-helpline/espanol
SAMHSA’s National Helpline
Toll-Free: 1-800-662-HELP (24/7/365 Treatment Referral Information Service in English and español) Website: https://www.samhsa.gov/find-help/national-helpline
Child Welfare Information Gateway
Toll-Free: 1-800-4-A-CHILD (1–800–422–4453) Website: https://www.childwelfare.gov/topics/responding/reporting/how
National Suicide Prevention Lifeline
Toll-Free (English): 1-800-273-TALK (8255) Toll-Free (español): 1-888-628-9454 TTY: 1-800-799-4TTY (4889) Website (English): https://www.suicidepreventionlifeline.org (español): https://suicidepreventionlifeline.org/help-yourself/en- espanol
National Child Traumatic Stress Network
Website: https://www.nctsn.org