Children isolated now for nearly two months — uprooted from their routine, school, friends and extended families — might be protected from the physical effects of coronavirus but are now feeling its toll on their mental health.
That social isolation coupled with fears about the coronavirus pandemic are causing some children to display odd behaviors, and regress in their school work and other areas, said Felisha Younkin, a psychology professor at Cedarville University, and Dayton Children’s Hospital Pediatric Psychologist Mary Beth DeWitt.
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The Dayton Daily News Path Forward project digs into solutions to the biggest issues facing our community, including youth mental health. For this story, the newspaper examined how the stay-at-home order due to the COVID-19 pandemic can affect children’s mental health and what parents can do to help their children cope.
Dayton Children’s Mental Health Resource Connection line refers patients and families to available mental health services in the community. While it hasn’t seen a significant increase in calls, it has made 323 referrals, 71 of them parents, since March 16.
Dayton area resident Margie Spence has seen the effects on her two daughters, and worries about their extended separation from school, friends and grandparents.
“I understand they’re both upset. I’m upset,” she said. “But I’ve never felt more helpless as a parent to not be able to fix what’s wrong with my kids.”
Yet Spence also has appreciated the extra closeness with her children. Helping kids find those positive elements, as well as schedules, creativity and tending to their own mental health, are key for parents to help their children cope right now.
The message that adults should send to children is, “It’s going to be all right, honey,” said Tim Callahan, a clinical psychologist and the Greene County Educational Service Center’s mental health director.
Long-term effects of isolation
Social behaviors and interactions with friends and relatives are important, particularly as children develop.
Although it’s too early to determine how the COVID-19 isolation will affect children in the future, isolation in general can have long-term effects on development. The severity depends on their family situation and other factors, according to a 2015 study in the Journal of the American Academy of Child and Adolescent Psychiatry. Those with mental disabilities and other conditions tend to be affected more, according to the findings.
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The study found that primary and secondary school-aged children who were socially isolated experienced greater mental health difficulties.
Five-year-old children who had behavioral problems or attention-deficit-hyperactivity disorder symptoms had a higher risk of becoming more socially isolated at age 12. However, children who were isolated at age 5 did not have greater mental health symptoms at age 12 over and above pre-existing difficulties, according to the study.
Given the long-term effects of social isolation, Dayton area parents should strike a balance between protecting their children from the deadly COVID-19 pandemic and keeping them engaged. Parents are urged to come up with creative ways without being too rigid or overly permissive, particularly since it’s unclear how long the pandemic will last, experts said.
“From what I’m gathering, children are experiencing a lot of stress,” Younkin said. “Sometimes to the point at which they’re overwhelmed and they’re just not functioning the way they normally would.”
Trouble sleeping, whining, clinginess, low tolerance and easily irritated are some signs that children are stressed, she said. Other indicators include frequent nightmares, more fights with sibling than normal, loudness and sudden refusal to follow rules and be compliant, Younkin and DeWitt said.
‘I feel helpless’
Spence and her family live near Trotwood. She has 6- and 14-year-old daughters, and both children have always been well behaved.
Natalie Reed, 14, helps care for her younger sister, including homeschooling her. She’s earned the nickname Mommy Jr. because she’s been responsible beyond her years, Spence said.
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Sydney Spence, the kindergartner, got glowing reviews from her teachers just before DeWine shut down schools, and her good behavior carried over during the lock-down order. She’d complete all of her assignments in a reasonable amount of time, she listened to her older sister and was compliant with her parents.
But nearly two months into the “stay-at-home” order, Sydney has hit a wall, said Spence, an education coordinator at Dayton Children’s Hospital who also does coronavirus screenings on everyone who enters the facility daily.
Sydney stopped completing her school work or refuses to do it at all, she’s become defiant and “no” has become one of her favorite words. In addition, the child talks back, regressed in her education and is unable to “put a sentence together,” her mother said. Prior to the isolation, she had a great vocabulary for a kindergartner, Spence said, and was creative.
Sydney also tells her parents that she doesn’t want to be home schooled anymore, and would prefer to return to school to see her friends and teachers.
Natalie also has become somewhat restless of late, her mother said. But she is handling it as well as a 14-year-old can while continuing to help with her younger sibling and do everything her parents ask of her. Although she uses FaceTime and social media to communicate with her friends, she misses the physical social interaction.
Natalie and Sydney also miss their grandmother, who they haven’t seen since January because she lives out of state. So Natalie frequently asks that they take a quick trip to visit her when she’s feeling down.
Spence and her husband, Ryan Spence, do all they can to comfort their children when they are feeling stressed. They explain that although things are tough, it’s important that they continue practicing social distancing so they all remain healthy.
The family has a large backyard with a garden, a pond, swing set, trampoline and other activities, so when the girls are feeling sad, they go outside to decompress. When Sydney refuses to do her school work, they allow her to go to her room to play with her toys for about 20 minutes, and that helps calm her down as well.
The Easter Bunny brought her a garden set, her mother said, so she helps with the family garden. The family also runs at a nearby park, where they’d run into someone they know, and the girls have conversations with their friends while practicing social distancing, their mother said. In addition, the family plays games and cooks together.
All of those activities provide temporarily relief, but seeing their children struggle is tough on Margie and Ryan Spence. However, they are committed to keeping their family safe.
“It’s just sad, I feel helpless,” Margie Spence said.
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Yet the isolation also has brought the family closer together in some ways. Natalie doesn’t spend as much time in her room away from her family, she’s more engaged, and Margie Spence said they have great conversations.
“I’ve enjoyed it,” she said.
The importance of structure and routine
The Spences are using some of the techniques area psychologists recommend to help children cope with stress during the pandemic.
Children thrive with structure and routine, and they need adults to organize and enforce that structure to help minimize stress, said DeWitt, the Dayton Children’s psychologist who also teaches at Wright State University. The pandemic has interrupted a lot of that structure, which , she said has been difficult for some children.
“What’s most important is that we begin with a conversation with our kids about how things are different and how this is tough for all of us,” DeWitt said. “They may not fully understand why they can’t go to the park or why they can’t go on a play date or why they can’t go to school. So we have to try to explain it in some simple developmentally appropriate ways for young kids that there are some germs out there that we’re trying to prevent from spreading. So we have to be careful about being close together.”
Parents should allow children to ask questions that might clarify some of their concerns or ease fears, she said. They should then continue to maintain structure — or put some in place if it didn’t exist — and enforce the rules. If they’re school-aged children, they should have a predictable time when they’re going to sit and do their schoolwork, have family meals time and play time.
But parents might have to help their kids be creative in how they play since playgrounds are off limits, DeWitt said. That might be playing a board game with them or things that you typically don’t do as a family, she said.
Developmentally appropriate chores should always be a part of a child’s routine, and those expectations should continue, DeWitt said, adding that she wouldn’t recommend adding to the list of chores now.
Too much screen time
The Greene County Educational Services Center provides mental health counseling to about 560 students across the county, and those individual sessions have continued during the lock down, said Superintendent Terry Graves-Strieter and Callahan, the center’s mental health director. For some children, they said, school is the only time they have any type of structure or routine in their lives. So when classes are not in session they tend to regress even more, particularly if they have overly permissive parents or less supervision because both parents work long hours.
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One of the main issues Graves-Strieter and Callahan say they and their staff have noticed during this isolation period is that their students are staying up late at night on social media, watching television and playing video games. The children then sleep through the day, Callahan said, and they often feel lethargic as a result.
“In the long run, their brains are not going to respond well to this lack of structure,” he said.
While it’s expected that the schedules and structures families have in place may change slightly, parents should not deviate too far from them, Graves-Strieter said. She recommends that parents not allow their children to stay up late, and they should limit screen time outside of school work.
The amount of screen time parents should allow depends on the child’s age. But giving teens up to two hours per day so they can communicate with friends and not feel so isolated is recommended, Graves-Strieter said.
It’s also important to turn devices off at night, she said.
“I don’t care how old the kid is, (even) if they’re in high school, I think that’s just something they shouldn’t be doing,” Graves-Strieter.
‘God is mean’
It may not always be obvious when children are stressed and, depending on their age, they won’t verbalize it, said Younkin, the Cedarville professor. If a child gets easily frustrated over minor things and it lasts throughout the day, that’s an indication they worried about something they believe to me important.
Simply asking what’s bothering them may get kids to open up. Their perception or fears may not be reality, and the parent can help them understand the facts. Parents can also help them better understand what the child might have seen on TV or overheard, Younkin said.
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One of Younkin’s colleagues recently had a counseling session with a 5-year-old boy via telehealth. The child expressed that God is mean because he’s been allowing people to die from the coronavirus. But the psychologist explained to him that while many people are dying, a lot more are getting better.
“So giving them some truth and helping them look at things in a positive way can be helpful,” Younkin said.
Parents can unknowingly cause stress when they discuss financial or other concerns related to the pandemic in front of children. That’s why one of the most important steps adults should take is tending to their own mental health, Callahan said. Children pick up on how their parents feel, he said.
Sending the message that everything is going to be all right creates a chemical effect on children’s brains that eases their fears and anxieties, Callahan said.
Children also need to hear adults telling them that they are doing a good job when they complete chores or do well on their school work. That triggers other chemicals in the brain that helps it grow.
“We know a lot of parents are distressed, especially with the financial piece and potential for unemployment,” Callahan said. “We certainly understand it. But we’re asking parents to be careful of this space in which they’re talking about that, and have private conversations about the worries among the adults.”
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