“It’s inevitable that there’s going to be some effect on kids and teens, just like there is on adults, from a change in social behavior — whether that’s school quarantine like we were in previously, or even now,” said Meghan Walls, pediatric psychologist at Nemours. “There are kids and teens whose friends are being allowed to perhaps do more things and that’s going to be really tough for kids.”
Teenagers in particular are social creatures, she added. They go to class, work after school, take part in sports and extracurriculars, spend time with friends.
“That’s purposeful. That’s developmentally appropriate,” she said. “That’s how they learn how the world works. Those relationships aren’t just important because kids like them, but also because they are formative for adult years.”
Schools went remote in mid-March as the first cases of coronavirus in Delaware were beginning to be reported. As the state has loosened restrictions — allowing for dining at restaurants, opening stores with lower capacity, etc. — socially, people have begun to expand their circles.
The comfort level of gathering differs from family to family, with health concerns a priority for some or general limiting of unnecessary exposure for others.
As families navigate those choices, Mark Borer, a child psychiatrist and member of the Medical Society of Delaware, said some youths are feeling isolated and lonely.
“I find that older kids are able to express it more because they’re able to put into words that they’re missing being able to go out with friends or go to parties or go on dates and things like that,” he said. “That’s really interfering with that developmental time in their life. … They need contact for their development.”
For the kids who are immunocompromised — or have family members who are immunocompromised — Dr. Borer said health concerns like asthma or diabetes creates a unique situation.
“It’s not always apparent to the people around them that they have these risks. So, some kids might be saying, ‘Well, how come you can’t?’” he said. “And then kids have to reveal a little bit more about their personal health, their personal reasons and they have to trust again on that circle, or that bubble, to include them in the ways that they can.”
“Health anxiety” can stem from when people have health conditions and that can lead to anxiety even without a pandemic.
“We want to make sure that people and kids and parents are doing the right things to address those stressors even before a pandemic, but I think where it has left people now is feeling the double stress,” Dr. Walls said. “So it’s both: ‘I have to navigate my illness,’ but it’s also ‘I have to navigate my illness during a time period that puts me perhaps at higher risk.’”
She said it’s important that families have conversations with medical providers to talk about who is and who isn’t high risk.
“The media can make it seem like everyone’s high risk no matter what your medical condition [is] and that’s not necessarily accurate,” she added. “For our teens, I want them to talk to their physicians and if they’re feeling really anxious or nervous to then reach out to a mental health provider.”
For younger kids, ages 0 to 5, caregivers and parents are their most important relationships, Dr. Walls said. As children get older, their social relationships gain more importance.
There’s certainly a negative impact if everything is taken away — sports, extracurriculars, socializing in person — but that isn’t the whole picture, she added.
“I think we sometimes jump to that conclusion without thinking about the mitigating factors,” she said. “When I think about what parents and teachers should be thinking about, or what teenagers should be thinking about, is how do we get creative about this?”
Thinking outside of the box is pretty much the name of the game during coronavirus. Dr. Walls suggests virtual hangouts and play dates be scheduled. Outdoor, spaced-out gatherings are also a possibility for families, and are pretty safe, she said. She also suggests teens and kids call each other on the phone.
“Like kids used to do before there was Snapchat and Twitter — and just chatting with your friends, even that can be really useful,” she said.
Even more old school, she suggested penning letters to friends.
“A lot of the young kids that I work with have started writing handwritten letters to people and they get mail and it is just so exciting for them to get a piece of mail from their pen pal or their grandparents,” she said.
For older kids, she said open and honest conversations with their parents is important.
“What are we and aren’t we comfortable with? Can you go drive by your friend’s house and sit outside in your car or things like that. That actually gives people a little bit more face-to-face time?”
Dr. Borer said that if someone is willing to Zoom in a friend who can’t attend a social gathering, that could include those who would otherwise be left out.
Walks outside in a park or a bike ride alone or with the household/family can “decrease that sense of being trapped or isolated at home,” he said.
He also suggested no-contact sports, like archery, golf or bowling.
“There are a lot of different kinds of sports that kids can do that maybe have a little bit less body contact that can still give them some of the social and team skills that they need, but maybe with a little more difference,” he said.
If social interactions are taken away completely, Dr. Walls, said, there is certainly a negative impact.
“But there’s so much we can do to prevent that and I really would encourage us, instead of consistently focusing on what is this doing negatively to us, to instead focus on how can we do better?” Dr. Walls said, adding that stress is OK and normal.
Most kids and families have adapted in various ways, Dr. Borer said.
“It’s the vulnerable kids that we have to watch for: the ones that had pre-existing anxiety going out into the world, the ones that were already prone to trauma or depression, or were already worried a lot about their parents. COVID-19 has probably affected those kids more,” he said.
If children and teens are irritable beyond what is normal for children, not sleeping, not eating or are overeating or sleeping all day, those are signs something more is going on, Dr. Walls said.
In addition to trouble eating or sleeping, Dr. Borer suggested looking at how kids are expressing their worries, in words or behavior: what are they avoiding? What do they express worry about? Are they having bad dreams? Changes in routine or withdrawing emotionally and physically are serious signs, he added.
Dr. Walls added that so much about how children and teenagers perceive the world around them is shaped by the adults in their lives.
“If you can be a parent who says, ‘This is really hard. I’m stressed out too. I want to yell and cry sometimes too. But we’re going to problem solve this and we’re going to figure it out together,’ those kids and teenagers will have better outcomes because they’re learning to be flexible around problem solving and they’re learning that even though this is difficult, their family is going to support them through it,” she said.