CARE for Children During COVID-19

As COVID-19 nips at the heels of New Zealand, a primary concern for many parents is protecting their children through this pandemic. Worry is a natural response when faced with the unknown. During this pandemic, worry may seem like a legitimate response to a fast-changing threat. However, we are able to safeguard our children from worry dominating everyday existence or morphing into anxiety. There is a barrage of advice available on the internet and it can be hard to determine what information is effective. Information overload can overwhelm, and cause confusion and anxiety. I wanted to create a simple model, based on evidence, that would help steer parents through a crisis. A model that is not only focused on “getting through” but also to actively foster their children’s psychological resilience and wellbeing. 

The CARE model ? Jacqui Maguire, 2020 is underpinned by psychological science, is designed for use with children of all ages, and is a guideline rather than a set of rules. Parents know their children best. Trust in your knowledge and apply aspects of the CARE model that fit best with your family. 

Communication

Agency

Role Modelling

Everyday normality 

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COMMUNICATION 

Children are observant and absorb what it is going on in their surrounding environment. Regardless of age, it is likely your child will be aware that life’s normal has currently shifted, or can sense that the adults around them are at unease. Older children who are exposed to classroom chatter, news and social media may be experiencing anxiety. 

Talking with your children in a calm, simple and factual way enables you to control the narrative, providing essential information without promoting distress. It also helps contain anxiety, as lack of information can lead children to imagine worse case scenarios. Be particularly mindful to dispel rumours circulating in the community, which can lead to heightened distress. Placing boundaries on media exposure is a good preventative action.

Determine what you want to say It is a good idea to map out how you want to discuss COVID-19 with your family. Make sure to include age appropriate information on:

• What COVID-19 is
• How COVID-19 is spread and managed
• Steps that are being taken to protect New Zealander’s help
• Preventative steps everyone can take 

If you would like helpful tips on how to discuss the science, Dr Michelle Dickinsons Nanogirl’s website provides useful videos. If you don’t have the answers to some of your children's questions, be truthful about that too.

Make yourself available and take their lead Be prepared for your children to have questions about COVID-19. It is a good idea to let children initiate these conversations, as we don’t want to create or heighten distress by continually raising the topic.  Making space communicates to your child that you are available to listen, and reaffirms they are an important priority. 

Some children may find it difficult to raise their concerns. Hovering around you may be an indicator that they wish to talk.  For young children they may ask some questions, go away to play, and then return to ask more.  

Validate Validation involves letting your child share their thoughts and feelings without judgment or criticism. This allows your child to feel heard and conveys the message that you love and accept them no matter their thoughts and feelings. Validation is a critical component of emotion regulation, and therefore is important in reducing and containing anxiety.

Example: “I can hear you are feeling really worried and are scared Nanny and Granddad will get sick” 

Not: “Don’t be silly, we’ll be fine. There is no point dwelling on it”.

Consistency of emotional validation in your communication promotes a sense of security for your child, again supporting the reduction of anxiety and protecting their wellbeing 

Be Age Appropriate Children are able to determine when life’s normal has shifted, yet how this is displayed can differ depending on their developmental age. In response, communication to children need to mirror accordingly. 

Preschool Whilst young children may not be able to comprehend what or why things are different, parents may still observe changes in their child. For preschool aged children, a primary worry is the safety and health of significant adults and friends. Common responses can include increased tantrums, whining or clinging, altered appetite, and regression in toilet training, language and sleep. Reassurance that adults are working hard to keep healthy is important. Lots of extra hugs are also helpful.

Primary Aged Children in this age group may have concerns about their own health or the financial health of their family. Common reactions include physical symptoms (headaches and tummy aches), emotional reactivity, withdrawing from friends, increased forgetfulness or agitation. This is a good age group for calm clear conversations, as well as focusing on preventive behaviours (hand washing, social distancing, sneezing into your elbow etc).  Innovative ways to retain engagement, such as using songs to gauge handwashing length can be helpful. As a parent maintaining your patience and calm will be important.

Teens In addition to the above, teens’ responses can be variable. Like adults, some may use humour as a defense coping mechanism for their worry. Others may seem indifferent, even apathetic. Whilst this may be true reflection of their perspective, it can be overshadowing genuine concern. Regular check-ins on your teen’s wellbeing (How are you feeling?) continually provides your teen with an opportunity to talk should they want to.  This cohort is more likely to be focused on the economic, political and public health landscape of COVID-19. If so, engage with them in meaningful discussion and as a family reply on only reputable sources for updates. 

A note of caution – it can be easy with adolescents to slip into adult conversations; voicing your own beliefs, emotions and concerns. It is important to avoid transferring your personal fear onto your teen, as this can heighten distress and may induce a parentification paradigm (with potential subsequent risks to their mental health and wellbeing).  Maintaining your own support network is thus important.

AGENCY

Human agency is the capacity for people to make choices and to impose those choices on the world. Psychological theory demonstrates that when we are able to focus on what is controllable in our life and influence change; this fosters resilience by lessening stress and activating coping strategies. 

What is within your circle of control? We all have an ability to minimise the spread of COVID-19 by following hygiene and social distancing guidelines. Talking with your children about how their actions can support their own health and the health of their community provides a sense of empowerment. This targeted focus also distracts from an over emphasis on the uncontrollable, for example the fact there is currently no COVID-19 vaccine.  

Establish your own family culture How does your family want to operate during the foreseeable future? Make a time to sit with your children and plan your family response, brainstorming ways you can continue to live meaningful lives. This will be especially important if your family is in self-isolation, or if school closures occur.  For example, we know that maintaining positive emotions is beneficial for wellbeing and culture. You might decide to schedule game nights, facetime calls with grandparents, cooking challenges using only pantry items etc.

Be community heroes Altruistic attitudes, volunteering, and informal helping behaviours make unique contributions to the maintenance of life satisfaction, positive affect and general wellbeing. Purposefully focus on how your family unit can support your community. For example, creating a street directory of everyone’s contact details or offering to shop for the elderly/those in isolation. If your family is in self-isolation, emphasise that compliance will help protect others (your children’s friends, teachers, grandparents etc)

ROLE-MODELLING

Children of all ages often look to their parents as a barometer during a crisis. Assessing parental reactions and coping skills has an influence on a child’s own ability to cope through crisis. As Social Learning Theory denotes “we do what we see”. So, remember your actions can be particularly protective during this time. 

Remain calm and practice self-care Utilise calming strategies that are most effective for you. Thinking about how you have managed previous setbacks is a useful way to generate ideas. Evidence-based methods to manage stress and anxiety include:

• Remember to breathe from your belly
• Daily exercise 
• Relaxation activities 
• Keep a gratitude journal
• Time off screens  
• Regular journaling 
• Connect with friends and colleagues 
• Accessing support if needed 

Follow recommended guidelines If you expect your children to follow hygiene and social distancing guidelines, they need to see this modelled consistently. 

Disrupt stereotypes and unhelpful commentary If appropriate, have a discussion on how COVID-19 has sparked discriminatory commentary and behavior in some communities; and that stigma and exclusion can have significant negative impacts on mental health. We have a collective responsibility to disrupt xenophobia. 

EVERYDAY NORMALITY

Consistency and routine provide a sense of calm and security during times of stress. Children, especially preschool and primary aged, or those who are anxious, will benefit from knowing what’s going to happen and when. Bedtime, meals and exercise are particularly important. 

If your work requires you to spend large amounts of time away from your children, work with your support networks to establish as much consistency in child minding as possible. 

Making an extra effort to engage in positive activities that promote fun is also a proactive wellbeing tool. Play games, watch movies, create crafts, bake, and participate in online community gatherings. 

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Children have a wonderful ability to adapt when their foundation is secure. Calm, consistent and reassuring conversations, focusing on the controllable and demonstrating desirable coping behaviours alongside familiar routines will support the care of our children as we continue into the unknown. I have no doubt our Kiwi families can come through COVID-19.