Discussing COVID-19 with Children and Adolescents

With ongoing shutdowns and disruptions to daily life, children may be asking many questions about the coronavirus disease 2019 (COVID-19), and what it means for them. Responding to their concerns calmly and truthfully is the key to assuaging their fears, said Dawn Maaks, PhD, CPNP-PC, PMHS, FFANP, during a session at the National Association of Pediatric Nurse Practitioners (NAPNAP) 2020 virtual meeting.

When it comes to handling children’s questions during the pandemic, Maaks said health care providers play a role in providing anticipatory guidance that is developmentally grounded. For example, preschool-age children crave reassurance and do not need in-depth details, while adolescents should be engaged in honest conversations about reducing the risk of contracting COVID-19.

For all ages, Maaks said it is important to be truthful, but answer the question asked instead of complicating the issue.

Discussions with preschool-age children should be fun and reassuring. Instead of dwelling on the lack of usual activities, for example, parents can emphasize games or puzzles that can be played at home and which may not be a part of the usual routine.

When discussing COVID-19 with school-age children, parents should identify their worries, and work to clarify their understandings. If they ask a question, answer that specific fear without overanalyzing it and adding unnecessary details that may confuse them further. Routines are also important, and Maaks recommended establishing a daily routine to ensure children feel secure.

Adolescent children present their own challenges. Maaks said adults should remember that adolescents feel invincible, and as a result may not take the virus and precautions as seriously as they should. To handle this, she suggested instilling a sense of responsibility. Remind teenagers that wearing a mask or taking other precautions are not only for their own safety, but also for the safety of others, such as their grandparents or other family members who may be more at risk.

“So much of what we’re doing with social distancing is about protecting us as individuals, but it’s seriously about protecting our most vulnerable populations,” Maaks said.

Like adults, many children may be experiencing fear and anxiety during the pandemic, Maaks said. When counseling parents on how to handle this, emphasize the importance of a healthy diet, physical activity, adequate sleep, and grounding or mindfulness techniques. Warning signs for anxiety in children can include developmentally inappropriate worries or sadness, altered sleep or appetite, excessive externalizing, or developmentally inappropriate separation anxiety.

“It’s normal to fear bad things happening to people you love in a pandemic, but that shouldn’t be consuming,” Maaks said. “And if it is, that’s a sign the child needs help.”

REFERENCE

Maaks D. COVID-19 Pediatric Issues. Presented at: 2020 Virtual Conference on Pediatric Health Care; June 4-6, 2020; virtual. Accessed June 11, 2020.