Johns Hopkins All Children's Hospital

COVID-19 and Helping Children Cope During Challenging Times

Strategies that families can use to help children cope with emotions and changes to daily life

As parents we often want to find the “right” words when speaking with our children about challenging or difficult topics. The COVID-19 pandemic has been no different, as we have found ourselves trying to make sense of it and the impact it has had on our daily lives.

It is important to know that it is OK to talk about COVID-19 with your children. Some ways to help foster open and supportive communication with your children include:

  • Be open about what the illness is, how it works, and what your family is doing to stay safe and healthy.
  • Discuss the importance of hand hygiene and physical distancing.
  • Think about doing a daily check-in. Sometimes children don’t need advice, they just want to be heard and understood.
  • Use reflective listening skills to demonstrate understanding. Ask what they are thinking about first and respond.
  • Normalize responses — it is OK to feel stressed, worried or angry. It is how you handle those feelings that matters.
  • Provide realistic reassurance; for example, statements like, “Doctors are working hard to help people get better,” or “We are doing what we know to keep you and those you love safe.”
  • Tailor information to meet your child’s developmental level. This may mean talking with your children separately if there are age differences within your family.
  • For teens, you may consider asking them what they already know, filling in any gaps, and clarifying any misconceptions.
  • Remind your children that the changes you’ve asked them to make during the pandemic (for example, cancelling playdates, tournaments, special events, etc.) is only temporary and that you will work with them to think creatively about how to maintain connection and reschedule activities when it is safe, and you are able.
  • Try limiting media exposure for your children and teens, and always check in with them to see if they have any questions about things they may see or hear in media.

How to help your child manage challenging feelings during COVID-19

Throughout the COVID-19 pandemic, we have experienced significant changes to our day-to-day, whether through travel restrictions, school closures, physical distancing recommendations or needing to self-quarantine. While we do our best to maintain our physical health, it is also important that we take care of our emotional and mental health.

Managing stress and anxiety

“Stress” refers to a feeling that is created whenever we react to events or things happening. A stress response is how our bodies react to something going on. Stress also can refer to the “wear and tear” on the body as it responds.

Signs of stress and anxiety in your child can include:

  • Fear and worry
  • Changes in behavior, including level of independence
  • Irritability, sadness, anger
  • Changes in sleep and/or appetite
  • Withdrawal from family
  • Difficulties with concentration
  • Avoidance of activities or interests your child previously enjoyed
  • Physical symptoms such as headaches, stomachaches, muscle tension, and increased heart rate

Some things you can do to help manage your child’s stress or anxiety include:

  • Help your child identify when he or she is feeling stressed. Label the emotion.
  • Normalize feelings and model how to respond to stress in a healthy way.
  • Provide opportunities for discussion about feelings and listen without judgment.
  • Create routines and encourage healthy habits with hydration, nutrition, physical activity and sleep.
  • Teach your child to identify situations that may cause stress and help them think about how to problem solve and cope with uncomfortable feelings. These things help us face challenging situations.

Below are some additional strategies to encourage your child to try. Praise your child when he or she uses the strategies.

“Doing” Strategies

  • Diaphragmatic breathing (belly breathing): Take deep slow breaths (inhale for four seconds, exhale for six seconds).
  • Visual imagery: Imagine a soothing/relaxing place. Try to tap into all five senses.
  • Whole body or progressive muscle relaxation: Learn to relax by tensing individual muscle groups (like shoulders, arms or legs) for five seconds at a time and then relax for five seconds. Pay attention to how your body feels when relaxed.
  • Do something you enjoy: Read, color, play a game, listen to music, cook, work on a puzzle, and connect virtually with friends.
  • Participate in activities that align with family or personal values. Create a new family tradition or shared activity.
  • Try a mobile app: Practice relaxation and meditation strategies using apps.

“Thinking” Strategies

  • Practice acceptance: Sometimes we have upsetting thoughts, but the thoughts are true. “Acceptance” means learning how to identify the thought, accept that it might be true, and still choose to do something that is important to you (for example: “I am worried about everything going on in the world AND I am still going to do the things that I enjoy.”)
  • Coping statements: When we are worried or scared, sometimes we think that it is too hard for us to handle. Many people find that it can help to have certain mottos (coping statements) they say to themselves over and over when they are scared or worried (for example, “I know I’m doing things to stay safe,” or “I’ll focus on what is in my control.”)

Managing sadness and depression

Your child may feel isolated or down due to the significant changes to daily life brought on by the pandemic. Your child may show signs such as:

  • Withdrawal from family
  • Irritability/sadness
  • Low energy/fatigue
  • Changes in sleep and appetite
  • Difficulties with concentration
  • Decreased interest in preferred activities
  • Low self-esteem

Some strategies to help your child cope with these feelings include:

“Doing” Strategies

  • Seek Support. Many children find it helpful to talk about feeling sad or frustrated/mad with someone they trust.
  • Doing something they enjoy or that is important to them every day for at least 15 minutes. Even when children are feeling sad, it’s important that they engage in activities that typically bring them joy.
  • Participate in activities that align with family or personal values. Create a new family tradition or shared activity.
  • Building Autonomy. During times of uncertainty, it can feel like we don’t have control over anything in our lives. Try to provide your child with options in their daily routine (like with their clothing, free-time activity or snacks). For young children, consider presenting two options.
  • Practice relaxation and meditation strategies using mobile apps.

“Thinking” Strategies

  • Coping Statements: When we are sad, sometimes we start to think negative thoughts about our circumstances and ourselves. It can help to have certain mottos (coping statements) that can be repeated if feeling down (for example: “I’ll focus on what is in my control,” or “I can get through this.”).
  • Emotion Acceptance: When sad things happen, it is OK, normal and even healthy to feel sad. “Emotion acceptance” means letting ourselves feel our emotions and cry or talk about our emotions without judgment.
  • Acceptance: Sometimes, we have upsetting thoughts, but the thoughts are true. “Acceptance” means learning how to identify the thought, accept that it might be true, and still choose to do something that is important to you. (For example: “I am sad that I can’t see my friends right now AND I am still going to set up a group text.”)

Creating Schedules and Routines during COVID-19

Children thrive with structure and routine. While some students may be attending school virtually and families are trying to think creatively to meet child care demands, it may be helpful to try to develop a structure or routine that works for your family:
  • As feasible, think about maintaining consistent wake and sleep times, and schedule in family mealtimes.
  • Consider creating a daily schedule that looks similar to the school day, making sure to factor in physical activity breaks. Get creative – take an online fitness class or bring back childhood favorites like jump rope and tag.
  • If you child has been attending school virtually, think about whether they have an area in the home that is free from distraction, with opportunity for supervision/monitoring. Don’t forget to schedule in homework.
  • Consider setting aside time each day for a daily check-in to see how your child is doing, the emotions they are experiencing, what concerns they have or questions they need answered.
  • Provide opportunity for ongoing social contact, like scheduling video chats with grandparents or coordinating a virtual playdate via video conferencing. Teenagers are all too familiar with multiple social media platforms and may help facilitate ongoing connectedness. Physical distancing does not need to lead to feelings of social isolation.
  • Institute a nightly wind down activity to help facilitate relaxation before bed. Take time to read a book, or listen to soothing sounds or music to help quiet some of their thoughts, fears or worries during the evening hours.

Contact Us

The Center for Behavioral Health at Johns Hopkins All Children’s in St. Petersburg, Florida, provides services in psychiatry, psychology, neuropsychology and pediatric developmental medicine. We serve families living throughout the Tampa Bay area.

For more information or to make an appointment, please call 727-767-8477.