Supporting children through the current health crisis

Updated: Feb 19

The current outbreak of #Coronavirus has sparked fear and anxiety around the world. Novel threats, like infectious diseases, have been shown to raise anxiety levels more than familiar threats. However, during this particularly stressful time in Hong Kong, it is important for all of us to keep calm and positive to avoid spreading more panic across our communities.

With schools closed until March, children’s normal daily routines are disrupted. Although many schools are currently using distance learning for children to keep up with the school curriculum, it is still important to help children manage through this disruption by creating a structured environment at home.


Adherence to routine may also make the transition back to school easier for both parents and children. This resource sheet, created by the Child Development team at Southside Medical Practice (part of Central Health Partners), includes some helpful information and guidelines for parents and caregivers to help children and young people to cope with this current situation.


Taking Care of Yourself

Before supporting children, it is important to check in with your own psychological wellbeing.


Given the unpredictable nature of the current situation, everyone in Hong Kong is under increased levels of stress, which can impact people in different ways.

It may be helpful for adults to consider the following:


Check in with your own emotions

Take a step back and check in with your own emotions. Stress can creep up on you, and can build over time. It is important to think about where your levels of stress, anxiety, or sadness are, and think about whether you need to take steps to better manage these emotions. Children are usually very attuned to your emotions, and will feed off your emotional pollution.


Take a mindful moment

It can be helpful to take a mindful break – focus on making a cup of tea, exercising, going for a walk, getting a massage – to break the cycle of stress that comes from talking about, reading about, and seeing the situation in Hong Kong and globally. When engaging in a mindful moment, take care to focus just on the moment, and if you notice your mind wandering away from the activity draw it back to the task at hand.


Manage social media

It is extremely easy to access information through various social media platforms, and the amount of information and footage can be overwhelming and constant. Ensure you take breaks from accessing this information. It is also important to ensure that you are receiving accurate information, and do not share information that is not credible.


Be mindful of your conversations

Children are often very perceptive of mood but also conversations. It is important to think about the messages you may be directly or indirectly sending to your children when discussing the current situation.


Talk to them about Hong Kong’s situation

As noted, children will pick up on feelings and nonverbal cues in the adults they spend time with, and if we hide this, it can make it worse as they do not know why things are different. It is important to give children some information, in an age-appropriate manner, to help them obtain some sense of what is happening. When sharing information, it is often helpful to be brief, honest, and offer the opportunity to ask questions.


Model managing your own emotions

In an age-appropriate manner, it may be helpful to acknowledge your stress and explain how you are struggling, and trying to manage this in a healthy way. This helps normalise the stress levels, and will help your child to manage the situation in a more positive way. Know when to seek help for you and/ or your child(ren). Although distress and worry, in addition to other issues, may last for a reasonably long duration of time and can be entirely appropriate following a traumatic event, seek immediate help from your family doctor or from a mental health professional if they are interfering with you or your child’s ability to function or succeed.


Supporting Your Child


Reassure your children that they are safe

All children, from toddlers to teens, look to adults for comfort and support. It is important to reassure them that they are safe despite what they may be seeing or hearing.


Encourage routine and normalcy

As long as it is safe to do so, it is important to continue activities, playdates, and the usual routines as much as possible. During school closures, it is also important to think about accessing online learning material that the school provides, and perhaps having classmates round to complete work together as long as strict hygiene measures are in place.


Increase motivation

Since distance learning requires self-discipline, it is important to help your child stay motivated. Helping your child set goals and making plans on how to reach them would be a helpful way of keeping them motivated. When goals are accomplished, celebrate these successes together. Stay positive and dismiss any self- doubts or fears they may have. Having a positive approach will brighten their outlook on the situation.


Plan for opportunities to talk

Find natural openings to have discussions without putting on pressure to talk if your child does not want to. Utilise simple questions to check in with how they are doing. Follow these conversations with a discussion about recent positive events (i.e., family story, activity) to help them feel safe and calm.


Explain the situation in an age-appropriate manner

Younger children may need simple explanations such as, “there is a virus that is making people ill and we need to wear masks, wash our hands, and stay home from school. If we look after our hygiene then we should be ok”. Adolescents may need more complex answers using figures and statistics from reputable sources that explain how the virus spreads and how we can reduce the risks involved.


Encourage healthy hygiene habits

There are many sources of information that outline good hygiene habits for the current situation, including washing hands, wearing masks when ill, avoiding crowds, and so on. Washing hands thoroughly has been shown to be an important defense, and it would be helpful to have children count to 20 or sing the ABC's while washing hands with soap. Making it more enticing for them may help them complete this properly, for instance counting in things they find interesting such as batman, “one batman, two batman, three batman, and so on”.


Prevent or limit exposure to news coverage

This is especially critical with primary school children. It is important to think about how your children may be accessing information – from friends, from social media channels, from the TV. Some older children and teenagers are likely actively seeking out information but may not have the capacity to differentiate sensationalist or fake news. It is important that if your older child or teen would like to research that you do the research together, or you oversee what sources they are accessing.


Be a good listener

Try to be understanding about how your child views the situation, and what is confusing or troubling to them. Do not lecture and let kids know it is okay to share with you how they are feeling at any time.


Validate what they are feeling

It is important to reflect and acknowledge your child’s thoughts and emotions, and that it is ok to not be ok. Try not to negate their feelings with responses like, “oh, don’t be worried”. This may cause them to feel embarrassed or criticised. It is better to confirm and reflect what you are hearing: “Yes, I can see that you are worried”.


Constant Questions

Realise the questions may persist as it is quite common for children when they are processing events. Let them know you are available to talk at any time. Children need to digest information on their own timetable, and questions might come out of nowhere.


Encourage children to tell the story of what happened

This can be done through talking, playing, drawing, or writing a story. Telling the story in their own words can help them to make sense of the event and cope with their feelings. It also provides them with a sense of control when in a situation that they cannot control.

Promote relaxation and model it


There are many ways to do this. Belly breathing, yoga, mindfulness, and so on are all helpful ways for the family to de-stress. GoNoodle provides a variety of interactive videos on Youtube that children may enjoy.


Express Gratitude and foster hope

There is significant research to show that expressing gratitude can boost positive emotions. Especially during this difficult time, it is important to focus on positive moments and draw everyone’s attention to what we can be grateful for. Hosting a gratitude circle in the evening where each family member expresses 3 new things that they are grateful for can really emphasis positive points.


Signs of Distress or Worry

  • Changes in sleep (e.g., nightmares, trouble settling down to sleep, expressing fear about sleeping, etc.)

  • Irritability, anger, and moodiness

  • Poor concentration

  • Changes in appetite

  • Behaviour problems (e.g., acting out, tantrums)

  • Jittery or jumpy behaviour

  • Regression of behaviour in young children, such as clinging, bedwetting, or thumb-sucking, trouble separating, baby-talk


Maintaining Structure and Routine


Keys to building structure: Consistency

Respond to your child’s behaviour the same way every time no matter what is going on or how you’re feeling.


Predictability

When your daily routine/rules are predictable, your child will know what to expect for the day. When your rules are predictable, your child will know how you will react to their behaviour.


Steps to creating structure:

  1. Identify the routine: Identify important daily activities and decide the order they should be arranged in Identify key times of the day when the activities should occur and make a routine Be sure the routine works for the whole family.

  2. Explain the routine:
 Make sure your child knows what you want him to do and when you want him to do it Depending on your child’s age, use simple charts with pictures to visually display the routines Ensure it is placed where they can see and interact with the routine display

  3. Follow the routine/rules: All family members should try to follow the routine
Your child may not always want to follow the routine/rules, so provide reminders and support when needed to help him be successful
 even when you’re tired/ stressed, do try to stick to the routine as much as possible.

Additional resources: Central Health’s Child Development Team therapists are experienced in helping parents, children and adolescents manage their emotions and handle stressful situations. Also, experienced learning enhancement teachers can facilitate and manage long distance learning. Support can be offered in the clinic as well as through video conferencing. You can also seek additional support and guidance with your child's school counsellor.


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