Looking after a child’s emotional needs during COVID-19:

Written by: Dr Catherine Pitfield @ Roots Psychology. Brighton & Hove

Many of us are overwhelmed as adults about what is going on around us right now. Whatever age your child is, they will have noticed many changes that are happening and to the people they love. Your children are watching how you cope with this and developing their own ways of coping during times of difficulty.

Importantly, please remember: Children do not need perfect parents, they need human ones.

Your children will very likely see you cry, shout, be worried, and display a whole range of emotions. There is nothing wrong with this, it’s how we help our children understand and process what is happening to us and to them.

Age-appropriate explanations:

It is important that children are given an age-appropriate explanation for the changes they are noticing to ensure they feel able to talk to you about it. Children will come up with an explanation themselves if we don’t give them one; what is left to the imagination is likely worse than the reality.

Imagine if we noticed something happening and no one talked to us about it; we are very likely to conclude that something very bad was happening, so bad that no one will speak to us about it.

It is important that you give your child honest and factual information, but adjust the amount and detail to fit their age. All children are different, and the below is a rough guide of how thinking about bodies and illness may develop with age. Your own child’s understanding and curiosity about what is happening will depend on many different factors. 

As a first step, find out what your child already knows. For example, you might ask, “have people at school been talking about Coronavirus?” Follow their lead about what they know and whether they have any questions. 

0 – 3 years:

Level of understanding:

  • Will struggle to understand things that they can’t see or touch

  • Focused on what is going on right now and will be unable to hold a future perspective

What you might notice:

  • Show distress at change in routine

  • More clingy, changes to eating, toileting, and sleep

What you can do / say:

  • Give words to what they are noticing in the here and now, for example, “Mummy is working at home now, and will be in the house with you more.”

  • Maintain structure and routine

  • Factor in additional time for playing and comfort

  • Possible explanations could include, “We are washing our hands a lot to keep us healthy.” And “There are lots of germs around so we can’t go to nursery today, today we’ll stay at home”.

4 – 7 years:

Level of understanding:

  • Focused on immediate environment

  • Will likely have some understanding around healthy behaviours like washing hands, eating fruit and vegetables

  • May show some magical thinking, for example, that they can stop illness by washing hands alone

  • May over-apply rules; worry they have caused someone else to get ill because they did not wash their own hands well enough

What you might notice:

  • May play out emotions; playing hospitals, nurses and doctors etc.

  • Repeatedly ask the same question as they are trying to make sense of what they are hearing

  • May increase behaviours that they think will keep them healthy

  • May “fill in the blanks” with their imagination or offer illogical or inaccurate explanations

What you can do / say:

  • Give simple answers and repeat the information consistently

  • Reinforce what you are saying by developing it with play, using teddies or dolls.

  • Possible explanations; “There are a lot of germs around at the moment that have been making some people poorly. To help us keep ourselves safe we need to wash our hands lots and we will stay at home to look after ourselves and others”

7 – 12 years:

Level of understanding:

  • An understanding that illnesses can cause lots of different symptoms and that things go on inside the body that we can’t see

  • They understand that medicine can help them get better

  • Will understand concepts of time and permanence and  that death happens to everyone and is permanent

What you might notice:

  • May not want to voice concerns or fears out of worry that they will upset parents or friends

  • Difficultly verbalising distress

  • More likely to experience stress as a physical symptom, such as a headache or stomach ache

  • Asking a lot of questions about health and impact of health on life around them

What you can do / say:

  • Encourage emotional expression through drawing, stories and questions

  • Normalise different feelings and give words to your own

  • Ensure they have accurate explanations, for example, not all coughs are worrying

  • Limit access to news and other media

  • Possible explanations: A virus called Coronavirus or COVID-19 has been making some people poorly, it is passed on when people come into contact with each other. Most people recover from this and get better. For the time being we will stay at home to keep ourselves and others safe

Aged 13+

Level of understanding:

  • Young people at this age have a good understanding of time, they can imagine the future and as such they are more able to worry about things that haven’t or might not happen

  • Teenagers are mainly influenced by their friends, so even though they can understand a lot of information about illness, what their friends are doing and saying will likely have the biggest impact on how they behave

  • Teenagers are developing their own identity, they are likely to look at their own sources of information and parents will have less impact on how they think about the information or how they behave

What you might notice:

  • They might seek out information

  • They are likely to take advice or guidance from friends in how to behave, and be conscious of not wanting to act differently from them

  • They may be more concerned social, moral and emotional aspects of illness and how illness is having a broader impact

What you can do/say:

  • Continue to offer space for support, affection and discussion

  • Ask open questions such as, “what do you think of the news that….”

  • Offer information from reputable sources, such as, “I just came across this, would you like to take a look at it?”

The possible explanations given above are to be thought of as building blocks in knowledge for your child. Depending on your child, you may need to give further explanations to expand and answer any questions they may have. Children may have misunderstood or heard things incorrectly, clearing up misunderstandings is really important.

Some example questions and answers are provided at the end of this blog post.

Supporting your child emotionally during COVID-19:

  • Connect:  Children and young people need adults love and attention during this difficult time. Find chances to play and relax together. Where possible offer undivided attention, free of screens and potential distractions.

  • Keep structure and routine: Children often thrive from routine and structure. Losing the structure of nursery, school or college can be really challenging. Keeping the basics of wake, sleep and meal times is really important. Aside from that you may want to add some loose structure to the day such as free play, activities, home learning or exercise. Where possible you can involve your child with this, for example, using Post-it notes with activities and getting them to help you decide the order of the day.   

  • Maintain the usual boundaries and rules: In times of crisis or change it can be tempting to relax normal rules and boundaries, however, this often has the effect of destabilising a child or young person. Rules and boundaries help us all to feel safe and contained. Particularly in times of crisis and change, it is reassuring to children that you are still in control as a parent.

  • Acknowledge emotion and offer words to explain it:  It is important to notice what is happening for your child and ‘wonder’ with them. They may be acting out of character or seem worried or anxious, or becoming angry or cross quicker than usual. You could offer up a wonder…“I wonder if you are feeling worried at the moment?”. You could ask them to draw how they are feeling, or ask them questions about it. So children don’t feel consumed or overwhelmed with the difficult feelings, think about limiting the time they do this for (up to half an hour maximum). After that time, think about a plan for managing the feelings and move onto something else. You may want to follow a pattern of talking about difficult feelings, then engaging in play together and then having some time for comfort so as children have a chance to express their feelings and have them acknowledged but they are not left ruminating on them.

  • Where possible remain calm: Imagine if you are a passenger on an aeroplane and you hit turbulence and you look over at the air hostess and they are looking panicked. You are not going to feel very reassured and contained. When you talk through emotions with your child, try to think about what they need from you; young people often need adults to be strong and in control, yet empathetic and understanding. This is hard, and it’s important that you then have an outlet for your feelings too and a time that you can also feel held and contained by another adult.

  • Importance of play: Play is vitally important for children. Not just to have fun, but it is often their main way of communicating, of experimenting, of learning and also a way to recover from emotional distress. Particularly for children under the age of 7 (but also often older) play is where children show their inner feelings and experiences that they can’t or won’t talk about. Provide opportunities for your child to show you how they are feeling through play in a way that you can support them to understand and manage these feelings. Setting up teddies, or dolls, who might talk to each other, can be a good way of seeing how your child is feeling. They may choose to go on an adventure and see who they see along the way (are these the people they might be missing at the moment?) or what is the emotional content of the play (are they more destructive in play or withdrawn?). As you develop the play you could offer words to that experience,” “I wonder if teddy is feeling a bit sad about not seeing his friends at the moment?” Stay in the play to help children resolve those feelings, ask “what can we do to help teddy?” “Does he need a hug?” “Can he write his friends a card?” “Let’s do something fun for teddy” etc. This doesn’t all need to happen in one go, you may slowly build on these emotional dialogues over time.

  • Limit the news and general chatter about the virus: We are surrounded by news and conversation about Coronavirus. If we have this on in the background then we may be exposing our children to a lot of scary images and dialogue. We may have become used to hearing this but children may not be able to process all of this information. Where possible, limit what is watched and for how long for. If your child has heard / seen some distressing images or language then make space to talk that through with them. Ask questions about what they have seen or heard and what they have understood about that.

  • Make space:  Where do your children tend to talk to you about difficulties? Do they tend to speak more freely in one setting vs another? Make time for talking more in these places, or look to do an activity together where you can ask gentle questions without the talking feeling too intense; colouring or completing a puzzle together can often be good activities to talk over. Show that it is ok to talk and have difficult conversations; you are there for them if / when they want to talk.

  • Modelling: Your children will look to you to learn how you respond to this crisis and how you manage your emotions. You do not need to manage this perfectly, but giving words to what you are doing to look after yourself can be really helpful for your child. See the handout on ‘Looking after yourself during COVID-19” for ideas on looking after yourself’. Many of these ideas will also be useful for your child, along with the explanation on anxiety.

  • Take the pressure of yourself: This is a really hard and unprecedented situation. Juggling the demands of family life, work, finances, and day-to-day household tasks is likely to be challenging. You will not be able to fix everything that upsets your children, and neither do you have to. You do not need to be the best home school teacher, the best children’s entertainer or plan the best activities for your child. Do not fear boredom; learning to tolerate boredom and problem solve it is incredibly useful for children. This is also temporary, normal life will resume.

  • Maintain connections: We are social beings and your child will likely miss the usual connections they have with friends and family members. You could problem solve this together, asking how they would like to stay in touch with others. They may choose to FaceTime friends, speak on the phone, or write letters or cards. For younger children you may want to print out some pictures of friends and family and talk about them through these photos. If children are finding the idea of talking over FaceTime difficult, you could ask family members such as grandparents to read their favourite story to them, or sing songs together.

  • Help children hold perspective around the virus: All media outlets are constantly releasing figures on the number of people who have died from Coronavirus. This can be really difficult for children to understand and have perspective over. One way of reassuring and containing a child’s worries around the statistics may be to draw out a health pyramid: You could think through:

    • How many people are there in the UK / your local area

    • How many people will experience a cough and high temperature

    • Of those number, how likely is it that they will be diagnosed with Coronavirus

    • Of those, how many will likely require hospitalisation

    • Of those, how many will need to have more intensive hospitalisation

    • Of those, how many will sadly die?

  • Answering tough questions:  It’s ok to not know the answer to everything. You can simply respond with “that’s a really good question. I don’t know the answer to that right now, but let’s find it out together and we’ll work that out”.

  • Remember you are the expert on your child: The above are all ideas of things to try, you will know your child the best and what they are most likely to find difficult or respond best to. In times of crisis, we can forget how we usually manage difficulties. Take time to remember how you have gone through tricky patches for your child, is there anything that worked before that you could try now?

Example questions with some ideas for answers:

  • Will Nanna and Grandad be ok? Why can’t I see them?

    • Acknowledge the emotion – “I wonder if you’re feeling worried about Nanna and Grandad?”

    • Check – “What have you been thinking about seeing them?”

    • Explain – “We really hope Nanna will be ok. Nanna and Grandad are older than us so they can become more poorly if they get this than if we got it.

    • Reassure and contain – “We are staying at home and not seeing them so as we can help to keep them safe. Nanna and Grandad are also keeping themselves safe by staying at home and washing their hands” “We can call Nanna and Grandad later to say hello, or how do you think you would like to stay in touch?”

  • Will people I know die?  

    • Acknowledge the emotion – “It is really sad and tough to think about people dying”

    • Check – “Tell me about what you have been thinking about this”

    • Explain – “Most people get better from Coronavirus. Lots and lots of people get it and they get better. But some people might get more ill and very sadly some people will die”

    • Reassure and contain – “We are staying at home to help protect people getting unwell and the doctors and nurses who work in the hospital are working really hard to look after people”

  • When can I see my friends?

    • Acknowledge the emotion – “I wonder if you are missing seeing friends? It’s really hard to not see everyone as much as we are used to”

    • Check – “What have you thought about seeing everyone?”

    • Explain – “At the moment we are staying home to look after ourselves. All your friends are staying home to look after themselves too. We don’t yet know when we can start to see people again. It’s hard not having a date of when things will go back to normal”

    • Reassure and contain – “Let’s think of all the ways that we can stay in touch with people. Perhaps we could write a list of all our ideas and then you can pick the ones you like best”  

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Looking after yourself during COVID-19