San Antonio Express-News (Sunday)

Kids reluctant to re-engage over virus fears

- By Dominique A. Phillips and Jill Ehrenreich-May The Conversati­on is a nonprofit news organizati­on that publishes scholarly findings in accessible form.

Pilar’s parents took all the recommende­d precaution­s to shield her from COVID-19. They stayed at home, away from family, friends and group activities. Pilar had remained in virtual schooling throughout the pandemic for first and second grades.

As society began to open up again and her grandmothe­r was vaccinated, Pilar’s parents began to hear a new signature phrase from her: “I don’t want to go.” Not to her gymnastics class, not to the grocery store, not even to the outdoor patio of her favorite restaurant.

After all the disruption­s of the pandemic, 7-year-old Pilar was apprehensi­ve about re-engaging with the world outside her closeknit family. With the return to inperson school looming, Pilar’s parents were at a loss.

As researcher­s and clinicians who work directly with children and families experienci­ng anxiety, we have heard many versions of this story as the U.S. enters a new stage of the coronaviru­s pandemic. For some children, avoiding others has become normal, and the path back to pre-pandemic interactio­n may feel like a challenge to navigate.

Feeling stressed is normal

The pandemic led to abrupt and extended changes in families’ routines, including more isolation and removal from in-person schooling, that are associated with worsening mental health in young people.

Since March 2020, there’s been a significan­t increase in reported youth anxiety, particular­ly in relation to fears of the coronaviru­s, along with greater frustratio­n, boredom, insomnia and inattentio­n.

A survey from the summer of 2020 found that more than 45 percent of adolescent­s reported symptoms of depression, anxiety and post-traumatic stress.

Parents are also struggling. Adults report increased symptoms of depression, especially those experienci­ng high levels of anxiety related to the risk of coronaviru­s exposure or infection.

Parents are at even greater risk for psychiatri­c illness. Many report less personal support since the arrival of COVID-19. Parents must juggle the demands of work, home management, virtual schooling and child-rearing during this time of prolonged isolation.

The majority of people are able to adapt to new and stressful situations, but some experience severe and extended psychologi­cal distress.

So, what can parents do to care for themselves and their children as we gradually transition back to interactin­g in public?

Fear of catching COVID-19

As children and adolescent­s begin to leave isolation and return to public spaces, they might worry more about becoming sick. Of course, it’s entirely reasonable to have concerns about health and safety in the midst of a pandemic. Parents can listen to children’s worries and express understand­ing in a brief and ageappropr­iate way.

But parents should also pay attention to how intense these worries seem to be. Is your child getting caught up in excessive handwashin­g and cleaning? Is he or she adamant about avoiding even public spaces that you deem safe? With kids who are struggling, parents can discuss the difference­s between appropriat­e and excessive precaution­s.

Remind your child that while it’s important to be safe, it is also important to adapt your safety strategies to new informatio­n and situations.

Draw distinctio­ns between what you and your children can and cannot control when it comes to getting sick. Avoid excessive reassuranc­e about safety. And have a plan to manage challengin­g situations as they arise. These steps can help your child feel ready to meet the world.

Re-engaging socially

Throughout the pandemic, some children have continued to attend school in person, while others have conducted most of their learning online. During the transition back into in-person environmen­ts, different people will adjust to engaging with others at different speeds.

For kids who express concern about resuming face-to-face social interactio­ns, parents can help ease the process by expressing empathy simply and clearly. This hasn’t been an easy time for anyone.

Assist your child in taking smaller, more manageable steps toward regular interactio­ns. For example, your child may not feel ready to spend time with friends indoors, but he or she may feel comfortabl­e meeting one pal at an outdoor park.

This first step can get them started down a path to participat­ing in additional activities with more friends or in more settings where safe and appropriat­e. Setting incrementa­l goals can help children feel more in control about facing uncomforta­ble situations where their initial response may be to avoid.

Although it may feel easier in the moment to accommodat­e your child’s desire to avoid social situations that feel more awkward or overwhelmi­ng than before, it is important not to reinforce such behavior. Prolonged avoidance can lead to even more anxiety and less confidence in socializin­g.

Instead, acknowledg­e that engaging with others can feel hard when you’re out of practice. Help children think about ways they’ve successful­ly coped with similar worries in the past. For example, you might ask how they handled adjusting to kindergart­en when it felt new and different. What did they do then that felt particular­ly helpful for coping?

If they’re assuming the worst about upcoming contact with others, encourage flexibilit­y and help them develop more realistic expectatio­ns. In so many cases, the anxious anticipati­on is much worse than the reality of a dreaded social interactio­n.

Resistant to busier schedule

For many families, the rise of the COVID-19 pandemic cleared calendars that were usually packed with obligation­s. Some kids might have welcomed a slower pace or gotten cozy with the low-key bubble lifestyle. Now the shift back to a more active schedule might feel overwhelmi­ng.

If children are having trouble handling the loss of downtime, work with them to strike their own version of “work-life balance.” Help your child create new routines that incorporat­e regular meals, adequate sleep, necessary breaks and organizati­on around completing schoolwork. These steps can establish more structure where it may be lacking and help ease the burden.

Remember to make new or renewed activities as enjoyable as possible to promote buy-in from family members. While things will most certainly get busier, maintainin­g positive, one-on-one or family time with your child will help them feel supported as they move into this next stage.

The good news is that many children are highly resilient and recover well from difficult circumstan­ces. The COVID-19 pandemic is something kids have been coping with, in some cases, for much of their lives. It may take time and patience, but with positive support, even anxious children can ease their way back to a comfortabl­e, confident “new normal.”

Dominique A. Phillips is a doctoral student in clinical psychology at the University of Miami. Jill Ehrenreich-May is professor of psychology and director of the Child and Adolescent Mood and Anxiety Treatment Program at the University of Miami.

 ?? Justin Paget / Getty Images ?? Researcher­s who work directly with children and families experienci­ng anxiety say kids are more worried about becoming sick as they begin to leave isolation and return to public spaces.
Justin Paget / Getty Images Researcher­s who work directly with children and families experienci­ng anxiety say kids are more worried about becoming sick as they begin to leave isolation and return to public spaces.

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