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Prakash Chandran: This Children's Health Checkup COVID-19 podcast was recorded on March 27th, 2020. You're listening to Children's Health Checkup. Today we'll be discussing how to talk to your child about Coronavirus with our expert, Dr. Nicholas Westers, a Clinical Psychologist at Children's Health and Associate Professor at UT Southwestern. This is Children's Health Checkup, the Podcast from Children's Health. I am Prakash Chandran. So Dr. Westers, let's start with what are some of the best ways to talk to kids about Coronavirus or COVID-19?

Dr. Westers: Well, at this point, most kids have heard about it and are aware of it after all, school doesn't typically get canceled for no reason. And one of the best ways that I recommend that parents, talk about this with their children is starting the conversation off by asking what do you know, what have you heard? And one of the questions I often will ask in my work here when I'm talking to children and adolescents at Children's Health is asking them if they've known anyone that has been affected. So I may ask them, do you know anyone, have you been affected in any way? Do you know anyone that has been affected? And I think this is a fair question for parents to ask their children because they may have heard friends through the grapevine that may have been exposed or affected. And adolescents in particular may have a greater exposure based on their social media connections, so they may know someone. So it's perfectly okay for parents at this point to check in with their children and ask them what they've heard. And then that allows the conversation to open up and parents can then provide correct information if there's misinformation and then, hopefully decrease anxiety that their children may experience as a result of misinformation.

Host: Yeah. You touched a little bit about on this already, but I'd love to hear a little bit around how you would recommend approaching the topic with these different age groups. You know, you mentioned some have access to social media while others may not. And I imagine that one approach is better for young children, while another might be better for those teenagers that do have that access. So what approaches would you recommend for these different groups?

Dr. Westers: For younger children and probably elementary school, providing them with facts is most important. And for a little ones, what they want to know is that they're safe. And one way rather than just say we're going to keep you safe is to detail strategies that you're teaching them as a parent, how to be safe. For instance, we're making sure that we're taking care of you as best as we can. Make sure that you're safe. And the way we're doing this is by teaching you how to wash your hands correctly, how to cough or sneeze into your elbow and then wash your hands. How to participate in social distancing, which is a term they may have heard at this point. And if not, breaking that down. Social distancing is making sure that we're still connected to people emotionally and socially. We're staying six feet away from them. We're not gathering groups and we're not hanging out with friends right now. So that's a sort of just giving facts also about the Coronavirus. They may not need to know that actually. They don't need to know the details of where it originated necessarily, how many people it's affected and who, you know, that might have been exposed to the Coronavirus unless it immediately and directly affects your child or family. Parents may want to talk about the political implications. That's not, that's unnecessary or who is to blame, that's unnecessary when talking to younger children and restrict how frequently and how much time we talk about this. We want to keep it short and sweet, but still open a conversation for children to be able to ask about any misinformation or just general questions that they may come up with you. We can be surprised by what information we share with children and what they take away from that. For instance, they may have heard that it affects elderly individuals, that are, or elderly individuals are at greater risk or those that are vulnerable populations with medical conditions. Well, do they know what elderly means? Because you may be old to them, but you may not necessarily fall in that category, but they can be very worried about your life and we don't know that, what kids walk away with. So we want to make sure we open that conversation up for them to be able to ask those questions for us to clarify. And a lot of parents, well, most parents want to be as honest with their kids as possible. And some do this by sharing as much information as they know so they can be as honest as they can, but that's not always helpful. It's great to be honest with what's going on and honest with our kids. But oversharing can lead our children left to filter that information on their own and come to their own conclusions, which could be far worse and anxiety provoking.

Host: Yeah. You know, that's really good advice and feedback. Really just helping them understand that they're safe, not necessarily oversharing, too many details. And I imagine this also leads into whether they should be watching the news or not, because obviously when you watch the news, a lot of this stuff can be sensationalized. But for teenagers who might have access to their own information, not only from their peers but from social media, what recommendations might you give to those parents?

Dr. Westers: Yeah, teenagers are going to be getting a lot of their information on their own through social media. And sometimes it's like you had said, sensationalized or satirical. There are a lot of hilarious means out there now and satire that can actually can sound very close to the truth, screenshots about breaking news. And then it's some title of the news article that's actually not a news article, but it's satire. And that can actually create fear in some teenagers when they walk away with information that's incorrect. So one of the things that we know based on research is that when parents sit down, particularly with their adolescence or not initially sit down with them, but watch news with them, or get their news online, when they guide their teenagers to critically evaluate the messages that they're seeing and reading, we know that our teenagers are less negatively affected by those messages. So these are times when our teenagers are getting their news online or even through the television, being able to coach our children to critically evaluate the messages, the sources of that information, is it accurate and teach them this skill and not just specific to the Coronavirus, but for any news that they may get in the future. And we talk about the importance of parents helping their teenager to critically evaluate that information. But we as parents need to make sure that we can do this same. I do see adults and parents sharing misinformation online and, they're not critically evaluating, they're not reading the actual full article or the source of it to know that that's either satire or just completely biased and misinformed. So we need to make sure we're modeling that for our teenagers when we're going to teach them how to critically evaluate it.

Host: So, you know, I do have a close friend whose four-year-old had a birthday party this weekend. And obviously it's been a little bit of time since we've been told to shelter in place and he's, he kind of threw a little bit of a fit. He just did not understand why, you know, it's my birthday. Of course I'm going to be able to go outside and have this party. And he started crying. And so, you know, I imagine that there are common indications like crying, that tell us that children aren't coping with this well. So I'm curious as to your thoughts around how parents might be able to deal with that.

Dr. Westers: Yeah, that's certainly disappointing to have this huge expectation of a birthday party and then suddenly it's canceled or we can't have it, whether it's related to Coronavirus or some other circumstances. So there are appropriate responses. It's very disappointing. The child is going to cry and be disappointed and we don't want to dismiss that and say, Oh, it's fine. You have plenty more birthdays to celebrate in the future. We want to validate. Yeah, that's really hard. I know you had such great expectations and right now, we're still going to celebrate your birthday and we can call your friends and maybe do a zoom meeting together with your friends. Or another social media app to allow them to participate and be able to utilize the technology that we have, but allow our kids to struggle a little at this point. Because we are also going to be struggling and it's appropriate to feel anxious, appropriate to feel disappointed or even sad at times or even stressed.

But it's not necessarily appropriate if your child is continuing to have a tantrum that's lasting hours upon hours and now it's days later and he's still really struggling. That might be more problematic for parents. And so for them to be able to identify that that's it's okay to be disappointed and we might expect some more tantrums, but it's not necessarily typical to have consecutive tantrums, consecutive days, beyond what would be normally expected in your child. So our parents know their kids best and so they're going to be able to know, are they experiencing just some stress or is this more abnormal than usual? Cause they're probably going to sleep a little more now that there's less structure with school, even though there is still school online for most students, but they may sleep a little half hour or an hour more, and may have some struggle going to bed at night. but are they suddenly not sleeping at all or are they sleeping all the time? Which is more abnormal. Is your teenager who is typically really social even, you know, whether face to face or online, are they suddenly withdrawing and not even connecting with their friends online anymore? That's a little bit more abnormal, most likely.

Host: So I want to zoom out a little bit to the family unit. You know, I know that for me and my family and my kids, we've had to really adjust to being home with each other as often as we are right now. So, you know, as families take these measures like social distancing to help prevent the spread of COVID-19, what are some tips that you might offer for helping them adjust to more time at home with one another?

Dr. Westers: Yeah, so we're still going to want to stick to some structure. Of course it may be a little bit looser than usual and that's okay. Because they're probably, you know, our kids are not going to be in school for six to eight hours. They might be doing some online school that they may not be able to tolerate for more than 30 minutes at a time or even less for some younger children. And needing to take breaks, and allowing those breaks I think is going to be important. But for all of us we're going to want to make sure we maintain some sort of structure and when there are so many unknowns like there currently are with the Coronavirus, for instance, we don't know when things are going to end. We don't know how long we're going to have to continue with these social distancing practices. And that can actually be the fact that we don't know that when this is going to end can cause so much more stress. So being able to create a sense of control in a time when we don't feel like we have much control can go a long ways. So that's helpful with the structure, making sure meal times play times are still consistent. And then getting creative there, I know a lot of online resources, apps, that are geared toward learning, but also connecting with others, that families can use.

And creating good positive memories during this time. What better time to bond with our families then when we're actually required to be around them much more than we typically are. And there are a lot of different creative ways I think about like doing treasure hunts where, you know, like inside the house, outside the house, fun activities like that or learning how to bake together or having your child, your child write a comic or make a video, a funny video, and or become an expert in some topic. And I think one other way that we can help, not only ourselves but our kids is to focus on what we can do to help. Cause other than just washing our hands, other than, you know, to staying at home, there's got to be more. And we can talk to our kids, children and teenagers about strategies to give back, such as writing letters to those who may be affected by visitor restrictions at the hospital or nursing homes who aren't getting their visitors. Or making videos and sending them to the healthcare workers on the front lines. And being, coming up with world-changing ideas for teenagers. Now is the time to become an expert in some topic and be creative.

What does this world missing, you know, or how can we help fight COVID-19 in a unique way that someone hasn't thought of before? So using a lot of this downtime to come up with creative ideas, reaching out to the community, sidewalk chalk with hopeful messages. You know, when it's nice out, being able to go out on the driveway and have your kid write a neat message for the people that are out walking and getting outside and getting some exercise that they can read and feel encouraged. Those are some practical ways that, and not only is it fun cause, you know, they're drawing and coloring outside on the, on the, on the sidewalk or on the driveway. They're also getting outside getting some physical activity and sending a positive message to their neighbors and people that probably could use some encouragement right now.

Host: Absolutely. Absolutely. So, you know, as we wrap up here, are there any final tips you'd like to share with parents around just how they can, you know, help their kids through this crisis or do things like encourage self care? Any final thoughts that you might want to leave the audience with?

Dr. Westers: I have two thoughts in particular. One is to keep things in perspective. This is not meant to last forever. We are going to get through this. We are resilient people and if we can keep that in perspective, and help our kids keep that in perspective, then I think that will go a long way. And second, particularly with teenagers or older children who may not be taking this as seriously, they may see social distancing or staying at home as an infringement upon their rights and autonomy cause they want that independence. We want to appeal to their altruistic nature, their kind nature. So rather than focusing on our adolescents and teenage kids about what they're losing, like their rights, their ability to go spend time with friends, what are they contributing to society. So we want to focus more on appealing to their altruistic nature rather than coerce them into staying and focusing on coercion. And so I think that's one message I want to make sure our families hear is that, altruism is better than coercion when it comes to older children and teenagers and appealing to them to participate in social distancing and how it can save those in the family that are at risk, whether they're medically vulnerable or elderly. And being able to do their part as heroes and keeping everyone safe, not only in the family, but in the neighborhood and in our world.

Host: Well, I think that's the perfect place to end. Thank you so much for your time today, Dr. Westers. That's Dr. Nicholas Westers, a clinical psychologist at Children's Health and associate professor at UT Southwestern. Thank you for listening to Children's Health Checkup. For more information, visit childrens.com/COVID19. If you found this podcast helpful, please rate and review or share the episode and please follow Children's Health on your social channels. Thanks. And we'll talk next time.