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Meeting Your Child’s Emotional Needs During COVID-19

Home is the most reassuring place to be for most of us, especially our children. But in this unprecedented pandemic, kids have to deal with a major life disruption they can barely comprehend. They may get anxious, have problems with sleep and concentration, or even develop symptoms of PTSD.

In this podcast, MarinHealth Pediatrician Cindy Greenberg explains how structure and routine can help ground and reassure your child. Dr. Greenberg offers advice on how to engage and support youngsters during the COVID-19 crisis, and when it may be time to seek professional help.
Meeting Your Child’s Emotional Needs During COVID-19
Cindy Greenberg, MD
Dr. Cindy Greenberg is a board certified pediatrician with MarinHealth Pediatric Care | A UCSF Health Clinic, who has been practicing medicine since 1996 and has been located in Marin County since 2000. She completed her residency at UCSD, where she trained to care for extremely sick infants, children and adolescents with acute and chronic disease. She has a strong interest in adolescents, dermatology and gastrointestinal illness. 

Learn more about Dr. Cindy Greenberg

Bill Klaproth (Host):  So, how is COVID-19 and the impact of Sheltering in Place affecting the mental health of our children? And as a parent, what do you need to know to help manage stress and anxiety for our children during the COVID-19 pandemic? Well let’s find out with Dr. Cindy Greenberg, a Pediatric Medicine Specialist at MarinHealth.

This is the Healing Podcast from MarinHealth. I’m Bill Klaproth. Dr. Greenberg, thank you for your time. It’s great to talk with you. So, we are all under stress and our children are under stress too. And I heard that 30% of children 18 and younger, will have PTSD from this pandemic compared to 20 to 25% of adults meaning this is weighing heavier on them than it is on we adults. Is that true?

Cindy Greenberg, MD (Guest):  It was a study that was done in 2013 looking at children and what happened when they were put under quarantine and the quarantine was from two to three weeks at that time and it showed that there was 30% PTSD. Children were having problems with sleep and concentration and eating and activity. It was a very well done study also.

Host:  So, it’s good to know the effect of what the Stay at Home orders could be having on our children. Are they struggling with this more because they don’t have the coping skills that adults have?

Dr. Greenberg:  I think that’s a lot of it Bill. I also think that they don’t process the same information. They don’t listen to the news and know what to take in and what not to take in. And some parents are much more able to take care of the children and explain it to them than others.

Host:  So parents really need to be aware of this. What can parents do to help reduce the stress and anxiety in their children during these times?

Dr. Greenberg:  Well I think our best thing to do is have the most structure as possible and a really strict routine. Children always do better when they know what’s coming. And we can’t control what’s coming right now and we can’t control what the government is saying so we need to control our household functions and daily hour to hour routine. I think that would be the healthiest and wisest thing for parents to do right now.

Host:  So, structure and routine. That’s a good principle for us to put into practice. And I know that’s good for us adults and it sounds like especially for our children. So, can you give us an example of what this structure would look like throughout the day?

Dr. Greenberg:  We just want to get up at the same time. Every single morning. As much as possible. Do your daily hygiene and then one thing that is really helpful is ten to fifteen minutes of movement. We used to move, get in the car, do things, get up, down, now we have to actually put it into our routine because your computer for online school is sitting right there. You don’t really have to move much. So, you actually have to get up and think okay, I’m going to do ten to fifteen minutes of jumping on my bed or pushups or tickling my child, but we have to get our whole body moving because we aren’t leaving the house anymore. So, that same regular movement that we’re used to is not happening.

Host:  So, those are really good guidelines for daily structure and routine. Get up at the same time every day, pay attention to your daily hygiene, and then ten to fifteen minutes of movement every day. So, then can you give us an example of structure and or routine for different age groups?

Dr. Greenberg:  Absolutely. So, I would say that a small person just needs their mom and dad to dance with them, tickle them where an elementary school person might need a jump rope or might need some music. A high school person might need a challenge where we’re doing our planks and we can do a side plank, side plank, front plank, back plank and we start with 20 seconds and then 30 seconds and so it’s a competition. High school kids often don’t want to do it at the same time so they need an incentive with okay you do these five days and on day six, we will do it together and we’ll see who has gotten the farthest. Or sometimes they need some money to say heh, if you can get to a whole minute on all these, then, you know there’s a ten dollar reward for it. That’s how I would break it down.

Host:  Well those are all really good suggestions. Let me ask you this, say you are doing all of these things, but you notice a change in your child. What are the signs that a child may be struggling with stress and anxiety?

Dr. Greenberg:  I think they just feel more irritable and may be unattached where they don’t want to be involved with what we’re offering or it’s harder to get them to smile or they’re more easily to blow up or cry or throw something. I would say would be the most typical type behaviors across the board for all ages.

Host:  So, if you see those signs in your child, when do you know it’s time to seek help?

Dr. Greenberg:  Well I think that there needs to be room for some increased irritability but if you have a project set out that you know would be regularly something that would be really fun like doing a tie dye and the child wasn’t engaging or wasn’t interested or they usually love when dad wants to sit down and read a book with them and they just sit there and don’t really want to be involved. Those would be some things that would make me really concerned. Or if they aren’t usually somebody that throws things or screams then that also would be a concerning thing. Quiet kids become more quiet. Kids that are more verbal tend to yell more. So, different types of personalities.

Host:  So, where should a parent turn if they feel they need an extra level of help?

Dr. Greenberg:  I think starting with the – their pediatrician is a great idea. I think pediatricians know families, know the dynamic, know hopefully a lot of times we know the family since birth and kind of know the personality of the child so it’s a great place to start is just with a video visit with your doctor and kind of talking though things. We’ve read about the summer studies. A lot of us have been doing this for many years so have a pretty good feel for some early problem solving and then of course, if that doesn’t work, then there’s lots of great psychologists and therapists out there that do family counseling and parenting advice also.

Host:  And you mentioned you do video visits as well?

Dr. Greenberg:  Oh absolutely. We have Zoom visits.

Host:  And then what about other resources and other things we should know?

Dr. Greenberg:  Well I think that there’s – the first five Marin has a great webpage for preschoolers that have tons and tons of information for parents for creative projects and learning. And then I also just really like to throw out there that children need to see their friends. And whether it’s just putting the computer on with the child sitting next to them while i eat their lunch or color or do an activity. There’s Netflix watching together where they can actually comment to each other while doing it but actually keeping social involvement at least once if not twice a day on a regular basis is really important.

Host:  And last question Dr. Greenberg and thank you for your time. We’ve been talking about heavy things here, how stress and anxiety are impacting our children. Is there something we should be looking for on the positive side of this like increased creativity, increased family time? Should we be looking for the positives in this as well?

Dr. Greenberg:  It’s such a wonderful time for families to just have a little bit more time together and space and I love the idea of families telling stories together and we used to do ad libs as kids which is just making up jokes and baking and cooking and coloring and drawing or just walking outside and collecting leaves. There’s just so much more time we could be creative together and I love that about this time for all of us.

Host:  Well that’s the perfect way to wrap this up Dr. Greenberg. We should be looking for the good in all of this. And that will help our mental health and the mental health of our children as well. This has really been informative. Thank you so much for your time.

Dr. Greenberg:  Well thank you.

Host:  That’s Dr. Cindy Greenberg. And for more information please visit And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is the Healing Podcast brought to you by MarinHealth. I’m Bill Klaproth. Thanks for listening.