Mental Health
Don’t Worry Alone By Bethany Ziss, M.D.
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AHN Pediatrics — Pediatric Alliance Bloomfield
In the future, I suspect many of us will recall the spring of 2020 with the words “coronavirus” and “Zoom meeting” at equal intensity. The world has changed very quickly in ways most of us could not have predicted even a few months ago. We are building the airplane as we are flying it, and our children are with us on board for the test flight. As a developmental-behavioral pediatrician, I spend my days with children who have delays or differences in development. About half my patients are diagnosed on the autism spectrum, while others have ADHD, anxiety, or genetic conditions. Many struggle with changes to their daily routine, and most receive community therapies or special education services. About 20% of all children have special educational needs or receive accommodations at school, and a similar number have a mental health diagnosis. This spring, as COVID-19 reached our area, I watched my colleagues step up to meet the medical needs of our families. How do we provide testing? How do we protect well children from infection in our offices? What visits can be safely provided by video? Meanwhile, I’ve been working to address the social-emotional needs of our patients. Providing video visits from my living room, I have talked with many families and keep encountering two related questions: > What about mental health? > And, what about school?
Underlying both of these is the related problem – the loss of our daily routines.
Mental health: Young children pick up more on the emotions and anxiety of those around them than the specific concerns. They may be extra clingy, whiny, or tearful. Expect them to ask “why” many times. There may be regression in toilet training or bedtime routines. Preschool children may find masks scary to wear or to see on those around them. Mister Rogers used to invite actors onto the show to demonstrate that the person is the same under the mask or costume. You may need to practice or demonstrate this. Older children will likely have a lot of questions and you may not have all the answers. They may worry about themselves or loved ones becoming sick. They may worry about family members who are out of work. Share with them the facts we know, and be truthful about the uncertainty.
Talking points: > Most people do not get very sick. Many children who get sick feel like they have a cold. > If someone does get very sick, people at the hospital work to help them get better. > Schools are closed and people are staying at home to make it harder for the disease to spread. > We are wearing masks if we are around other people outside the house. > We don’t know how long these changes are going to last. Consider limiting news consumption (for you and for kids). Set aside a plan to check the news at certain times, and to try to step away at other times. Videos can be very distressing for some people. Everything else may be closed but the outside is still open. Go outside if possible. Try to give siblings physical space apart from each other. If your child has anxiety or other mental health needs, reach out. Many outpa-
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AHN Pediatrics-Pediatric Alliance • Spring 2020 • www.ahnpediatrics.org
