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COVID-19 Impact on Kids: Q&A with Pediatrician Dr. Adam Richards

April 4, 2021

Dr. Adam Richards is the Director of Pediatric Services for Jefferson Washington Township Hospital’s Emergency Department and Chief of Pediatrics for Jefferson Health - New Jersey.

Will masks, social distancing and remote school affect the social and emotional development of children?

Masks – no. Kids have adjusted to masks remarkably well. I remember last spring everyone thinking, there is no way little kids will put up with wearing masks. Yet, in my experience, children have been just as compliant, if not more so. If you think about it, we teach preschoolers they have to wear clothes to leave the house. We expect kids to eat pudding with a spoon, not their hands. They pick this stuff up from us. So, the masks haven’t been a big deal.

Remote school – yes, disproportionally so across different families. The children most affected have been kids of single parents, kids of parents who must work outside the home, and younger kids. The effectiveness of remote education has just not been equivalent, especially for little kids. And the social isolation has been a stressor for kids of all ages. That said, there is no reason to think that students can’t catch up. And there is a silver lining that the pandemic has impacted all the kids, so schools will have to adjust to accommodate the entire group, rather than the individual adjusting to the group. I do feel bad for the kids who have missed one-time events like graduation or senior prom, though.

COVID-19 has created a lot of stress for adults and kids. How do parents help their children through the anxiety they may be experiencing?

One great way to support them is to ask them how they are doing, as in genuinely ask them and listen to the answer. Don’t make kids feel like they have to respond “fine” so as not to stress you out. Create an environment where it’s OK to express sadness or frustration about a missed football season, or isolation from friends. Encouraging kids to express their frustration and disappointment is different from encouraging self-pity, though. It is possible to both validate kids’ feelings of loss without messaging that they should feel aggrieved or entitled. A teen can recognize that Zoom-school stinks, for instance, but also feel grateful that their family is healthy.

Exercise, in all its forms, is another proven solution to reducing stress and anxiety. It doesn’t have to be a sweaty work-out either. Brisk walking counts.

How does a parent know when an anxiety-ridden child needs professional help or emergency treatment?

Any child expressing suicidality or unassuageable hopelessness needs help. That’s the obvious answer. For a more nuanced picture, think about anxiety as existing on a continuum. Feeling anxious sometimes is normal or even helpful. But if the anxiety is disruptive or interfering with life, that child could benefit from professional help. For a kid to worry about catching COVID - that is normal. But a kid who refuses to leave the house because of that fear probably needs help. A child who worries at bedtime is pretty normal – but a child who stays up really late because of worry may need help. If you’re not sure if it’s a problem, ask your pediatrician.

Over the course of the pandemic, what mental health issues have you seen in the ER?

Hopelessness, suicidality, depression, aggressive and self-destructive behavior. We have also seen many kids with physical symptoms of anxiety, such as headache, chest pain, palpitations, and abdominal pain. Clinical anxiety is almost always associated with physical symptoms.

Black and Latinx families have been hit harder by the pandemic. Have you seen an influx of children from these families coming in for treatment? If so, what can be done to help these kids?

We haven’t seen a dramatic change in the demographics of kids coming to the ED for behavioral health problems. The same populations who were most vulnerable before the pandemic are still the most vulnerable during the pandemic – kids with bipolar disorder or severe autism, kids from Group Homes, kids without strong social support, etc. 

As we start to see “a light at the end of the tunnel,” what is your advice to parents about adjusting to the “new normal?”

Encourage exercise. It reduces stress and improves resilience.

Get outside. Exposure to nature is an independent stress-reducer. Playing and exercising outside is a double-win. Outdoor activities are safer, too, thanks to dramatically better air circulation. That means kids socializing outside in small groups is also pretty safe. Peer-socialization is another stress-reducer. If your kids go inside their friends’ houses, make it clear to them to wear a mask.

As the weather improves, it will become easier for kids to cut back on screen time and increase outside time. By the time cold, dreary weather rolls around again next winter, I predict COVID vaccines will be available to school-aged children. It has been a tough year, but we are through the worst of it. We have a lot to be grateful for and to look forward to.

For more information on our Pediatric Emergency Medicine Services, click HERE.