Talking to Children About Pandemics

During a pandemic, children may experience strong emotions when faced with photos of ill or grieving children and adults, overcrowded hospitals or tired medical workers. Pandemic illnesses are discussed constantly on television or online.

This publication helps parents and other adults find ways to support children through age-appropriate
information, understanding and reassurance.

A pandemic is a worldwide outbreak of a serious disease. The world has a long history of pandemics. Some occurred centuries ago, such as the “Black Plague” (bubonic plague), while others have included polio and influenza. Another major pandemic is associated with a strain of coronavirus and its related illness, COVID-19.

Media coverage of pandemics has increased significantly, and public responses from government and other entities have expanded as well. As a result, children are more likely not only to be exposed to the illness but to experience ongoing awareness of its effects.

Children of all ages see adults absorbed in the news coverage. They listen to parents or other adults discussing symptoms of the illness. They also observe worries among adults about who they may know in a target population or hear about deaths in the news. Children often want to know what is happening, express concern and anxiety, and wonder if it will happen to them
or someone they love.

When parents and other adults don’t have ready and satisfying answers for children and youth, the lack of information can create uncertainty, fear and insecurity in children. Pandemics can be similar to other disasters or traumatic events in their effects on children. Such disasters tend to be events that are quite sudden, very disruptive, lasting in their effects and public in their impact.

Children who express emotional strain due to pandemics may be responding to at least four sources of stress:

• They are dealing with the sudden and unexpected confusion associated with events around the pandemic.

• They may have to cope with weeks or months of continuing disturbance in life routines or typical ways of thinking and feeling because of news media coverage, quarantines, etc.

• They may be responding to increased patterns of stress and difficulty that parents or other adults feel. Such stress can change the family’s routines and emotional atmosphere.

• They may be worrying about the possible impact on themselves or others they know. Children may internalize the events in a manner that reflects fear or anxiety.

Parents and other adults are critical in helping children of all ages deal with the stress from a pandemic.

• Adults can help children understand how to stay well in a pandemic. Children look to parents or other adults for insight into how to respond to difficult circumstances or events. Staying calm and setting a supportive example for children is important. Let them know what adults will do and what the children can do to help (wash hands frequently, catch sneezes and coughs in tissues, etc.).

• Create a supportive environment for children during highly stressful events. Maintain a sense of security in your own home and environment. It reassures children that they can continue to feel safe. Continue or establish healthy family routines. Schedules may be interrupted if schools are closed or other restrictions about gathering in groups have been imposed. Calmly explain why this is necessary right now and what you will do as a family instead of the usual activity.

• Practice a “media diet” if you are with children. Some media outlets sensationalize the events of the day. Children do not have experience determining the difference between factual statements and exaggeration intended to maintain viewer attention. Consider checking the news only when the kids are in bed so your reaction doesn’t cause them more stress. Also, help them learn about using trusted, reliable sources of information.

• Parents and other adults should be a resource for helping children cope as needed. Express your concern for people living in areas where the pandemic is causing sickness. Reassure children about their protection and safety. Answer your children’s questions directly, but give them information that is appropriate to their age and maturity level. Acknowledge their feelings and concerns. They need to know they are being listened to and heard.

• Help children manage fears or uncertainty they might feel or express. Parents and other adults need to be attentive to children’s needs in helping them overcome fears or maintain a sense of trust and security.

During and in the aftermath of a pandemic, parents and other adults should be aware that some children are more likely to be at risk for problems needing attention. Children are more likely to suffer negative effects due to:

• Physical proximity – witnessing the person with a serious illness, the ambulance/emergency personnel, hospital room or unfamiliar medical equipment

• Emotional exposure – having a family member or friend affected by the illness, especially if the person is very sick, hospitalized or dies

• Pre-existing mental health issues – emotional or mental disturbances or anxieties already present in the child

• Pre-existing loss or trauma experience – previous experience with significant loss or trauma as a child

• Parents with emotional strain – living in a family situation with caregivers who are having difficulty coping or who have emotional challenges

• Other family stressors – being in a situation with other family stressors, such as divorce, unemployment or significant poverty

• Extensive or repeated media exposure – awareness due to repeated or extensive exposure to the events on television, radio, internet or other media sources

Common Reactions of Young Children

• Separation concerns or fears, clinging or searching for parents

• Tantrums or irritability

• Anger or aggression (yelling, threatening, hitting, etc.)

• Withdrawal or restlessness (isolation, change in normal routines)

• Repeated questions about the illness, safety, where loved ones are located

• Regressive behaviors (thumb sucking, clinging to adults, wetting bed, etc.)

• Sleep or physical problems (disturbance of sleep, nightmares, stomach problems or other symptoms of physical distress)

What to Say and Do

• Ask children to share their thoughts and feelings with you. Let them know this is a topic they can ask questions about. Ask if they feel scared or angry, and let them know such feelings are normal and can be worked out.

• Allow repetitive questions and a search for understanding. Give honest and clear answers.

• Monitor adult conversations around children. Be cautious when talking about your fears and the pandemic because this can upset young children.

• Give children physical comfort and verbal reassurance of safety. Young children need to hear and feel messages of support and security.

• Help children express feelings through play, drawing or telling a story. Ask them about a story or picture related to being sick and what it means to them.

• Limit the children’s exposure to prolonged or intense media coverage.

For more information, see The Coronavirus Pandemic and Young Children, Ages 4-8.

Common Reactions of Adolescents

• Fears and anxiety, concern about being alone or what else might happen

• Anger or aggression toward siblings or peers, or toward parents preoccupied by dealing with stress

• Sadness about events and loss, isolation, tendency to withdraw

• Sleep or physical problems (disturbance of sleep or other symptoms of physical distress)

• Repetitive thoughts, questions about events, discussion and concern

• Exaggerated attempts to protect or help parents, other adults

What to Say and Do

• Encourage expression of feelings and listen carefully to youth. Ask open-ended questions so the adolescents can direct the conversation and you can assess their thoughts and feelings.

• Reassure your adolescents about their safety. Explain what you, as a parent, and others will do to provide safety.

• Talk about the adolescent’s responsibility to follow all rules for hand washing, surface sanitizing, sneezing and coughing hygiene, keeping a distance in public and staying away from group activities. Also, follow all rules for sheltering at home if that is put in place.

• Encourage helping adults in the home with tasks. Acknowledge the adolescent’s concerns for others.

• Reduce exposure to extensive media coverage. Answer questions directly if they arise.

• Ask your children what they know about the pandemic and how they know it. They may have discussed events with peers or teachers online. They are likely seeing a lot of information and misinformation on social media. Spend time as needed to compare what each person has heard or read and use an internet fact-finder to verify facts about the illness and safe practices.

• Read books or watch movies together that involve dealing with challenges. Discuss the characters and how they responded to events.

• Contact grandparents or older friends or relatives who have lived through pandemics in history. Ask them to share their stories of resilience with your children.

• Allow children to participate in opportunities such as researching needs and making a donation, providing a service or other appropriate activities that are done from home.

• Show children an example of self-control and positive coping in the face of change. An example of a positive attitude, maturity and caring will help children as they choose their responses to the pandemic.

For more information, see The Coronavirus Pandemic and Adolescents, Ages 9-13.

Common Reactions of Teens

• Disbelief, resistance, feelings of invincibility – that can’t happen to me!

• Discouragement, disillusionment and pessimism about life, people, changes

• Mood swings, irritability, anxiety, emotional distance and isolation

• Acting out, engaging in risky behaviors, substance use

• Fear of death, betrayal of the future, etc.

• Thoughts about the future, concern about well-being of themselves and others

What to Say and Do

• Discuss the pandemic with your teens. Assess how they feel, what they have heard, and where they go to check the information they are receiving.

• Encourage expression of feelings and listen. Allow for continuing discussion of events, give time to talk and provide reassurance.

• Establish and maintain consistent routines that involve teens, such as regular meals, bedtime, exercise and playing family games.

• Develop a plan with teens for action if someone in the household becomes ill with the disease. This may include knowledge of contact information, awareness of first aid or planning next steps.

• Involve teens in service activities that can be done safely. Here are a variety of examples: sewing masks for home use, recording family members’ medication schedules for easy access in case they fall ill, may need teens to help care for younger siblings or assist them with their schoolwork.

• Engage teens in leading activities that relieve stress. Suggestions might include safe outdoor activities, yoga or stretching exercises, daily games, jokes, music and art.

• Slow down and help teens appreciate the positive things in life. Sheltering at home may be especially difficult for this age group, but staying home saves lives and that message is important for everyone in the community.

• Share stories of people in history who have chosen to be resilient in the face of adversity.

For more information, see The Coronavirus Pandemic and Teens, Ages 14-18.

Images and stories of pandemic illness are likely to spread fear and anxiety in the general population. Individuals or groups may provide images and messages that further spread fear and concern.

Extensive news media coverage of images of concern worsens this problem and is a cause of anxiety for parents and other adults. Children witnessing or being exposed to images of concern during a pandemic situation can experience negative effects.

Some things to consider:

• Help children establish a set of values to guide their responses and actions. Guide children to develop values that look to the future, take precautions that safeguard themselves and others from the disease, and encourage positive behaviors and attitudes. Model your own expressions of gratitude daily.

• Speak to a child’s level of understanding and avoid blaming. Concepts raised by a pandemic might include where and how the illness originated. Educate everyone about the dangers of blaming and stereotyping a particular group of people for the outbreak of an illness.

• Avoid constant coverage of the pandemic through television or other media. Be aware of how much children see on TV or the internet and set limits. Repeated exposure to images of illness and death may lead to anxiety, trauma or unhealthy responses.

• Be available to discuss what your children see and help them make sense of disturbing images. Discussions with children may help clarify the context of what they are seeing and help them understand what is happening in the world, their country, your community and your home.

• Reduce exposure to images of concern in children’s lives. Relying heavily on screen time is tempting when families are sheltering in place. However, remember that feelings of fear or anxiety that occur due to exposure to images of concern can affect children negatively, even at the level of brain function and development. Limit frequent exposure to images of concern whether on television, on the internet or in other contexts.

American Psychological Association Help Center

www.apa.org/helpcenter

Centers for Disease Control and Prevention – “Coronavirus (COVID-19)”

www.cdc.gov/coronavirus/2019-nCoV

Child Mind Institute – Supporting Families During COVID-19

https://childmind.org/coping-during-covid-19-resources-for-parents

Common Sense Media: “For Parents” link and other features

www.commonsensemedia.org

National Center for School Crisis and Bereavement (a site for parents, children and educators) – “COVID-19 Pandemic Resources”

www.schoolcrisiscenter.org/resources/covid-19-pandemic-resources

National Association of School Psychologists: COVID-19 Resource Center

www.nasponline.org/resources-and-publications/resources-and-podcasts/co…

Parents Lead (resources for parents and caregivers on key topics)

http://www.parentslead.org/

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