You can also read an edited Q&A based on the transcript of the video to get the highlights. Answers were condensed from unscripted responses to the questions asked in the live session.

During this presentation hosted by Laura L. Fuller, PhD, ABPP, Jamie L. Elizalde, PhD, NCSP, and Todd Kopelman, PhD share ideas for helping children and teens do as well as possible during this time of uncertainty.

How will this new normal impact my family?

For some of us, we're settling into new routines and it is starting to feel a bit normal, but there's still a lot of uncertainty. And this applies to our children and teens as well.

In all of the changes that have happened very rapidly, we now have social distancing to consider and connections with others have changed. We have altered schedules and routines and lots of surprises thrown in, like using Zoom and using the internet for all different sorts of activities.

For our children and for us as adults, there are lots of milestones or customs that are changing, or not happening, as we would hope or expect.

For children this, might mean birthday parties. It might mean missing a graduation ceremony that they had been anticipating. It might mean they are not able to play their favorite sports, be on their teams, go on field trips or to other family events. These are all changes for us that we're kind of coping with on a daily basis, and sometimes they catch us off-guard.

There's also the uncertainty that surrounds the COVID-19 and understanding what it means and when things will change again. We want everybody to be aware of those things and understand that this uncertainty and newness leads to an increased sensitivity for all of us, and it can lead to some very big emotions. And those are normal reactions given what we're experiencing.

How can we find calm in the storm of COVID-19? Does maintaining a routine help?

In times of uncertainty, most children, as well as adults for that matter, do best when they're able to follow a structured and predictable routine. Setting up routines for kids does require some upfront work and can be a little bit of a hassle, no doubt. But it can really pay off in a lot of different ways.

Routines make us and our children more efficient in the long run. We can go more on autopilot because we know what we need to do each day and exactly when we need to do it. In addition, if they're set up correctly, routines can help us make sure we get those important, but less fun activities done and make sure we've really carved out time for the more enjoyable activities that we actually want to do.

Another benefit of routines is that they can make our children more independent over time and more confident. As they complete the routines every day, they'll become more familiar with what they need to do. And oftentimes that means they'll need less help from us, which is always a really good thing.

And finally, having routines can definitely reduce stress and anxiety for everybody in the family. There's something inherently calming about knowing what we can expect in our day. And it's also just gratifying to be able to check items off of our boxes.

What is the best way to establish routines with children? How do you effectively make changes to established routines?

We have to give ourselves a little bit more compassion and just awareness that we can't control everything and do things just the way we want to. At the same time, for our own sake and our children's sake, we do want to establish routines, because they give us a sense of predictability and control.

So, it's both being aware that life has thrown us a wrench, while at the same time, considering how we are going to respond to it. Routines can be really helpful for that.

You can't act as though what we are experiencing is typical. You can't pretend these things aren't happening. So, modeling the emotions that you're having for your children in the midst of this is more than appropriate. We just want to make sure that we're also demonstrating use of coping skills.

So, if we as adults walk around and pretend that we are fine (in the midst of COVID, social distancing, etc.), that's going to probably feel a little creepy for kids. It's okay to say, "I'm feeling a little confused today. The routine is going to have to change, and we'll be okay. We might need to do some relaxation and then we'll go on to the next part of the day." This is our new normal, but that doesn't mean that every day is going to go smoothly. Building on routines then becomes the most important.

Try lumping your daily activities into very straightforward categories, such as:

  • What time should everyone go to bed?
  • What time should we wake up in the morning?
  • When should we have meals and snacks?

Once you establish those basic choices, move on to thinking about routines for other organized activities like schoolwork, chores, and exercise, as well as making sure that the kids have free time every day, which is very important to them.

If you’re working from home, make sure that your schedule has time built in to check in on your kids briefly. That way you can see if they are following their own routine and ensure there is time for the family to be together.

Your setup and routine should be based on your child’s age and learning style. For example, with preschoolers, you might use a very simple picture schedule or visual schedule. So just pictures of the specific things you're hoping your child will do, along with what we call a lot of modeling or showing.

For elementary students, if they can read, it might be a written schedule. For older children or teens, just shooting them a text message to check in might work as well.

Keep in mind that routines don't have to be the same every day. In fact, they probably shouldn't be, because that might result in boredom. Mixing things up to a certain extent can be very healthy.

So, depending on the day, it could look like different chores, different types of schoolwork. For example, in the Iowa City School District, they've made a recommendation that different subject areas are covered on different days of the week or days might even vary as far as early or later bedtimes.

The important thing is to review any major changes that you make in schedules or routines with your children so they're not surprised or frustrated with you.

Try and involve your child in creating routines or establishing them to the extent that you can. Just like adults, most children like choices because it gives them a sense that they have some control or ownership over what's going on in their lives.

Even something as simple as chores, you could give your child a choice of which chores they're going to do on different days of the week, the order in which within that day they're going to do their chores. If they want to listen to music or not, or other types of things while they're doing the work. Those kinds of simple choices, I found can really make a positive difference and result in more buy-in.

What do you do when the schedule ultimately changes?

Let your kids know as best you can, as early as you can, and then just move forward. In these times, we all have to be a little bit flexible.

How do you determine what your kids need or want?

Communication and listening are crucial here. Giving children and teens choices is part of communication, and that also involves listening to their needs and their wants. When you're creating that routine, one thing you can do is build in time to listen or check in. You can do this weekly or on whatever schedule works best for your family.

We would also suggest just setting aside a few minutes every day, it doesn't have to be more than five minutes to check in. Depending upon the age of your child, they may not have anything specifically they want to talk about, but you just want to make sure you have that option available for them.

You might start a discussion by saying:

  • "What have you heard from your friends or seen on social media about the coronavirus?"
  • "How are you feeling about what's been happening lately with everything going on?"

Give them an opportunity. Sometimes children may be experiencing things that they don't know how to express, or they may be worried that they're going to create more worry or strain for you as the parents. So you want to open up that dialogue with them.

There are some special steps to coach you through this concept. They come from authors Adele Faber and Elaine Mazlish.

Try these steps to communicate with your kids:

  1. Simply show that you are listening. Put down whatever it is that you're doing, make eye contact, get on your child's level. If they're younger and they're on the floor playing, sit down next to them. You want to really make sure they understand that you're listening and that they're being heard.
  2. Acknowledge what is being said so you can repeat back what your child is saying using simpler words. If you're not quite sure what to say, just nodding or saying mm-hmm (affirmative) is also a good way to let them know you're hearing them. Don't try to fix what's happening, what they're telling you. This isn't the time to offer advice, let them have their feelings and experiences.
  3. Helping to label the feeling for your child. So you want to take a guess, if you're not sure it's okay to label what it is that they might be feeling. This is a helpful educational tool for children to learn about emotions. It also lets them know, again, that you're really paying attention. So, you're feeling sad that you won't be able to see your friends for your birthday. If you're wrong, they'll let you know. They may not really have a word for that. So this is a way for you to problem solve and exploring motions with them.
  4. Acknowledging the fantasy that the child is missing out on. So a good way to do this is to start with, “So you wish you could have...”

Those are really important steps, it's just the listening part at this point. Setting aside time to do this is great, and possibly it'll come up spontaneously when you least expect it. If you are in a moment when you can stop and follow those same four steps, it will go far.

How would you label feelings for a child? How can you follow up on wishes your child has after they express them?

One of the things that we hear a lot, and this comes from children as well as teenagers is “I'm bored.” Boredom is something we can probably all relate to right now. But in truth, sometimes bored is a word for an emotion that they don't know how to explain or articulate.

If a teenager says they’re bored, try asking "Well, what is it that you feel like you're not able to do right now? Because boredom is not having anything to do."

Their answer may show that what it really was about was missing friends or not being able to participate in sports. And so, then you could follow up and say, "It sounds like what you're feeling is a little bit of sadness or loss, because you're not able to have that connection with your friends."

Sometimes you can tell how your child is feeling by watching their body language or facial expressions, or even by listening to their tone of voice. Then you can use those as examples to label too. "Wow. I noticed that you were kind of clenching your teeth and your fists when you said that. It sounds like you're a little bit angry."

As far as following up on fulfilling their wishes, maybe make a plan for when you'll be able to do those things again, or how can you connect with those people if it's missing friends in the meantime? Plan ahead, because we know this isn't going to last forever. We may not know how long it's going to last, but we will return to some of those activities. And so, it's okay to plan ahead for some of those events as well.

How do I handle questions from my kids about COVID-19?

The best way to handle this is to answer in a straightforward manner based on their age. Try to tailor your language and the words you use to the age of your child.

There may be a lot of misinformation out there. They may be hearing things that aren't true at all, or misunderstanding what it is that they're hearing. So you really want to hear what they have as questions.

Then, as best you can, you want to model that calmness and how to talk about feelings. It's okay if you don't know, it's okay to be realistic about what you do know and share things like we know washing your hands and following those routines works.

One of the best ways to do that is to actually model the use of those skills yourself. You can tap into relaxation and mindfulness techniques and even bring your children in on them.

Try the five-sense technique for grounding:

  1. Say five things you can see.
  2. Say four things you can touch.
  3. Say three things you can hear.
  4. Say two things you can smell.
  5. Say one thing you can taste.

Practice that and try doing it with your children. It's a great way to bring everyone back into the present moment.

People say “just breathe” all of the time–does that actually work?

There's research behind the idea of learning how to take deep breaths and expand your diaphragm to help regulate your systems when you’re feeling nervous or under stress. The best way to do this is to practice it when you're calm and not wait until you're really stressed out.

Practicing this with your children before bed, or nap time, or in a calm moment is a really wonderful way to get them to understand and practice the technique on their own. You can do this in a way that is easier for children to relate to.

Try this example with your kids:

“I want you to sit up nice and straight and think about your favorite warm beverage, like maybe hot cocoa, or your favorite hot food, maybe it's pizza or spaghetti. I want you to imagine that you're holding it right here in front of you. While you're holding it, I want you to take a deep breath in through your nose and smell it. Then I want you to blow slowly on it, to cool it off. So take a deep breath in and smell it. Blow to cool it off. Do it one more time. Smell it, cool it off.”

This exercise is a simple way to make deep breathing a little more accessible for children. We know that this is a way that helps to calm your body down. We also know that it can just give you an opportunity to give your child something else to do if they're starting to become a little distressed or having difficulties with strong emotions.

Practicing this when they're calm is the best way to go. Don't try to introduce it when they're in the middle of having a lot of panic or distress. That's a time when you want to go back and use the steps for listening and waiting until they're at a place where they can actually use the skills.

How do I know if I’m in over my head and need more help or support?

With all of the changes and uncertainty, that can lead to sensitivity and big emotions. These are very challenging times for everybody. So to an extent, these more intense emotions are just to be expected.

There are some potential red flags as parents that you should look out for. It really depends to an extent on a child's age and developmental level, but really the important thing is to keep an eye out for patterns of major changes in your child's mood, behavior, or any physical symptoms that might suggest your child's experiencing some distress.

Here are some examples based on age:

In preschoolers, you might start to notice your child going back to displaying behaviors that they had when they were much younger but you thought maybe they'd outgrown. So now they're sucking their thumb again, or they're wetting their bed, or they're becoming much more clingy. They may have some difficulties with sleep that they didn't have before, like wanting to come back into your bed at night, or maybe more frequent tantrum behaviors. So those could be potential areas of red flag or concern.

In the elementary age, children, you might see your child becoming more withdrawn. They're not wanting to do things that they used to really like to do in the past. Or again, they might seem overly needy. They may start to ask questions repetitively. It could be about COVID-19, asking you lots of questions, or it could be other concerns that just suggest that they're worried. They may have nightmares at night, or they may have a lot of difficulty concentrating.

In teenagers, a lot of the same areas of concern apply. Changes in sleep are harder to figure out given their sleep patterns, but staying up even later than usual, waking up even later as well. There might be changes in their activity level, just not a lot of energy. They may have interpersonal conflicts that are increasing. They may start to describe physical complaints, stomach aches, headaches, a lot of soreness, or tension.

This webinar is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. If you think you may have the medical emergency, please dial 911 or go to your nearest emergency room immediately. No provider-patient relationship is created by this webinar or it's use. Neither the University of Iowa nor its employees nor any contributor to this webinar makes any representations or warranties expressed or implied with respect to the information provided here in or to it's use.

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