Children have been victims of the sudden and traumatic changes brought out by the outbreak of Covid-19. Basant K. Pradhan, associate professor of psychiatry and paediatrics at the Cooper Medical School of Rowan University, U.S., spoke to Pratigyan Das about the coping mechanisms for both parents and children.
Covid has affected the mental health of people significantly. When adults are affected, it trickles down to the children as well in many ways. First of all, the stressful impact of Covid depends on the developmental age of the child and the associated psychosocial changes. For example, children below seven years of age react differently compared to those above seven, because of the level of cognitive development. Often, under severe stress, kids below seven years are affected not only psychologically but also physically, kids above seven are affected mostly psychologically. Though an in-depth study is required on this topic, data from adult studies suggest that Covid has affected children badly, mostly kids of less than seven years of age. It has increased their anxiety, lowered their confidence level, and affected their sleep, socialisation, exposure to sun, among many other things. In the US, as a child psychiatrist, I am observing that kids below age seven are more anxious, while kids above age seven have become more irritable and depressed. It has also worsened the internet addiction, insomnia, and problem of being overweight because of stress-induced eating. Moreover, internet addiction has made them more withdrawn from the social world and more impulsive as well. In fact, many kids have become suicidal.
What are the ways through which their stress can be taken care of in these conditions?
Well, talking about stress levels among children is different compared to adults. Children are resilient to stress but they can be vulnerable. So, in order to reduce their stress level, it’s very important to take care of the mental health of the parents because kids’ stress can be improvised positively by reducing parents’ stress. So, it is important to enhance the psychosocial stability of the parents whose life has been tormented because of Covid. For instance, most people have resorted to the Internet, there’s no socialisation. So as parents, it is important for them to adapt to this big social change. Through this adaptation, children’s lives can be improvised. In other words, parental stabilisation is the key. Improving their sleeping schedule, level of physical activity, stress management etc. are also needed. Besides, it’s been observed that children with anxiety are having low Vitamin D levels in their blood: this is especially more important for children with pre-existing depression or autism. Therefore, apart from psychology, their biological developments need to be monitored. Yoga, meditation, enhancing pro-social activities while following the social distancing and related restrictions, and spending time in the laps of nature can also very helpful.
With lockdowns in place in most of the states in India, how can kids cope within the confines of their home?
Despite lockdown, we can work more on improving our micro environment, customised to every household, especially in India, which has a heterogeneous population and a unique psycho-social milieu. Micro-environment involves exposing the kids to some kind of physical exercises, dietary consistency, and stress management through Yoga or meditation: these can be done in the confinement of our houses. Besides spending quality time with kids, it is important to monitor their use of the internet and popular media, especially traumatic news.
Has online learning affected the cognitive development of children?
Well, I won’t say, it has affected social development more than cognitive development. Development as you know has four aspects: fine motor, gross motor, language and social. So, cognitive development has broadly been affected but not in IQ, more in the level of social development, courtesy the increase in online learning and anxiety among children. It differs depending on the age group. For instance, whenever there is a traumatic experience for kids below age three, it will affect the social as well as the cognitive development of the child. If the child is more than three years old, this kind of destruction will not affect that much. Beyond that, it will affect more socially than cognitively.
How has it affected their personality?
Data on this are mixed. Online learning has helped kids, who have school phobia. Anxious kids, kids with mild autism, or kids with bullied history are liking the online set up, as they are spared from getting bullied in the school. However, in the long run, it will affect their personality and skill development as in how to work in a team structure or handle stress, and adapt to the demands of the society. On the other hand, many students didn’t like when online learning was imposed on them due to Covid-induced restrictions.
Amidst fear that the third wave in India is likely to affect children, what precautions should be taken? How should we prepare kids to face the third wave?
As I said, changes in lifestyle, based on the developmental stage of the kids is a must. Rather than going with a general strategy, our priority should be customisation based on the personal vulnerability of children, their developmental level and the data on the cultural and socio-psychological adaptations of parents. Many of the customisations can be enhanced, regardless of the lockdown or social constraints. Secondly, restricting their exposure to the media relaying the traumatic messages is important. It is also important to avoid miscommunications about the government’s initiatives on how to mitigate a disaster and to avoid the lack of a uniformed voice. Discrepancies in the messages given by leaders can create a sense of panic amongst the common mass. It needs to be avoided by having one spokesperson nationally for a national disaster like Covid. Managing communication is a very important strategy. Finally, education wise, having a hybrid model will work, as it will enable them to have some coping mechanism in person.
Why is it being said that the third wave in India will hit the kids hard?
In the second wave, we have become familiar with the pattern and distribution of Covid and social determinants of it to some extent. Earlier, it was believed that sunlight is a protective factor but it was proved wrong in the second wave in India. So, the third wave, I am not very sure how it will affect or it will affect more badly than the second wave. Hopefully not, because we have learnt, particularly in the US, where the Covid cases are completely under control, thanks to successful vaccination and social distancing, among others. But having said that, we have to be prepared for any eventuality as we don’t know what kind of mutant we may be facing in the third wave.
Will Covid affect a new-born child?
According to studies, the youngest to get Covid are four-year-olds. But if a mother of an unborn child has Covid, it affects the oxygenation and theoretically, it can affect in severe cases. More studies need to be on neonatal cases.
Will it become like a seasonal flu in years to come?
I don’t think it will be eradicated as the virus is quickly changing the structure (via mechanisms called the antigenic shift and antigenic drift). Smallpox could be eradicated as in that case, the virus was stable, as literature on flu suggests. Secondly, Covid is more virulent than regular flu, that’s precisely, why it takes the form of a pandemic. Even if it stays in isolated pockets in any part of the world, it can be dangerous, thanks to travelling of people from one part to another. So, it seems unlikely that Covid will be ending completely. Whether it will be more confined to like a flu remains to be seen. But data so far show that with the mutant strain, it’s unlikely to be as benign as a regular flu.
What is the role of parents?
Covid is a unique situation, which has affected us globally, restricting our social lives. Our role as parents should be debriefing, which means how to communicate with the kids clearly- not to over expose them to information and at the same time not to keep them away from necessary information. So, parental communication is extremely important to give the right message- which should have some elements of facts coupled with hope based on evidence. Parents should take feedback from their wards on how they are feeling. They have to believe in the self-assessment of their kids. They should sit with them periodically and assess in what way their life is changing by the limitations and restrictions and in what way they would like things to change. Most importantly, parents should revamp and reschedule and reassess their own coping strategy and their own level of skills to customize what more they can do for their own stress management to balance. At the community level, we should try helping people and pay back to society.
Views expressed above are the author’s own.
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