Kid Stuff

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Practical strategies help children foster a healthy state of mind

Parents can now receive behavioral health as a facet of their child’s pediatric primary care. This integrated approach, a collaboration between Savannah Behavioral Pediatrics and SouthCoast Health, is the first and only of its kind in the region — and the timing couldn’t be better.

Over the last several months, daily routines have been turned upside down due to the coronavirus, and as people struggle to find stability, anxiety levels are collectively rising. Unfortunately, this isn’t limited to adults, says Savannah Behavioral Pediatrics owner and pediatric psychologist Dr. Kristi Hofstadter-Duke. Using behavioral health methods, Hofstadter-Duke (along with her colleague Dr. Kristen Hembree, Savannah Behavioral Pediatrics’ director of integrated care) offers practical tools to help children find resiliency during unprecedented times.

First, a bit of relief: “It is absolutely normal that we are seeing changes in the behavior of our children,” Hofstadter-Duke says, pointing to coronavirus guidelines that have dismantled children’s daily routines.

Parents are finding that simple play dates or swim lessons are not as straightforward as they used to be. Now, children might need to wear a mask or have their temperature checked prior to doing an activity.

“When we have significant changes in day-to-day life, we can see an increase in behavioral and emotional changes,” Hofstadter-Duke says. This trend is not new. It happens on a small scale during times of change — the shift from school routine to summer routine when a child seems “out of sorts,” for instance. But coronavirus presents parents with large-scale shifts that affect predictability, routine and connectedness. And for children, these are the very three elements that foster emotional stability and well-being.

A parent or caregiver might see an increase in a child’s emotional anxiety or tantrums, or observe that a child who never had emotional issues before is now in a heightened state of anxiety. When children are distressed emotionally, adults need to pay attention, Hofstadter-Duke says. Because kids, particularly young children, often do not have the complex language to say or even know what they need, they act out to get the attention of someone who can help them make sense of the situation.

“What’s critical for children is how adults respond,” she says. For older kids, Hofstadter-Duke recommends encouraging simple but purposeful actions, like hand-washing and mask-wearing. “Letting them know that they can actively take part and contribute to pushing things in the right direction is a major part of helping children feel like they have self-efficacy in a crisis situation.”

No matter a child’s age or ability, Hofstadter-Duke has three tangible ways to support children emotionally while also providing strong roots of resiliency for their future.

“One of the best things we can give children is our time,” Hofstadter-Duke says. Of course, with so many of us staying mostly at home, parents might think that they are spending more time with their kids than ever before. However, being around kids doesn’t necessarily equate to being with kids.

Being with kids is characterized by engaging face-to-face, she says — and engagement doesn’t take as much effort or planning as one might think. Hofstadter- Duke says in most cases, a daily check-in will do the trick. “It communicates to a child, ‘I am here for you,’” she says. This is not a time for criticism or a conversation about what needs to improve, but rather an opportunity to ask questions, invite questions and listen.

Next, while it seems almost impossible to establish during coronavirus, routine is essential to a child’s sense of wellbeing. This doesn’t mean planning out every minute of the day, Hofstadter-Duke says. Instead, “it’s a matter of finding the right balance between helping children be flexible while also providing routine. We need both.” In practice, that means creating a family calendar, or a list of things to count on for the week: This week we will call grandma and grandpa on Zoom, or this week we will work on an art project. When certain things don’t work out or things change, a bit of routine lets children know that there is still a plan in place.

Children also need social engagements — another necessity that feels increasingly difficult to achieve. Children rely on peers, grandparents, coaches and teachers to help them feel connected to something larger than themselves. But Hofstadter-Duke makes the distinction that social distance is not social isolation. Fostering and maintaining social relationships will require creativity, but these intentional moments of connection will go a
long way in helping a child feel protected both physically and emotionally, she says. As rules for social interaction continue to change, it’s important to look for ways to adapt: think drive-by birthday parties, visiting with grandparents through a window, and taking walks six feet apart.

Fundamentally, all of Hofstadter-Duke’s tips center on stepping up rather than zoning out. “The number-one thing that encourages resilience in children is the presence of a stable, consistent adult,” she says. Addressing children’s behavioral health head-on ultimately provides resiliency, an important coping skill for every age and epoch.