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A magical emergency department visit

When 3-year-old Vinny and his mom Nikki visited CHOC Children’s for the first time, they didn’t expect a calming experience thanks to a magic show, or that staff would go above and beyond to make them feel comfortable.  

 Vinny had a fever, and his pediatrician suspected pneumonia. After a few days of antibiotics, the fever returned, prompting his trip to the Julia and George Argyros Emergency Department at CHOC Children’s Hospital. 

“His pediatrician had told us that if Vinny didn’t seem to get better, we should rush him to CHOC,” Nikki says. 

Nikki called the emergency department before bringing Vinny in, to check on COVID-19 visitor requirements. His fever was nearly 104 degrees when they left the house for their first-ever visit to CHOC. 

 Nikki and Vinny remember feeling nervous, stressed and scared when they arrived, but appreciated how CHOC staff reassured the two from the very beginning.  

“Everyone had a very palpable sense of confidence that they will take care of the children, while also being super soothing and calming in their attitude and demeanor,” Nikki says. 

In the emergency department, Vinny was given a COVID-19 test. He’d had one before but had a much smoother experience this time. 

“Vinny has had a test done elsewhere prior to being at CHOC and that experience was traumatic for him,” Nikki says. “The test done at CHOC was faster and went smoothly thanks to the child life specialists who helped distract him.” 

Vinny’s vitals and stats were checkedand he was prepared for a chest X-ray. The X-rays showed that he not only had pneumonia, but also pleural effusion, a buildup of excess fluid in the lungs. 

Dr. Seth Brindisa board-certified pediatric emergency medicine specialist is an expert in taking care of sick kids. But before he discussed the X-rays results with Nikkihe put Vinny at ease with something else he excels in — magic tricks. He greeted Vinny by pulling a coin from behind the 3-year-old’s ear. That trick was followed by a series of magic tricks that brightened Vinny’s evening, and eventually, his entire experience at CHOC. 

Vinny pictured outside CHOC
Vinny smiles behind his mask outside CHOC, after being discharged.

Aside from magic tricks, Dr. Brindis also had a treatment plan up his sleeve. He sent Vinny home with a prescription for stronger antibiotics and ainhaler. He also explained to Nikki what should and should not happen with Vinny while he healed at home. 

choc emergency department
Dr. Seth Brindis often performs magic tricks for his patients.

“From early on, CHOC always had a future plan, and communicated that to us,” Nikki says. “I was always able to ask whatever questions, and they had answers.” 

Nikki and Vinny went home, but four days later his fever returned, and he was unable to breathe, so they returned to CHOC’s emergency department.  

This time, doctors determined that Vinny needed to be admitted to CHOC Children’s Hospital for further evaluation and treatment. As part of this process, he was tested a third time for COVID, an experience that again went smoothly, thanks to the child life specialists of the Cherese Mari Laulhere Child Life Department. 

Vinny stayed at CHOC for a week for stronger antibiotics, monitoring and supplemental oxygen. Throughout his stay, he was under the care of a multidisciplinary team of pediatric experts. This included Dr. Antonio Arrieta, medical director of infectious diseases, who was determined to help Vinny feel better. This level of care helped Vinny’s mom feel better, too. 

Dr. Antonio Arrieta
Dr. Antonio Arrieta, medical director of infectious disease at CHOC Children’s

Dr. Arrieta was truly one of the most intelligent human beings I’ve ever had a conversation with, and we felt extremely comfortable in his care and that of his whole team,” Nikki says. 

Being in a hospital for the first time was not easy for Vinny. He’s a naturally active child, but due to his compromised lungs and playrooms being temporarily closed due to the pandemic, he was unable to play in areas outside of his room. Luckily, Child Life had just the thing for him. A specialist showed up to his room with a box full of plastic bowling pins and a ball. Vinny was thrilled, and so was his mom 

“Every single nurse, respiratory therapist, child life specialist and doctor we met was just amazing,” Nikki says. “The only thing you truly want in a situation like this as a parent is for your child to be healing and comfortable, and they all worked to make that happen daily.” 

Vinny’s treatment plan was successfulAfter his fever subsided and his symptoms improved greatly, he was able to go back home. 

“Bringing my child to the hospital for the first time was scary at first, especially during a pandemic,” Nikki says. “I will always remember the kindness and world-class expertise that helped my son feel better and get back to being a kid. Vinny will never forget how a doctor turned into a magician right before his eyes. 

Learn more about emergency services at CHOC Children's

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A gain against pain

A child, resting in bed, fires up her 7-inch tablet and opens an app.

She selects from a variety of cartoon avatars — such as a panda or penguin — and backgrounds that include a colorful ocean floor with fish and other sea creatures.

Game on.

But this isn’t a typical game. It’s a kid-friendly tool that allows the child, who is being treated for cancer, to report the severity and type of pain she’s experiencing from her home — information her doctor can access in real time.

The app, named Pain Buddy, may aid in the reduction of pain severity in children during cancer treatment, according to results of a pilot study recently published in the online journal Pediatric Blood & Cancer.

The study found that Pain Buddy may be especially beneficial in helping children who have high levels of pain.

Pain Buddy is the brainchild of Michelle A. Fortier, a CHOC Children’s pediatric psychologist who is also a faculty member of the UC Irvine Sue & Bill Gross School of Nursing.

A screenshot of the Pain Buddy app
Pain Buddy app

Fortier, who specializes in pain management in children, was principal investigator of the recently published pilot study that was based on clinical studies of CHOC patients monitored by pediatric oncologist Dr. Lilibeth Torno and pediatric oncology nurse practitioner Christine Yun.

“Pain management is an important part of cancer survivorship, and I think Pain Buddy’s potential for use is very broad,” Dr. Torno says.

Most of the 48 children participating in the eight-week study had been diagnosed with leukemia. All were between the ages of 8 and 18. Results of this particular study come amid ongoing studies on the Pain Buddy app at other sites. Results of the comprehensive research effort, which will track 206 children, are expected in three years, Fortier says.

Pain Buddy, Fortier explains, was developed a few years ago to address a gap in pain management of kids at home compared to kids in the hospital, where it’s easier for doctors and nurses to stay on top of patients’ needs. The 48 children who participated in the pilot study spent a lot of time at home.

Tapping the expertise of professional app developers and researchers at UCI in the California Institute for Telecommunication and Information Technology (Calit2), Fortier and several other colleagues came up with a way for children to rate their pain as they were feeling it from home.

“Most kids experience pretty moderate to severe pain throughout their cancer treatment, and this pain just wasn’t sufficiently being addressed when the patients were at home,” Fortier says. “And when we think about pain assessment, we’re really terrible retrospective reporters of our pain experience.”

But with Pain Buddy, users can say how much they’re hurting, and where, as it’s happening.

“Pain can come from the cancer itself, such as a solid tumor, and it can come from treatment procedures,” Fortier says. “For example, lots of skin-breaking procedures occur during cancer treatment. And treatments like chemotherapy can cause nerve pain, inflammation of the gastrointestinal tract and mouth sores.”

In addition to completing a pain and symptom diary twice daily, the app automatically alerted the participants’ medical teams about such symptoms as nausea, itching, sadness and redness.

With a touch of a finger, the patients could select word bubbles to indicate descriptions — such as bad, annoying or terrible — to describe their pain.

A screenshot of the Pain Buddy app
The Pain Buddy app allows users to describe their pain with word bubbles, and can alert the care team.

Clinicians, in turn, could promptly address any symptoms that warranted intervention.

A key component of the Pain Buddy app, which for now only has been used by the pilot study participants, is the incorporation of coping skills shown to be effective in the management of pain, such as deep breathing, progressive muscle relaxation and guided imagery.

During these skills training exercises, patients could accumulate coins and, visiting a virtual store, customize their personal avatar and buy additional background themes.

A screenshot of the Pain Buddy app
The Pain Buddy app can help patients learn coping skills.

Pain Buddy represents an effective partnership between parents, young cancer patients and the health care institutions that treat them, Dr. Torno says.

“Our focus on cancer survivorship begins on the day of diagnosis,” Torno says.

CHOC’s After Cancer Treatment Survivorship (ACTS) program features a multidisciplinary team of clinical experts who monitor the late effects of cancer and develop a plan for long-term surveillance to ensure the best possible outcomes. Every child at CHOC who has gone through cancer therapy eventually lands in the ACTS program.

Fortier said the ultimate goal is to further refine Pain Buddy and license the app to hospitals for widespread use.

“The goal is to have every kid undergoing cancer treatment — from sarcoma patients to those with bone and other cancers — to have the ability to use Pain Buddy.”

Learn more about the Hyundai Cancer Institute at CHOC Children's

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Activity ideas for kids during COVID-19

During the COVID-19 pandemic, many children are spending more time at home than usual. Here’s a roundup of what parents and caregivers can do to keep kids occupied during this time.

Online learning

    • The Orange County Department of Education has created a roundup of free resources to help students supplement other materials that are being provided by their teachers.
      • OCDE also has a complete list of school districts providing grab-and-go meals at campuses across Orange County. See the full list here.
    • Many educational companies are offering free subscriptions in light of school closures. Here’s a guide.
    • Scholastic offers day-by-day projects to keep kids reading, thinking and growing.
    • PBS SoCal | KCET, in partnership with the Los Angeles Unified School District and in collaboration with California PBS stations, are offering broadcast programming and accompanying digital resources that adhere to California’s state curriculum. Learn more here.
    • Budding scientists can access Nova Labs at PBS, for video, animation and games on scientific topics like predicting solar storms and constructing renewable energy systems.
    • NASA’s Teachable Moments, offers a range of activities and lessons for grades K-12.
    • NASA’s Kennedy Space Center Visitor Complex has educational and fun Facebook videos where kids can learn from astronauts and other educators. For activities, instructions are available as free downloads.
    • Make any room a classroom with BrainPop, where curious learners can take units in science, social studies, math, engineering and tech, and more
    • Tynker is offering free premium coding courses during school closures.
    • Khan Academy offers free daily schedules for kids and teens ages 4-18 to keep stability and routine during this time. The online learning non-profit also offers a free downloadable app called Khan Academy Kids,that contains thousands of activities and books for children ages 2-7.
    • FunBrain.com offers hundreds of free games, books comics and videos for Pre-K through eighth grade.
    • National Geographic Kids offers free online quizzes on topics ranging from animals to planets to sports and food.
    • Cool Math 4 Kids offers games and lessons to make math fun for kids.
    • Math Game Time offers a variety of games, videos and worksheets for Pre-K through seventh grade.
    • Inspired by Dr. Seuss, Seussville has activities, crafts, printables and recipes to engage your child in playful learning.
    • Online  games that include K-12 curriculum.
    • Skillshare is offering two-month free trials for online classes that include animation, creative writing, web design and more.
    • Amazon is offering free computer science courses online for various grade levels.

YouTube channels

  • Camp YouTube — a digital learning experience to help parents recreate the fun of summer camp at home.  Summer camp themes include arts, adventure, sports, STEM and more
  • Crash Course Kids — bi-weekly shows on grade school science, including Earth, habitats, space and more.
  • Science Channel – learn about outer space, new technology and more.
  • SciShow Kids – the hosts explain fun, complex science concepts; do experiments and interview experts.
  • National Geographic Kids – videos feature animals, science, pets and more.
  • Free School – exposure to famous art, classical music, children’s literature and natural science in an age-appropriate and kid-accessible way.
  • GEOgraphy Focus – explore geography, maps, flags, culture, languages and travel.
  • TheBrainScoop – explore the work and research of natural history museums.
  • Kids Learning Tube – educate kids through music and animation.
  • Geek Gurl Diaries – videos on programming, computer science, logic, electronics and more.
  • Mike Likes Science – science-inspired music videos.
  • Science Max – large-scale science experiments.
  • SoulPancake – in addition to the well-known Kid President shows, this channels offers content that explores and celebrates the ways humans seek connection.
  • Course Hero – study guides and videos for various subject matters.

Story time

  • Here’s a list of podcasts — featuring stories, meditation, music and more — for ages 2 through 6.
  • Celebrities are taking to social media to read children’s books to little ones staying home during this time. The Los Angeles Times curated this roundup of these posts.
  • Audible, which has the world’s largest collection of audio books, is offering free stories — in six different languages —  for kids as long as schools are closed. Start listening here.
  • Here’s a list of authors doing read-alouds of their famous books, as well as books by their favorite authors.
  • Storyline Online, the SAG-AFTRA Foundation’s award-winning children’s literacy website, streams videos of celebrities reading aloud children’s books alongside creatively produced illustrations.

Music class

  • Carnegie Hall’s Music Explorer program offers a way to learn new musical genres and cultural traditions. Courses conclude in an interactive concert experience.
  • Chrome Music Lab lets kids learn music through a hands-on website.

Learn a new language

  • Learn a new language with Duolingo.
  • English52 allows users to strengthen English skills through video lessons and activities.
  • Fabulingua is an interactive app that teaches Spanish.

Virtual field trips

  • Google Arts & Culture has partnered with thousands of museums around the world to offer virtual tours from the comfort of your home. Here’s the complete list.
  • The San Diego Zoo offers 10 different webcams so animal lovers can keep up with a variety of their favorite creatures.
  • The Monterey Bay Aquarium also offers 10 different webcams for families to experience underwater life from anywhere.

Cook with your kids

  • CHOC nutrition experts have curated some of their favorite recipes and offer tips for how to get kids involved in the kitchen. “Children as young as 2 years old can help out in the kitchen. You can have your child wash fruits and vegetables or stir ingredients,” Shonda Brown, CHOC clinical dietitian, says. “Children are more open to trying new foods if they have opportunities to explore and learn about the food before they eat it.”

Opt outside

Kids can still benefit from nature while practicing proper social distancing. Even babies and toddlers can join a family nature walk. if you’re in a public space, keep them in a carrier or a stroller. If you’re in your backyard, they can explore more freely.

Children who spend more time outdoors have improved motor development and lower obesity rates. Playing outside promotes more curiosity, creativity, and critical thinking — especially essential with schools closed and extra-curricular activities canceled.

  • On a nature walk, collect twigs, leaves or rocks. Then, build a nature sculpture by sticking these items in play dough. Help your child notice the patterns created by different items.
  • Go on a family bike ride, while keeping a safe distance from others.
  • Nature scavenger hunts can be fun for the whole family. How many different kinds of plants, flowers, animals or birds can you see?
  • Playing soccer or catch is fine, but don’t share equipment with people outside your household.

Highlights@Home

The beloved classic kids’ magazine, Highlights, is posting frequent roundups of stories, puzzles, craft ideas and more to help children cope with being cooped up and help parents make the most of this time with their kids. Each installment has a different theme:

  • Celebrate reading — Reading can transport us somewhere else for a while, even when we’re stuck at home.
  • Pajama day — Showing your children affection with a hug, snuggling on the couch to watch a movie, or reading together in a cozy blanket tent are all ways you can be fully present with your child.
  • A never-ending pile of fun — Sequestering at home may actually provide you with the time to teach kids tasks like matching socks, folding clothes, and putting away clean laundry. Kids usually like to help, and when we make the chores fun, they’re often eager to pitch in.
  • We are (all) family — Whatever your family configuration, this week’s issue has ideas for strengthening your family bond.
  • Staying connected — Children are likely feeling the loss of connection with friends and extended family. This guide is full of ways you can help your kids feel more connected to people they love but can’t safely see right now.
  • Just keep dancing — What raises our spirits more or gives us a burst of energy like music and dance? These activities will help  your kids move their bodies, use their creativity, and improve their mood.
  • Shoot for the stars — Young or old, we’re all fascinated by space. What’s known is often mind-boggling, and what’s unknown leaves so much to the imagination.
  • Thank you teachers — Thanking teachers is not only a nice thing to do, but showing appreciation is a simple but important practice of gratitude.
  • Hooray for helpers — National Nurses Week presents an opportunity to expand your kids’ understanding of what it means to be heroic.
  • Let’s talk family — Someday, this quarantine will be a memory, and we hope your children will remember some of the family fun you’ve been enabling, and also the ways you are helping them focus on the things that really matter.
  • Cleaning up — A bundle of resources for making cleanup fun.
  • Celebrate the sun — Puzzles, stories, and activities related to growing gardens, having picnics, and taking nature hikes will remind your kids of some of the fun to be had in the sun. Sunny days together provide an opportunity to talk to your kids about optimism.
  • Alone together — Games, played alone or together, are great for practicing reading, math, and strategic thinking. They also help build memory, focus and interpersonal skills.
  • Soar into summer — Activity ideas to help imaginations take flight.
  • We’re going on a scavenger hunt — Encourage children to sharpen their powers of discovery and plan their own hunt.
  • Be nice, be kind, be you — Reinforce the messages of being sensitive to others’ feelings and that kindness is never wasted.
  • Blaze a trail — Ideas on connecting with nature, sparking creativity and thinking of others.
  • Be the best BFF — Cultivating friendships helps foster kids’ social-emotional development. The qualities we seek in friends—kindness, positivity and shared interests—are found in friends who  may look like us, or in those who may look different.
  • Celebrate your superpower — This bundle will help your children see themselves as having the ideas and abilities —superpowers, if you will — to do good in the world.
  • Pack a picnic — Menu and game ideas that will let kids show off their creativity.
  • Camp out or camp in — Ideas for making a backyard or living room campground memorable.
  • Welcome to summer — Activity and bonding ideas to promote relaxation, enjoyment and memory making.

Programming to help explain COVID-19 to kids

  • This CNN/Sesame Street town hall offers reminders on how children can help protect themselves against COVID-19.
  • PBS KIDS aired a special episode of Daniel Tiger’s Neighborhood that addressed challenges and disappointments children and their families may be facing during the COVID-19 pandemic. Learn more here.

Other activities

This article was last updated on September 14, 2020.

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CHOC rare disease expert stresses importance of newborn screening

From just a tiny sample of blood, a lab can test for 35 rare diseases in newborns that if left undetected could lead to seizures, developmental delays, permanent brain damage or death.

September is Newborn Screening Awareness Month and Dr. Jose Abdenur, director of CHOC’s metabolic laboratory, stresses the importance of these newborn screenings in order to prevent such grim scenarios from playing out.

Newborn screening is a public health program that screens all babies for many serious but treatable genetic disorders, and CHOC Children’s metabolic laboratory is one of the state’s largest referral centers for the program. All babies born in California are required to get screened soon after birth, but the diseases babies are screened for varies by state. In Orange County alone, some 38,000 babies are born every year.

CHOC is the only location on the West Coast for children who need cutting-edge treatment for certain metabolic disorders that can be detected from newborn screenings. Further, CHOC’s metabolics program is a leading destination for children from around the world afflicted with certain metabolic disorders, which are rare genetic disorders that result from a missing or defective enzyme in the body. These include disorders such as galactosemia, which impairs the body’s ability to process and produce energy from the sugar galactose, and adrenoleukodystrophy, which causes the buildup of very long-chain fatty acids in the brain.

“There are many, many very good success stories at CHOC, but there are still many things we can improve,” Abdenur says, citing too many false positives for some conditions that make families feel anxious and worried. “But we continue to get better at this.”

Newborn screening began in the 1980s. Over the decades, the Department of Health and Human Services has added recommended disorders for states to screen for in their newborn screening (NBS) programs. There now are 35 core conditions on the so-called Recommended Universal NBS Panel, as well as an additional 26 secondary conditions.

In addition to metabolic disorders, newborn screening can detect disorders related to hematology and immunology — such as sickle cell disease — as well as endocrine disorders, pulmonary diseases including cystic fibrosis, and such neurological conditions as spinal muscular atrophy.

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The link between COVID-19 and suicide: What parents should know

By Dr. Meredith Dennis, post-doctoral fellow at CHOC Children’s; and Alva Alvarez and Christopher Reeves, mental health social workers

It is an understatement to say that living through the COVID-19 has been tough. For kids and teens already struggling with mental health issues like depression, their symptoms may have worsened with the added stress of COVID-19. No parent wants to imagine that their child would think about ending their life or hurting themselves in any way, but the reality is that kids and teens are not immune to severe symptoms of depression like suicidal thoughts. Unfortunately, we have seen a negative impact of everything that comes with the COVID-19 pandemic on child and teen mental health, including increased suicidal thoughts. This can raise many questions and concerns for parents. Why is this happening? What can I do about it? How can I make sure my child is safe?

A good place to start as a parent is to be aware of the risk factors for suicide. Among others, here are things that could increase risk for thoughts of suicide:

  • Feeling like a burden. If your child believes they are a burden to people in their life, this increases risk for suicide. Keep in mind that it doesn’t matter whether or not this is actually true. It’s about what your child may mistakenly believe.
  • Being disconnected or isolated from others. No matter how much support you try and give, your child may feel lonely or think no one cares about them. This may be especially true if your child feels they do not have any friends.
  • Repeated engagement in self-harm behaviors or suicide The more your child harms themselves or makes attempts at dying, the “better” they get at it. They are also better able to tolerate pain — studies show they experience less pain with more self-harm —, and become less scared of dying.
  • If your child believes that things will stay this way and not get better, there is greater risk. Again, this is not about what is actually happening, but what your child believes to be true.

The COVID contribution

Our lives are nearly unrecognizable these days amid the COVID-19 pandemic. So many elements have changed as we work together to follow various safety guidelines. From the way we go to school and work to the way we interact with our social groups, this new way of life has vastly transformed our routines. Furthermore, these changes occurred suddenly and without warning. It is no wonder that we are seeing increases in symptoms of depression and anxiety, as well as in suicidal and self-harming behaviors. Here are some specific ways COVID-19 may be affecting mental health:

  • Sudden disconnect from peers and support groups outside of the home may increase feelings of isolation while also deterring one’s motivation to seek support, knowing they are unable to interact face to face.
  • Most opportunities we used to enjoy for fun and relaxation have been closed, canceled or restricted. There are limited replacement options. Daily life is now filled with more stress and less fun, making it harder to ignore feelings of loneliness, sadness, worry and hopelessness.
  • Separation from stressful situations within the home may not be possible due to safety precautions. While confined to your home, your child may begin to focus more on their current stressors with little or no distraction from them.
  • A major challenge many families face in these times is financial insecurity or loss of income. Though young, kids and teens are often acutely aware of their parents’ stress. Knowing that parents are worried about finances can increase a youth’s perception of being a burden, and thus increase risk for suicide.
  • Increased exposure to social media and news coverage could lead to increased thoughts and risk of suicide for your teen. Since youth’s activities are severely restricted now, many are spending more time on their screens. This means increased exposure to “doom and gloom” news coverage as well as increased exposure to negative online peer interactions. These things increase hopelessness that the pandemic will ever be resolved and decrease the sense of social connectedness. Increasing suicidal thoughts and behaviors means kids and teens are more frequently exposed to this content online. We know this is a dangerous risk factor for youth suicide.
  • Decreased physical activity along with an increase in screen time may diminish one’s ability to focus throughout the day and negatively affect sleep. Poor sleep and diminished concentration may lead to impaired judgment. This is a recipe for misinterpreting the environment — for example, believing no one cares about them, or feeling like they are a burden.

Accidental adult errors

More often than not, caregivers are doing a great job of reaching out for support and guidance when it comes to a child’s mental health. There are times, however, when adults inadvertently engage in verbal and non-verbal behaviors that can increase or exacerbate risk factors for suicide in children. While these behaviors can be perceived as harmless by adults, to a young person who is already struggling with suicidal thoughts, they can make the difference between ideation and intent. Examples of these behaviors can include:

  • Avoiding conversations about the current state of events, including COVID-19, may accidentally increase distress in youth. This may include avoiding discussing your own thoughts and feelings regarding the impact of COVID-19. Attempting to protect children from the current state of life creates the impression that COVID-19 is too scary to talk about, potentially increasing anxiety or hopelessness about the situation.
  • However, oversharing information — such as financial burdens, parental stress, workload and constant news updates — can also increase suicidal ideation in adolescents by creating what feels like a flood of negative messages that they feel they can’t escape from.
  • Adults sometimes try to help youth feel better by telling them they are overreacting, that things aren’t that bad, or by saying things could be worse. This accidentally increases the intensity of those emotions, leading to escalations of experiences like depression, anxiety and self-harming behaviors.
  • Expecting children and teens to continue functioning at the same pre-COVID-19 levels can place unrealistic pressure on them. Many adults continue to struggle with symptoms of grief related to COVID-19 losses that may be financial, emotional or social.As a result, adults have had to make adjustments to their own expectations for “normal” functioning. Youth also need to know that they are allowed to make adjustments and that not everything needs to be perfect.

Action steps to support children and teens suffering during COVID-19

There are things you can do as a parent, guardian or caregiver to help children and teens who are suffering during this time. Kids are resilient, meaning they have the ability to “bounce back” when difficult things happen. There are also several protective factors to be aware of that are helpful in lowering the chance your child will experience more serious risk. Here are a few ways you can help:

  • Stay connected. With social distancing guidelines in place, it may be difficult to find safe and appropriate ways to keep your child socially engaged that meet your needs. Set up virtual hang-outs with friends, or meet at an outdoor space like a park where social distancing can be maintained if everyone agrees to wear a face covering.
  • Stick to a routine. Maintaining predictability in the day can help your child build structure and have a sense of security. Daily routines also help increase engagement in activities, which can increase feelings of accomplishment and self-confidence, directly reducing things like hopelessness and feeling like a burden.
  • Have a conversation. Setting aside time to talk to your child about how they are feeling is important. Give them a safe space to share their thoughts and feelings. Show them you are there to help by validating them and being supportive. Let them know it’s OK to feel the way they feel and that you will get through it together.
  • Find time for self-care. Keep your child engaged in things they like that are fun and/or relaxing. It works best if you do this with them! Do fun things or a favorite activity, do things you are good at, learn a new skill, and keep them involved in extracurricular activities like sports or clubs if possible.
  • Take care of basic physical needs. A healthy body helps us be as prepared for the daily stresses as possible. Get enough sleep, move your body and eat balanced foods.
  • Limit screen time. Even though our lives revolve almost exclusively around screens, make time to disconnect and seek social connection, fun, relaxation and joy using “old school” ways.
  • Self soothe. We could all use some extra comforting these days. Teach your children to use their physical senses to comfort themselves by listening to relaxing music, finding a soft comfort object such as a blanket or T-shirt, or using a favorite scented candle or lotion.
  • Seek mental health support when needed. If your child seems to be having a pretty hard time and does not already have mental health services like therapy or counseling in place, this would be a great time to start. Medication may also be an option. Talk to your doctor, insurance, or school about where to get connected.
  • Get immediate help if needed. If your child continues to express thoughts about harming themselves or dying, go to the nearest emergency room or call 911.
  • Help your child identify reasons to live. What is important to your child? What are their values and goals? Helping them get connected to these things can be a very powerful way to recognize that they have things in their lives that are important and matter – and that this situation is not going to last forever.
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