How parents can help kids navigate holiday disappointment during COVID-19

By Dr. Mery Taylor, pediatric psychologist at CHOC

mindfulness
Dr. Mery Taylor, pediatric psychologist at CHOC

By this point in the COVID-19 pandemic, many children have experienced disappointment about missing out on birthday parties, family vacations or special occasions they had been looking forward to. If your child or teen feels disappointed right now over missed holiday celebrations, let her express her feelings, and validate them. Share your own disappointments and how you are managing your feelings.

As a parent, it is difficult to see your child experience disappointment. As adults, we have the perspective of knowing that there will be other holiday seasons in their future. During this time, children will be most comforted by parents’ words of reassurance that you will get through these challenging times together, and that life will return to normal eventually.

Remind children why things have changed

It can be helpful to remind them about why things are different right now. Remind your child that as a community, we are all doing our part to curb the spread of COVID-19

Discuss changes in plans earlier vs. later

For most young children, it will be helpful to start to discuss changes in plans earlier than later. Start slow and return to the topic several times, each time adding a little more detail. Ask for your children’s input on how they would like to spend the holidays given the stay-at-home order and how they might celebrate with loved ones who they cannot see in person. For example, they can help you bake your favorite holiday recipe to drop off on someone’s doorstep or create a special holiday craft to mail to a loved one who lives far away.

Limit children’s exposure to the news

At this point, all but very young children are clear that something has drastically changed in their world. While it is important to keep very young children away from the daily news which can include death tolls and speculations, parents should be honest about what we are trying to accomplish by social distancing. Here’s an explanation of social distancing. It could be helpful to ask them what they already know, debunk misinformation, and provide additional information for better understanding and clarification.

Let them use their imagination

Have fun thinking about what makeup holiday celebrations and other gatherings with family and friends would look like. Let them use their imaginations on what decorations they would have, food they would eat and people they most want to see.

Celebrate special events in a creative way:

  • Use technology such as FaceTime, Zoom or Skype to enjoy a holiday meal with loved ones who don’t live in your household. Consider sharing recipes between family members and friends ahead of time and cooking your meals together over video chat.
  • Host a virtual party — decorate a backdrop, make a music playlist and create a themed game.
  • Join friends for a virtual cookie or gingerbread house decorating party.
  • Have a virtual, interactive watch party for your favorite holiday movie using Netflix Party or Disney +’s GroupWatch. These services allow you to synchronize your show or movie with friends and family, and chat while you’re watching.
  • If your traditional outings during the holiday season aren’t an option due to COVID-19, consider planning a virtual field trip and inviting families from other households. Many museums and other attractions are offering free virtual visits during this time.
  • Help your child prepare a special meal or dessert for the holiday or special day.
  • Go into nature for a scavenger hunt or take a drive through a holiday light display.
  • Organize a Zoom or Skype call with family and friends to sing your favorite holiday songs.

Building resiliency

Although this pandemic is not the situation that we would have chosen for our kids to face, experiencing adverse events, with their parent’s support, will help kids build resiliency. They will be able to look back on this time and reflect on how they were creative in finding ways to celebrate holidays and how they found new ways to entertain themselves at home, while persevering over new challenges.

Mental health tips during COVID-19

For many of us, the COVID-19 pandemic has created a fluid environment that has forced us to adapt to countless changes in many areas of our lives – school, work, activities and socialization, to name a few. In this roundup, mental health experts from CHOC offer their go-to mental health tips during COVID for family members of all ages.

Idea: Track your G-R-A-P-E-S

Submitted by: Dr. Francesca Bahn, pediatric psychologist

I like to use G-R-A-P-E-S tracking calendars to help with mood stability and management that doesn’t require intensive therapy. This stands for:

  • G Gentle to self
  • R Relaxation
  • A Accomplishment
  • P Pleasure
  • E Exercise
  • S Socialization

Kids can create a calendar or download one online that tracks days of the week on one axis and each “grape” along the other axis. They should place a sticker in each box when they engage in that activity for the day.

Idea: Look for ways to stay kind, created and connected during COVID-19

Submitted by: Dr. Adrianne Alpern, pediatric psychologist

Kids for Peace is a non-profit organization that works to create peace through service, global friendships and acts of kindness. I recommend their activities to many families who I work with, who have found them to be really helpful.  Some of my favorite activities include:

  • Make peace rocks — paint rocks with kind words and place them around town to delight your neighbors.
  • Harvest seeds from fruits and replant them.
  • Discover something new about a different culture or a different country.
  • Listen to music from different parts of the world.
  • Pick at least one country from each continent and discover their favorite food or dish.
  • Create an acts of kindness checklist and complete as many items as possible from home.
  • Create a family vision board to track your dreams and goals

Idea: Activities to help boost your mood

Submitted by: Paloma Bautista, licensed clinical social worker

  • Arts and crafts — Paint your favorite quote on a canvas and hang it in your bedroom or a common area. Or, gather old magazines and create a collage with short-term goals and positive quotes.
  • Journaling — Practice journaling by writing three to five positive things that happened today, and/or explore your personal strengths and add them in your journal.
  • Exercise — Go on a short 10-15 minute “mind-full’ walk with a loved one from your household. Incorporate your five senses. Identify five things you can see, four things you can feel, three things you can hear, two things you can smell and one thing you can taste
  • Movie — Watch your favorite or perhaps a new holiday movie with a loved one. Take turns after the movie talking about your favorite part.
  • Baking — Bake your favorite holiday treat or learn to bake a popular family dish.

Idea: A new way to ask and answer, “Are you OK?”

Submitted by: Liz Hawkins, CHOC volunteer and mental health advocate

One simple check-in I heard that really resonated with me was from managers at Dell beginning team meeting asking team members, “Are you above the line or below the line?” It gives you the opportunity not to delve too personally if you don’t want to with your co-workers but at the same time that shorthand gives people a snapshot that things may not be great today. I think this could also apply with teens and with others in your life that don’t always want to go into detail but for whom you want to know how they are really doing.

Idea: Window swap

Submitted by: Liz Hawkins, CHOC volunteer and mental health advocate

WindowSwap is a beautiful website that allows you to escape mentally to someone else’s view outside their window — all around the word — even if for just a few moments. When our travel is limited, this is a great way to escape our current reality and gaze upon someone else’s for a while.

Idea: Draw it out

Submitted by: Liz Hawkins, CHOC volunteer and mental health advocate

Drawing mundane household objects using prompts – like the ones in Believer magazine – forces us to look at these everyday objects in a different way. These activities are great for kids and adults alike.

Idea: Self-care comics

Submitted by: Liz Hawkins, CHOC volunteer and mental health advocate

Creating your own comic can be a way to track emotions, and visualize yourself in soothing situations. These prompts from Believer magazine are my favorite:

  • What am I grateful for today?
  • What is out of my control today?
  • What is in my control today?
  • What can I do for my body today?
  • How will I (safely) connect to other humans today?
  • Think of your safe, no-stress zone/place and draw it.

Idea: Make your own self-care kit

Submitted by: Liz Hawkins, CHOC volunteer and mental health advocate

Similar to the idea of a coping box, self-care kits might include physical items such as a white noise machine, puzzle or your favorite lotion, or intangible options like reminders to relax your muscles, get outdoors or reminders to take to-do lists one step at a time.

This is a good reminder that it’s OK for self-care to be “boring.” Social media can lead us to believe that self-care equates to luxurious bubble baths or nice meals, but to can really be as simple as setting aside time to read a book or magazine, taking a shower or changing your sheets.

Idea: Repeat mantras

Submitted by: Liz Hawkins, CHOC volunteer and mental health advocate

I repeat these sayings to myself often. These might help you, too – or maybe you’ll find your own phrases that resonate most with you:

  • Relate. Reason.
  • You’ve made it through 100% of your bad days.
  • Wake up intentionally. Work intentionally. Eat intentionally. And rest intentionally.

Idea: Coping cards

Submitted by: Liz Hawkins, CHOC volunteer and mental health advocate

Coping Skills for Kids has an online store that offers customizable workbooks and coping skills cue cards. Children can get cards to focus on distraction, calming, processing or physical activities.

Idea: Write it down; tear it up

Submitted by: Joni Rogers, mental health assistant, Cherese Mari Laulhere Mental Health Inpatient Center

If kids are struggling with a parent, friend or situation and they haven’t found the words or strength to talk to them, I have them write it down on a piece of paper and then tear it up when they are done. It’s double gratifying to be able to put your thoughts, feelings and emotions down but also be able to tear it up and help put the past behind you.

Idea: Plan fun moments

Submitted by: Michael Ketterer, interim nurse manager, Cherese Mari Laulhere Mental Health Inpatient Center

The biggest tip I can give coming from a father of six kids in the middle of this crazy pandemic is to plan fun moments into your week. Having something planned to look forward to that your children really enjoy can help them push through the times they don’t enjoy. My wife is so good at doing this; she basically plans fun moments into every day. It doesn’t have to be big – it can be a favorite desert, board game, movie, or going for a walk around the reservoir in our neighborhood. In warmer seasons we would plan a safe beach day or drive up to the mountains to play in the snow. We always have family movie night once a week.

Idea: Question Jenga

Submitted by: Dr. Sheila Modir, pediatric psychologist

Label Jenga pieces with fun and engaging questions, so when the child pulls on that block piece, they answer that question. Also label some pieces with “feeling” words like brave, sad or happy, and have them provide a time they have felt that way. You can give a prize for the most “labeled” pieces a person has so there can be two ways to win the game — whoever doesn’t knock all the pieces over, and whoever has the most labeled pieces — to reinforce getting a labeled piece.

Idea: Sunday family meetings

Submitted by: Dr. Sheila Modir, pediatric psychologist

Have family meetings every Sunday night to review the plan for the week ahead, anything coming up in the family agenda, check in with everyone, and end with a fun family board game. This helps get children ready for the week and can be a source of predictability amid a chaotic and unpredictable time.

This article was updated Dec. 10, 2020

How to help a child who feels COVID-19 burnout

By Dr. Diana Graham and Dr. Christopher Min, pediatric psychologists at CHOC

For many of us, the COVID-19 pandemic has created a “new normal” as efforts to curb the spread of the virus have changed what day-to-day life looks like. It can be difficult to balance maintaining our physical and mental health while also supporting one another.

Over the last several months, many parents and guardians have tried their best to think of creative ways to help children understand the dangers of COVID-19 while also trying to limit its interference with their children’s quality of life. Kids and teens alike are struggling with the challenge of increased isolation from friends, barriers to traditional academic instruction, and uncertainty about the current events of the world, all without their usual outlets of fun and stress relief. This may result in children becoming burnt out during the era of COVID-19.

As a parent you may notice signs of the following symptoms in your child who feels burnt out by the COVID-19 pandemic: increased irritability, changes in sleep and/or appetite, less motivation to engage in things that used to interest them, withdrawal from others at home and/or increases in levels of reassurance they need due to uncertainty of current events.

Here are some things you can do to help your child if they are struggling with their mental health during COVID-19.

Help them engage in a consistent routine

Having structure and routine most days can help reduce your child’s reliance on screens, their anxiety related to COVID-19 uncertainty and changes, and increase their feeling of purpose during a time that typical go-to activities may be restricted.

  • Start with thinking about what a typical day looks like for your child. Do they have online schooling or a hybrid of in-person and online schooling? What types of chores do they need to get done? Do you want them to get some physical activity each day?
  • Next, decide whether it would be most helpful to schedule by the hour or in chunks of time (e.g., 9 a.m.-noon) in their routine. Be careful to not overschedule (e.g., every 30 minutes), as this may be too difficult for both you and your child to follow long-term.
  • Scheduling in sleep and meal routines can help your child remain on a schedule similar to the one they follow during a typical school year. Having consistent sleep, wake and meal schedules can also help your child regulate their mood and manage stressful situations.
  • Make these schedules visual for your child to see and follow. Put the schedule in a place that your child will most likely see, such as on the bathroom mirror, making it more likely to become their norm.

Schedule flexibility into your routine

While it is important to have consistency, it is also very important to be flexible with routines because, as we all know, life can get in the way! Having this flexibility allows your child to have an element of control during a very uncertain time, which can often help with managing anxiety. Here are some small ways to build flexibility into your child’s schedule:

  • First, choose a couple of activities in your child’s schedule that allows for several choices to pick from. They can choose what food they want for lunch, or pick what to play during game time. Here’s a roundup of activity ideas for kids during COVID-19.
  • Make lists of a three to four different choices available throughout the day for the activities on your schedule. For example, your child may have lunch at the same time every day but can have a list of different food options to choose from.

Keep your child moving

We are staying at home now more than ever, making it difficult to stay active and get “brain breaks.” However, we know that being more active can have a positive impact on our mood, ability to manage stress, and ability to focus. Here are some tips to include physical activity into your child’s daily schedule:

  • Schedule in time for a physical activity to ensure that your child’s brain is getting the break it needs, especially from screens. Research has shown that recess at school can help children to stay on task and increase sustained attention.
  • Keep a varied list of COVID-19-friendly physical activities that your child can choose from to help decrease sedentary behavior. Examples may include jumping jacks, YouTube yoga, a household dance party, and even taking a walk around the block while listening to music. Remember to practice physical distancing if exercising outdoors.
  • Although physical activity is beneficial throughout the entire day, studies show that exercise between 4 p.m. and 6 p.m. can help a child’s ability to fall asleep and stay asleep. If your child is having sleep difficulties, time your child’s exercise activities to help promote more restful sleep.
  • It can be challenging to motivate your child to be active when they are feeling burnt out. If your child seems uninterested in engaging in a physical activity, try to schedule it at a time when another person in the household can participate so that it can feel more fun and socially engaging rather than punishing. Or, they can take an online yoga class with a friend. As this becomes a more regular part of your child’s routine, it will likely become easier. For school-aged children and teenagers, it can also be helpful to collaborate with them on the list of choices for physical activity to increase their engagement when it becomes time to be active.

Normalize not always being OK

Kids learn from those around them. Let your child know that it’s OK to feel uneasy about how things are right now.

  • You can do this by modeling good coping skills when you make a mistake or don’t have the answer to something and recognizing the uncomfortable emotions that might come along with this experience.
  • Sometimes labeling emotions is enough to help validate your child’s experiences. By showing and discussing all the different emotions you may be experiencing during a difficult situation, it will help normalize this type of emotional processing for your child too.
  • Create opportunities with your child to discuss how challenging COVID-19 is for so many people, the different ways these challenges may show up in our daily lives, and to brainstorm ideas on how to cope. This can build a pattern of communication in which your child notices warning signs of burn out sooner and can let you know when they need help.

Learn how to cope together

Engaging in family activities together can be a good way to decrease the likelihood of experiencing feelings of social isolation and give you and your child shared goals. By learning these coping skills together, it models for your child that it is OK if we do not feel happy all the time and there are ways that we can help manage challenging feelings.

  • Consider regular family game nights where each person gets a turn choosing the game. Other examples may include an at-home scavenger hunt or a puzzle that the family takes time to work on each day. This provides both consistency and flexibility, in addition to social interaction.
  • One fun idea can be to set family challenges each week. You may have a week where each day involves practicing a different coping skill (e.g., deep breathing, guided imagery, stretching or journaling) or a week where each person shares something that they are grateful for. Whoever can complete the most challenges during the week gets a reward, such as choosing Saturday night dinner or the next movie for family movie night. If there is a tie, then you can always split up portions of the fun night that each person gets to choose, such as one person choosing the movie and another choosing the meal.

When is this all not enough?

Let’s face it, we don’t always have all the resources to implement every strategy whenever we need it. Or, you may encounter situations where you try every recommendation and still notice concerning changes in your child. Either way, it is OK to ask for help.

  • Be aware that you are only one person and many of us are forced to function without our typical support networks such as extended family and childcare centers because of COVID-19 restrictions. Consider some other avenues of support that may be helpful for you and your child to decrease burn out and help manage coping during the pandemic.
  • Reach out to your child’s teacher or school counselor for support. Are they able to check in with your child more often? Have they noticed any changes in your child’s school engagement beyond what they think is typical right now? They may be able to provide more frequent or regular support.
  • If you become concerned about your child’s mental health, contact your primary care physician. You can also call your insurance company for a list of in-network mental health professionals or do a search online for local mental health providers.

Here are additional mental health resources for your child during COVID-19

Help Lines

  • Substance Abuse and Mental Health Services (SAMHSA) Disaster Distress Helpline
    • Toll-Free: 1-800-985-5990 (English and Español)
    • SMS: Text TalkWithUs to 66746
    • SMS (español): Text “Hablanos” al 66746
    • TTY: 1-800-846-8517
    • Website — English| Website — Español
  • National Suicide Prevention Lifeline: 1-800-273-8255
  • Crisis Text Line: Text HOME to 741-741
  • Orange County Crisis Assessment Team:

Apps

  • MindShift: a cognitive behavior therapy-based app from Anxiety Canada that helps kids to learn about and track anxiety, as well as coach them through coping skills
  • Headspace: A mindfulness app for everyday life
  • Smiling Mind: An app that guides helpful coping skills based on age

How to help kids cope with social isolation during the COVID-19 pandemic

By Dr. Hannah Greenbaum, neuropsychology postdoctoral fellow at CHOC and Dr. Melanie Fox, pediatric psychologist at CHOC

As we have taken important steps to practice physical distancing throughout the COVID-19 pandemic, virtually all children and teens have had much less interaction with their peers than they typically would.

Peer support is a very important part of childhood and adolescence, as friendships provide support, mitigate feelings of loneliness and boredom, help build a sense of belonging, and encourage identity development. As caregivers, it is important that we promote resilience and help children cope with not being around their peers during this time. For any caregivers who are struggling with how to help children cope with social isolation, there are many things you can do to help:

Encourage creative ways to connect with others

Help your child come up with creative methods of spending time with their friends. The safest way for your child to talk or play with people outside their household during this time is through video chats or phone calls. One way is to encourage a weekly video chat with a friend or family member. Older children and teens may prefer texting or playing online games with friends. This might require temporarily loosening rules about daily screen time. Children might also enjoy writing letters to their friends. Here’s a few more ideas:

  • Schedule “social time” each day, so your child can look forward to it.
  • Scavenger hunt walk in the neighborhood
  • Create arts and crafts together with friends. Choose a project and supplies in advance and make the same craft as friends over video chat.
  • Video chat with other family members and friends.
  • Set up calls or video chats to allow your child to spend time with extended family and other people important to him or her. You might ask a relative to read a story to your child over the phone or on a video chat. Or, invite family members or friends to a video chat party.

Seek daily purpose

Kids and teenagers often thrive on daily purpose. Spending time doing activities they care about or value can give your child’s day meaning and help them cope with social isolation. Your child might find meaning through reading, biking, creating music, making movies, baking, dressing up, drawing, writing, planting a garden or building something.

Encourage your child’s unique creativity. To motivate them, consider organizing a family reward board, where for example, by doing something like riding their bike they can earn a sticker working toward movie night.

Older kids might enjoy researching a topic that they’re passionate about and sharing what they’ve learned with friends.

Children and teens often feel rewarded when they help others. Consider encouraging them to find ways to connect with their larger community, like making crafts for the local senior facility, picking up litter around the neighborhood, doing yard work for a neighbor, or finding a safe way to volunteer.

Talk about feelings

Your child might feel sad about missing an important social event, such as a birthday party. Acknowledge your child’s loss, ask about his or her feelings, and validate them by showing that you understand. Allow your child to lead the discussion, rather than making assumptions about how he or she thinks and feels.

You also might consider giving your child an age-appropriate book that deals with loneliness. This can give your child words to describe his or her feelings. Or, have your child write down what they miss about certain people, places or events as a way to cope. Also, explore different ways he or she might cope with these kinds of losses, such as having a different kind of birthday celebration or planning something for when social distancing is no longer needed. Here’s more tips for talking to kids about disappointment and celebrating special events in a creative way.

Your wise mind vs. your emotion mind

Your wise mind can take in new information, be flexible considering alternatives, and be creative in thinking of solutions. Your emotion mind will urge you to give up, act impulsively or rage. Wait for your wise mind to lead, and make decisions and problem solve with your wise mind.

We cannot control the pandemic, but we can control what we do with it. Your child cannot control the current need for social distancing, but they can control how they choose to deal with the circumstances.

By encouraging your child to connect with others, share his or her feelings, and find daily purpose, you’ll help him or her cope with inevitable challenges associated with this pandemic. Working through this challenge also might contribute to your child’s personal growth and better prepare him or her to deal with future obstacles.

We know children and teenagers will continue to struggle being separated from friends as the pandemic continues. Given the importance of peer support, try to acknowledge the loss your children are experiencing, and work in your wise mind to problem-solve and find ways to continue to find peer support. After all, as the Beatles so eloquently stated, “I get by with a little help from my friends.”

20+ tips for maintaining and strengthening a family bond during a hospitalization

We understand how important it is to visit loved ones during a hospitalization, especially a child’s. However, for the safety of our patients, families, physicians and staff, CHOC strictly enforces limited visitation on our campus during times such as flu season and the COVID-19 pandemic.

Our pediatric psychologists and child life specialists have teamed up to offer families the following creative ways to stay connected throughout a hospitalization:

  1. Phone calls and video chats are often the easiest ways to stay in touch with a hospitalized loved one. If a patient does not have access to a smart device, the Cherese Mari Laulhere Child Life Department can make special arrangements.
  2. Explore new apps to stay in touch – does the child or teen in your life love using WhatsApp, Messenger, Google Hangouts, Snapchat or other apps? Download their favorite app as an easy way to stay in touch their preferred way.
  3. Send an e-card to a patient at CHOC Hospital.
  4. Use the voice recorder on your smartphone to sing your child’s favorite song, read them a short story, or tell them goodnight or good morning. The parent or guardian who is at the child’s bedside can play the messages on your behalf.
  5. Write to each other in a journal. The child can write a note or draw a picture, and then send the notebook home with the visiting caregiver. Any family members who are at home and unable to visit the hospital can write messages or draw photos in the notebook, and the visiting caregiver can bring it back to the hospital for the child to read.
  6. Assign clinical family liaisons to update non-visiting caregivers or other family members on the patient’s status or call them during rounding.
  7. Family members who cannot be at a patient’s bedside may be comforted by visualizing the space their loved one is in. CHOC has a library of experience videos that can help family members – whether preparing for a visit themselves or not – learn more about CHOC.
  8. Setting up a CaringBridge page can help families share updates and photos with loved ones near and far.
  9. Use Zoom’s whiteboard feature to draw pictures together, write a story or play Pictionary.
  10. Use an online game sharing app to play your favorite board game together online. If a child doesn’t have a laptop available during their hospital stay, their child life specialist can help secure one to borrow.
  11. Pick a craft – anything from painting to decorating a coaster – that all family members can do together via Zoom or video call.
  12. Create a family gratitude journal, where each family member picks three things that they are grateful for every day. Share them with each other via a notebook that is carried from home to the hospital by the visiting caregiver, or with a free journaling app.
  13. Do a scavenger hunt via video chat with different family members. You can each try to find certain items in your spaces that start with a specific letter.
  14. Create coping boxes that kids can use when they feel sad or worried. Some items to consider adding are bubbles, coloring pages, Play-Doh and fidget spinners.
  15. Play a virtual game of Simon Says.
  16. Have family story time through video chat. You can do this at bedtime so family members not at the child’s bedside can participate in their bedtime routine.
  17. Have a virtual, interactive watch party for your favorite TV show or movie using Netflix Party or Disney+’s GroupWatch. These services allow you to synchronize your show or movie with friends and family, and chat while you’re watching.
  18. Create and send a personalized Build-A-Bear with a special “get well soon” message.
  19. Create virtual rooms together using Google Slides. Add furniture, people and links to different activities or games. There are many helpful and free tutorials online for creating these rooms.
  20. Create video diaries to keep each other updated on what you’re doing throughout the day – it could be something exciting or mundane. Share with each other via social media or use a free app to string together your video snippets throughout the day. There are also free apps that will allow you to create a calendar showing a photo of something fun or unique you did each day.