Children and Young People

SOCIAL, EMOTIONAL, AND MENTAL HEALTH


Coronavirus disease (COVID-19) can affect children and young people directly and indirectly. Beyond getting sick, many young people’s social, emotional, and mental well-being has been impacted by the pandemic. Trauma faced at this developmental stage can continue to affect them across their lifespan.

 

Some of the challenges children and young people face during the COVID-19 pandemic relate to:

  • Changes in their routines (e.g., having to physically distance from family, friends, worship community)
  • Breaks in continuity of learning (e.g., virtual learning environments, technology access and connectivity issues)
  • Breaks in continuity of health care (e.g., missed well-child and immunization visits, limited access to mental, speech, and occupational health services)
  • Missed significant life events (e.g., grief of missing celebrations, vacation plans, and/or milestone life events)
  • Lost security and safety (e.g., housing and food insecurity, increased exposure to violence and online harms, threat of physical illness and uncertainty for the future)

Early Childhood (Birth to 5 years old)

Coronavirus disease (COVID-19) can affect young children, birth to 5 years, directly and indirectly. Beyond getting sick, many young children’s social, emotional, or mental well-being has been impacted by the pandemic. Trauma faced at this developmental stage may have long-term consequences across their lifespan.

Full CDC Early Childhood Toolkit


Challenges


CHANGES IN ROUTINE
When children are very young, their parents and caregivers—including extended family members, a worship community, and childcare workers—provide them with daily caretaking routines that support their development and well-being (i.e., diaper changes, feeding, hair combing). Disruptions in these routines and the sudden loss of usual caregivers due to the need to physically distance can be traumatic for young children.

Establishing routines and structure for young children with other trusted caregiver(s) (e.g., babysitters) who also practice social distancing and hygiene measures can provide support to parents with caretaking responsibilities, giving parents time to take healthy steps to cope with their own stress.

BREAK IN CONTINUITY OF CAREGIVERS, LEARNING OR HEALTHCARE
Intermittent daycare and school closures may mean that young children have to stay at home while parents and caregiver juggle caretaking, supervision of play and learning, and potential telework responsibilities. Depending on your child’s age and ability, supervision of play may require more hands-on engagement. Unfortunately, some parents do not have jobs that offer telework. It is important for parents to determine how their family’s composition and access to social supports (i.e., individual and work policies) could make caretaking of young children less challenging. For families with children who have special needs, extra social supports may be required.

Parents may have felt pressured to avoid seeking health care due to earlier stay-at-home orders and may continue to do so because they are afraid of getting sick with COVID-19. However, well-child visits and immunizations are important to maintain the health of your child. Similarly, social services closures may have impacted many young children’s ability to receive other therapeutic services, like speech and occupational health. It is important to ensure children receive continuity of health care, including checking on their development at well-child visits, continuing speech, mental health, and occupational health therapies (e.g. via telehealth), and receiving vaccines for illnesses such as measles, influenza, whooping cough, and others. Developmental milestones matter.

MISSED SIGNIFICANT LIFE EVENTS & GREIF

Physical distancing can make you feel as if your family’s life is on hold. The truth is that the clock keeps ticking. Birthdays, vacation plans, births, and funerals are just a few of the many significant life events that families may miss experiencing during the COVID-19 pandemic. Social distancing, stay-at-home orders, and limited gatherings have affected the ability of friends and family to come together in-person to celebrate and/or grieve in typical ways. When parents or caregivers experience grief, young children may also experience emotional challenges. It is important to have honest conversations with young children about grief as a normal response to losing someone or something important to you. For pre-verbal children, reading books about emotions can help them begin to understand expression of emotions. Also, be creative in ways to celebrate life events differently—birthday parades and virtual celebrations with family and friends can help.

LOSS OF SECURITY AND SAFETY
Being safe and feeling safe are essential for young children. The household income of many families with young children has been affected during the COVID-19 pandemic due to job loss and lost wages. Economic insecurity is linked to adverse childhood experiences that can negatively impact their social-emotional development, learning, and health. Young children living in families that are experiencing economic difficulties may feel unsafe. They may have inconsistent access to healthy foods, safe transportation, and housing. Parents’ mounting economic stress can increase children’s risk for exposure to violence.

With increased time spent at home during COVID-19, some children may have been increasingly exposed to child abuse and neglect, intimate partner violence at home, and sexual violence. It is important for parents to access social supports and services—including mental health services. Telemental health and national helplines may provide emergency options for emotional and mental health support during a crisis. Moreover, being attentive and responsive to a young child’s behaviors or questions can help support feelings of safety.


What can you do?


RECOGNIZE AND ADDRESS FEAR AND STRESS
When adults in the household are worried or stressed, even very young children (birth-2 years) may experience emotional distress. Children ages 3-5 years might worry about getting sick with COVID-19 or about their loved ones getting sick. Excessive worry or sadness, unhealthy eating or sleeping habits, and difficulty with attention and concentration are some signs of stress in young children. 
Adults should seek mental health services or spiritual guidance if they are experiencing worry and stress that interferes with caretaking, household duties, or their ability to work. Adults can also take steps to provide stability and support to help children cope. Parents can support positive coping through play and talk about emotions. For instance, choosing a comfortable space on the floor, at the child’s level, to talk about things that they are seeing adults do differently can provide the opportunity for children to express their fears in a safe place. To help young children have some sense of control and safety in these circumstances, parents can encourage conversations about being part of a community, such as protecting their family and their neighbors by standing 6 feet apart and wearing a mask. Have these changes become part of a fun and new family routine.

TEACH AND REINFORCE EVERYDAY PREVENTATIVE ACTIONS
There are actions we can take to limit the spread of COVID-19. Be a good role model—if adults wash their hands often, stay at least 6 feet apart from others, and wear their mask in public spaces to help protect themselves and others, then children are more likely to do the same. CDC recommends that children age 2 years and older wear a mask.

HELP KEEP CHILDREN HEALTHY
Schedule well child and immunizations visits for children. Seek continuity in mental health and occupational health care. Help children eat healthy and drink water – instead of sugar sweetened beverages – for strong teeth. Encourage children to play outdoors—it’s great for physical and mental health, and can help children stay healthy and focused.

HELP CHILDREN STAY SOCIALLY CONNECTED
Reach out to friends and family via phone or video chats. Write cards or letters to family members they may not be able to visit. Schools may have tips and guidelines to help support social and emotional needs of children.

Childhood (6-12 years old)

Coronavirus disease (COVID-19) can affect children directly and indirectly. Beyond getting sick, many children’s social, emotional, and mental well-being has been impacted by the pandemic. Trauma faced at this developmental stage may have long-term consequences across their lifespan. 

Full CDC Childhood Toolkit


Challenges


CHANGES IN ROUTINE
In addition to other everyday steps to prevent COVID-19, physical or social distancing is one of the best tools we have to avoid being exposed to this virus and to slow its spread. However, having to physically distance from someone you love—like a grandparent, friends, your worship community, or sick family members—can be hard for children. It is important for adults to support children in taking time to check in with friends and family to see how they are doing.

BREAK IN CONTINUITY OF LEARNING
School closures have meant that children stayed at home with parents and caregivers who had to juggle caretaking, learning supervision, and potential telework responsibilities. Participating in school from home is one way to help stop the spread of COVID-19. Online platforms and learning communities have become essential, as children and their families turn to digital solutions more than ever to support children’s learning. Unfortunately, the immediate need to have virtual school and learning revealed inequity in resources, access, and connectivity across students and communities. It is important for parents to reach out to teachers, school administrators, or school counselors to discuss the challenges your family may face supporting virtual learning. Together, you can discuss options that may be available through the school or county. Also, keep in mind that some students may experience nervous or anxious behaviors due to uncertainty about going back in-person to school. Families and communities can join together to troubleshoot ways to make the transition back to in-person school safe and healthy.

BREAK IN CONTINUITY OF HEALTHCARE
Parents may have avoided seeking health care due to stay-at-home orders and may continue to do so because they are afraid of getting sick with COVID-19. This includes important well-child visits, immunizations and oral health care. Additionally, school closures have impacted many children’s ability to receive mental health and speech therapy services. It is important to ensure children receive continuity of health care, including checking on their development at well-child visits, continuing mental health and speech therapies (e.g. via telehealth), and receiving vaccines for illnesses such as measles, influenza, whooping cough, and others—including COVID-19, when it becomes available.

MISSED SIGNIFICANT LIFE EVENTS & GREIF

Physical distancing can feel like placing life on hold. The truth is that the clock keeps ticking. Birthdays, graduations, talent shows, vacation plans, births, and funerals are just a sample of the many significant life events that children may have missed experiencing during COVID-19. Social distancing, stay-at-home orders, and limits to gatherings have affected the ability of friends and family to come together in person to celebrate or grieve in typical ways. Grief is a normal response to losing someone or something important to you. It is important to help children understand that hosting gatherings during COVID-19 could be dangerous to those who would want to participate. Family and friends can help them find alternate ways to connect and support each other at a distance. Also, be creative in ways to celebrate life events differently—birthday parades and virtual celebrations with family and friends can help.

LOSS OF SECURITY AND SAFETY
The household income of many families with children was affected during COVID-19 due to job loss and lost wages. Economic insecurity is consistently linked to children’s adverse development, academic achievement, and health outcomes. It may affect their ability to consistently access healthy foods, safe transportation, and housing. Mounting economic stressors can increase children’s risk for exposure to violence. Along with stay-at-home orders during COVID-19, some children may have been increasingly exposed to child abuse and neglect, intimate partner violence at home, and sexual violence. Children’s increased online activity also puts them at increased risk for online harms, such as online sexual exploitation, cyberbullying, online risk-taking behavior, and exposure to potentially harmful content. It is important for parents and caregivers to maintain a trustworthy relationship and open communication with children, watching for behavior changes that may signal distress.


What can you do?


RECOGNIZE AND ADDRESS FEAR AND STRESS
Children might worry about getting sick with COVID-19, and about their loved ones getting sick, too. Excessive worry or sadness, unhealthy eating or sleeping habits, and difficulty with attention and concentration are some signs of stress in children.

Adults should seek mental health services or spiritual guidance if they are experiencing worry and stress that interferes with caretaking, household duties, or their ability to work. Adults can also take steps to provide stability and support to help children cope. 

TEACH AND REINFORCE EVERYDAY PREVENTATIVE ACTIONS
There are actions we can take to prevent getting sick and slow the spread of COVID-19. Be a good role model— if adults wash their hands often, stay at least 6 feet apart from others, and wear their mask in public spaces to help protect themselves and others, then children are more likely to do the same.

HELP KEEP CHILDREN HEALTHY
Schedule well child and immunizations visits for children. Seek continuity in mental health and occupational health care. Help children eat healthy and drink water – instead of sugar sweetened beverages – for strong teeth. Encourage children to play outdoors—it’s great for physical and mental health, and can help children stay healthy and focused.

HELP CHILDREN STAY SOCIALLY CONNECTED
Reach out to friends and family via phone or video chats. Write cards or letters to family members they may not be able to visit. Schools may have tips and guidelines to help support social and emotional needs of children.

Adolescence (13-17 years old)

Coronavirus disease (COVID-19) can affect adolescents directly and indirectly. Beyond getting sick, many adolescents’ social, emotional and mental well-being has been impacted by the pandemic. Trauma faced at this developmental stage may have long-term consequences across their lifespan. 

Full CDC Adolescence Toolkit


Challenges


CHANGES IN ROUTINE
In addition to everyday steps to prevent COVID-19, physical or social distancing is one of the best tools we have to avoid being exposed to the virus and to slow its spread. However, having to physically distance from someone you love – like friends, boyfriend or girlfriend, family or your worship community – can be hard.  Adolescents may struggle when asked to change their social routines – from choosing to skip in-person gatherings, to consistently wear masks in public settings. It is important for adults to help adolescents take personal responsibility to protect themselves and others, as well as support them in safely taking time to connect with friends and family remotely.

BREAK IN CONTINUITY OF LEARNING
School closures due to COVID-19 have meant that adolescents have been participating in learning from home. Online platforms and communities have become essential, as families turn to digital solutions more than ever to support students’ learning. Unfortunately, the immediate need for virtual learning environments brought to light inequity in resources, access and connectivity across families and communities. School closures have also meant a break in access to some essential developmental services like occupational, behavioral, or speech therapy. It could also have impeded continuity in adolescents’ development of athletic or hands-on vocational skills, with potential impacts on their higher education and professional future. It is important to understand how virtual learning could make learning increasingly challenging for students with limited resources or special needs.

Moreover, some children may experience anxiety about going back to school in-person or virtually. Some may also experience fatigue from online video conferencing—commonly referred to as “zoom fatigue.” Families, schools. and communities can join to troubleshoot ways to ensure the learning needs of all children are appropriately addressed.

BREAK IN CONTINUITY OF HEALTHCARE
Parents may have avoided seeking health care for their adolescents due to stay-at-home orders and may continue to do so because they are afraid of getting sick with COVID-19. This includes important well-child visits, immunizations and oral health care. Additionally, school closures have impacted many adolescents’ ability to receive mental health, speech therapy and occupational health services on campus. It is important to ensure adolescents receive continuity of health care, including continuing mental health, occupational and speech therapies (e.g. via telehealth), and receiving vaccines – including  the COVID-19 vaccine - Get Vaccinated

MISSED SIGNIFICANT LIFE EVENTS & GREIF

Physical distancing can feel as if one is placing life on hold. The truth is that the clock keeps ticking. Birthdays, graduations, proms, homecoming, vacation plans, births and funerals are just a sample of the many significant life events that adolescents may have missed experiencing during COVID-19. Social distancing, stay-at-home orders and limits to gatherings have affected their ability to gather in person with friends and family to celebrate or grieve in typical ways. Grief is a normal response to losing someone or something important to you. It is important for family and friends to help adolescents find alternate, creative and safe ways to connect and support each other at a distance.

LOSS OF SECURITY AND SAFETY
Job loss and lost wages affected the household income of many adolescents’ families during COVID-19. Economic insecurity is consistently linked to adverse development, academic achievement, and health outcomes. It may affect adolescents’ ability to consistently access healthy foods, safe transportation and housing. Mounting economic stressors can increase their risk for exposure to violence. Along with stay-at-home orders during COVID-19, some adolescents may have been increasingly exposed to abuse and neglect, intimate partner violence at home, and sexual violence. Their increased online activity also puts them at increased risk for online harms, such as online sexual exploitation, cyberbullying, online risk-taking behavior, and exposure to potentially harmful content. It is important for parents and other prosocial adults to maintain a trustworthy relationship and open communication with adolescents, watching for behavior changes that may signal distress.


What can you do?


RECOGNIZE AND ADDRESS FEAR AND STRESS
Adolescence is a time of big changes. Adolescents can be particularly overwhelmed when stress is related to a traumatic event, expressed as excessive worry or sadness, unhealthy eating or sleeping habits, and difficulty with attention and concentration. Adults can provide stability and support to help them cope, as well as facilitate access to professional help and distress emergency hotlines, as needed.

TEACH AND REINFORCE EVERYDAY PREVENTATIVE ACTIONS
There are actions we can take to protect others, prevent getting sick and slow the spread of COVID-19. Encourage adolescents to be good role models— if they wash their hands often, stay at least 6 feet apart from others, and wear their masks in public spaces to help protect themselves and others, then younger children – and even their peers – are more likely to do the same.

HELP KEEP ADOLESCENTS HEALTHY
Teach adolescents the importance of taking care of their health. Engage them in scheduling routine check and immunizations visits. Ensure continuity in their mental health and occupational health care. Encourage them to eat healthy, drink water – instead of sugar sweetened beverages – for strong teeth, be physically active, or learn something new. It can help them stay healthy and focused.

HELP ADOLESCENTS STAY SOCIALLY CONNECTED
Encourage adolescents to reach out to friends and family via phone, video chats, social media, or even via video games. Schools may have tips and guidelines to help support their social and emotional needs.

Young Adults (18-24 years old)

Coronavirus disease (COVID-19) can affect young adults directly and indirectly. Beyond getting sick, many young adults’ social, emotional and mental well-being has been impacted by the pandemic. Trauma faced at this developmental stage may have long-term consequences across their lifespan. 

Full CDC Young Adulthood Toolkit


Challenges


CHANGES IN ROUTINE
In addition to other everyday steps to prevent COVID-19, physical or social distancing is one of the best tools we have to avoid being exposed to this virus and slow its spread. However, having to physically distance from someone you love—like friends, family, coworkers, or your worship community—can be hard. It may also cause change in plans—for instance, having to do virtual job interviews, dates, or campus tours. Young adults may also struggle adapting to new social routines—from choosing to skip in person gatherings, to consistently wearing masks in public. It is important to support young adults in taking personal responsibility to protect themselves and their loved ones.

EMPLOYMENT OR EDUCATIONAL CHANGES
Many higher education institutions temporarily transitioned to only virtual courses to help stop the spread of COVID-19. This included the temporary closing of college campuses, prompting the suspension of many work-study opportunities and campus housing services. Many young adults also lost their internships or practicums, jobs, or wages due to business closures. Having to juggle moving to a new place, spending long hours online completing coursework, and job seeking without the in-person support from peers could be overwhelming for many young adults. It is important for young adults to acknowledge that these extraordinary circumstances may have an effect on their socioemotional well-being, continuity of learning, finances, and professional development. College and university students may reach out to their institutions’ career development, learning and counseling services teams for support. They could also reach out to college student-serving organizations, like the National Association for Equal Opportunity in Higher Education, Excelencia in Education, and the Hispanic Association of Colleges and Universities.

BREAK IN CONTINUITY OF HEALTHCARE
Young adults may have avoided seeking health care due to stay-at-home orders and may continue to do so because they fear getting sick with COVID-19. This includes skipping regular health exams and tests— like those done during the annual physical check-up—that can help find problems before they start. Additionally, higher education campus closures have impacted many young adults’ ability to receive their accustomed health care services on campus. During COVID-19 and always, it is important to promptly seek necessary care. Several telehealth modalities allow physical and mental health care providers to connect with patients and deliver care remotely. Many young adults are eligible for low-cost care at Community Health Centers of Lane County.  It is also important to keep us with vaccination including  the COVID-19 vaccine - Get Vaccinated

MISSED SIGNIFICANT LIFE EVENTS & GREIF

Physical distancing can feel like placing life on hold. The truth is that the clock keeps ticking. Birthdays, internships, graduations, living on campus, vacation plans, births, and funerals are just a sample of the many significant life events that young adults may have missed experiencing during COVID-19. Social distancing and limits to gatherings have affected their ability to join friends and family in person to celebrate or grieve in typical ways. Grief is a normal response to losing someone or something important to you. It is important to help young adults understand that hosting gatherings during COVID-19 could be dangerous to those who would want to participate. Encourage them to connect and support each other at a distance.

LOSS OF SECURITY AND SAFETY
COVID-19 has impacted many young adults’ personal finances—for example, due to job loss and lost wages. Economic insecurity is consistently linked to adverse academic achievement and health outcomes. These adverse outcomes and unexpected college or university closures may affect the ability to consistently access healthy foods, safe transportation, and housing. Mounting economic stressors can also increase the risk for violence exposure. Stay-at-home orders during COVID-19 may have resulted in some young adults being increasingly exposed to intimate partner and sexual violence, with potentially fewer opportunities to seek help and social support. It is important to cultivate a trustworthy relationship and maintain open communication with young adults, watching for behavior changes that may signal distress.


What can you do?


RECOGNIZE AND ADDRESS FEAR AND STRESS
Young adults might worry about getting sick with COVID-19, and about their loved ones getting sick, too. Excessive worry or sadness, unhealthy eating or sleeping habits, and difficulty with attention and concentration are some signs of stress. Encourage them to practice healthy ways to cope with stress.

HELP YOUNG ADULTS TAKE CARE OF THEMSELVES AND THEIR COMMUNITY
Taking care of friends and family can be a stress reliever, but it should be balanced with self-care. Young adults can help make their community stronger by helping others cope with their stress, such as by providing social support, and following everyday actions to prevent getting sick and slow the spread of COVID-19. Being a good role model is key—if young adults wash their hands often, stay at least 6 feet apart from others, and wear their masks in public spaces to help protect themselves and others, then their peers are more likely to do the same.

HELP YOUNG ADULTS STAY HEALTHY
Encourage young adults to keep their routine physical checks, as well as their behavioral health appointments. This may include helping them locate providers.  Inspire them to eat healthy, drink water – instead of sugar sweetened beverages – for strong teeth, be physically active, or learn something new.

HELP YOUNG ADULTS STAY SOCIALLY CONNECTED
During times of increased social distancing, young adults can still maintain social connections and care for their mental health. Phone calls or video chats can help them feel socially connected, less lonely, or isolated.


How to support your child in the transition back to the classroom

For some children, learning from home the past year has been a welcome break from school days that were difficult to navigate. For others, closing schools resulted in the loss of a daily routine and an environment in which they thrived.   

Change can be hard, even for those who are excited about it. Children’s feelings about the transition back to in-person school may be complicated and their reactions may change as time goes on. Parents and caregivers will also likely have new feelings about it, which may not be the same as their kids’ reactions.  

 

Here are some ways to help your child with the transition:  

  • Remember the fundamentals. A regular pattern of a good night’s sleep and eating nutritious meals and snacks goes a long way to fuel flexibility, engagement and problem-solving during the day. 
  • Re-establish morning and afternoon routines. Involve your child in deciding the details. Having opportunities for choice and agency makes handling uncertainty easier for everyone. 
  • Create a visual aid like a calendar to help them understand what to expect in their new routine.  
  • Let them know what might be different at school this year.
  • Ask your child what they are feeling and how you can support them. Knowing you recognize that this is an exciting and challenging time and you are open to listening is reassuring, regardless of whether they have something to share.


    • What your child is feeling may not be what you expect. Let them know that whatever they are feeling is OK.
    • You may not be able to offer answers or certainties. Like adults, kids find it helpful to have someone who will just listen.
    • If talking is not your child’s thing, think about drawing with them, playing/listening to music, playing catch, swinging, going for a stroll. Doing something often inspires communication.
  • Encourage them to think of what will be good about returning to school. 
  • Your child may be worried about bringing COVID home. Reminding them of what your family and the school are doing to reduce the chances of infection can help them feel calmer.  

If you think your child or family may need more support, contact your child’s primary care provider or check out the Safe + Strong mental and emotional health resources page.

Here are some links to learn more:

If your children are 12 or older, they can get vaccinated against COVID-19. If you have questions about the vaccine’s safety or effectiveness, we encourage you to talk with your trusted health care provider. You can find a vaccine at Get Vaccinated.


Tips to help make COVID-19 testing easier for kids

Getting tested for COVID-19 might feel scary to some children. As parents or guardians, we want to make it as easy as possible for them. Preparing our kids for a COVID-19 test ahead of time can help make it more comfortable.

You know your kids best and you know what works for them. Use language that your child understands. Here are some ideas:
  • Make sure your kids know what COVID-19 is and why they are getting tested. Getting the test is a way to keep themselves and their loved ones safe.
  • Explain what the process will look like. For example, you can explain that they may wear protective clothing and that it may be uncomfortable, but it will be over fast.
  • Make a plan with your kids about what to do during the test. Ask them what they can do to stay still like counting, hugging a stuffed animal, taking deep breaths or thinking of a favorite activity.
  • Explain to them how you’ll find out the results of the test.
  • Let your children know that they’ll have to quarantine if they test positive. Reassure them that you’ll make sure their needs are met while they’re at home.

Identifying the signs of stress in children

This summer has not been what we expected. The sudden burst of freedom earlier in the summer followed by the reinstatement of masking mandates later in the summer has been confusing.

Changes like these can be stressful. If we feel stress as parents, it’s likely our children feel it as well.

Children often react to stressful events differently than adults. How the child in your life reacts will vary by age, their previous experiences and how they typically cope with stress.

Signs of stress in young children

Preschool age

  • Crying or screaming
  • Afraid to separate from parents or caregivers
  • Not eating or losing weight
  • Having nightmares

Elementary School Age

  • Felling guilt or shame
  • Trouble concentrating
  • Not sleeping well

How parents and caregivers can help

  • Be calm and reassuring
  • Talk to children about what is happening in a way they can understand
  • Provide children with opportunities to talk about what they are experiencing.  Encourage them to share their concerns; ask questions

Teens who want to talk to someone can check out the Oregon YouthLine by:

    Calling 877-968-8491 Texting "teen2teen" to 839863 Emailing Teen2Teen@LinesforLife.org  Using the chat feature at oregonyouthline.org 

Teens are available to help daily from 4 p.m. to 10 p.m. Pacific Time, and adults are available by phone all other times.

You can find resources and learn more about how to support children of all ages by visiting CDC’s Helping Children Cope website or the national Child Traumatic Stress Network’s (NCTSN) Parent/Caregiver Guide to Helping Families Cope.