How COVID-19 May Affect Our Children's Behaviors

On Friday March 13, 2020 a national emergency in the United States was called and within a week, most of the school districts in the country were shut down causing scrambling parents to figure out how to homeschool their children, care for their children, and continue to work and make a living. We are all in this together, but everyone’s struggle is unique. Parents across the country are worried about the impact this will have on their children.

Behavior analysts study the impact that the environment has on behavior and develop interventions to reduce unwanted behavior and teach appropriate behavior. When we take a behavior analytic account of how this current pandemic has affected our children’s behaviors, we must first identify what new and challenging behaviors our children are engaging in or experiencing. Every child and situation is different. Some children may have little to no change in behavior and some children may be struggling significantly. Some children may be engaging in more externalizing behaviors such as physical aggression, verbal aggression, and impulsivity, while other children may experience more internalizing behaviors such as withdrawal, anxiety, and depression. Why the difference in some children over others? A combination of genetic and environmental factors influence how a child responds to significant events such as loss of a loved one or physical abuse. Some factors include the number and severity of adverse events in a child’s life, reinforcement and punishment history, relationships, parenting, mental health, genes, problem solving skills, emotionality, and emotional regulation.

Since the pandemic occurred and people were asked to stay in or near their homes, did you notice a change in your child’s behavior? Use the list below to check-off what you’re noticing. Look for increases in frequency, duration, or severity.

Behaviors

Once you’ve identified unwanted behaviors your child is engaging in, you can look at the antecedents, which are events that trigger behavior. Antecedents may happen immediately before the behavior, such as a sibling hitting and the child crying. Antecedents may also consist of several events that can add up and lead to the challenging behavior, such as loss of school, friends, sports, graduation, and cancellation of the family trip. Below is a list of situations that your child may or may not have experienced since this pandemic began. It’s important to know which may be having a negative impact on your child so we know what interventions are most helpful. For example, if your child experienced a loss, he or she may need grief counseling. If your child lacks motivation or hope, he or she may need a preference assessment completed to identify ways to increase motivation. If the antecedent is still on-going such as loss of family income and scarcity of food and resources, the initial intervention may be to provide food, resources, money, and/or support in locating another source of income.

Antecedents

Now that you have identified the unwanted behaviors your child is engaging in and the antecedents which may have led to the increase in behaviors, read on to learn what changes you can make that can have a positive influence on your child’s behavior.

What We Can Do

1. Provide access to counselors, social workers, psychologists, and behavior analysts. All of these experts can help children cope with their stressors, manage their behaviors, and learn healthy ways to respond. Some children may specifically need a grief counselor.

2. Provide children with safe and healthy ways to socially interact with others such as:

   1. Online play dates and conversations

   2. Online workouts, yoga or dancing

   3. Online birthdays or weekly check-ins

   4. Online video games

   5. Socially distant get-togethers, chats or walks

   6. Talking or texting with friends on the phone

   7. Send letters and gifts to friends and family

   8. Have teachers and coaches provide check-ins with their students

3. Practice mindfulness based strategies such as Acceptance and Commitment Therapy with your children.

   1. Notice and label your emotions. (i.e.,My anxiety is back; Oh hello sadness, my old friend).

   2. Accept how you feel (i.e., I feel angry and that’s okay. It’s normal to feel angry right now. I’m just going to sit with this feeling for a while).

   3. Defuse negative thoughts by using one of several techniques such as saying the negative thoughts in a funny voice or visualizing them floating away in balloons.

4. Empathize with your children. Ask how they’re doing. Actively listen. Validate their concerns. How they feel is important and real. They want to be heard and understood. Reassure them that they are safe or that you will do everything you can to keep them safe.

5. Give them choices when possible instead of direct instructions or demands. For example, instead of telling them what’s for dinner, give them a choice between hot-dish and pizza. If they need to get some chores done give them a choice between cleaning the kitchen or mowing the lawn.

6. Maintain a regular schedule and structure. Consistency helps children predict what is coming and decreases the amount of change and unstructured time in their day. Download a visual timer app or set the timer on your phone whenever you prompt your child to wait for something. Set up activities ahead of time. For example, if you’re going to do an art activity, gather all the materials and have them set up on the table. This will reduce wait time and unstructured time.

7. Get them outside! Research shows nature has a positive impact on children’s physical and mental health. Nature play research has also shown a reduction in conflicts between children.

8. Have them fill out a preference assessment. Give them a list of fun things you can safely do and have them check off the ones that interest them. They can also write-in their own ideas. Schedule fun activities often so they have something to look forward to and to provide them with some positive experiences during this time.

9. Positively reinforce your child’s good behavior. When you see them share with their sibling or pick up after themselves, provide immediate behavior specific praise (i.e., “Thank you for sharing that is so nice of you”; “I appreciate you picking up your toys. That really helps keep the house clean”).

10. Take care of yourself. Eat well, exercise, sleep, spend time outdoors, clean the house, engage in mindfulness exercises, and find a support group. Children can feed off of your stress, so do your best to set an example for them. Model the behaviors you want to see out of them.

This pandemic has been challenging in so many different ways and we sometimes overlook the ways it is affecting children. While some children may not need additional support, there are some children who may be affected particularly hard or in unexpected ways.

These are difficult times. Even as the country begins opening back up, things are still not back to normal and they will not be for a long time. It’s okay to be stressed and scared. It’s normal to feel like you’re in survival mode. It’s okay if you’re giving your kids extra screen time and sugar. If you are looking for help and support beyond these ten tips please contact me. I provide parental support and child behavior strategies via telehealth. If you’re new to telehealth or uneasy about it we can set up a free initial consultation and talk about how it could work for you. Telehealth can be a safe and effective way to learn strategies to reconnect with your child, decrease unwanted behavior, teach appropriate behavior, and start to regain a sense of normalcy again.

Sara Athman, MS, BCBA

Online Behavior Consultant

sara@onlinebehaviorconsultant.com

Further Reading

Depression & Children

• If your Kids are Acting Out, they Might just be Sad, by Kristen Rogers at CNN Health https://www.cnn.com/2020/05/18/health/child-acting-out-sadness-coronavirus-wellness/index.html

• SAMHSA’s National Helpline 1-800-662-4357 https://www.samhsa.gov/find-help/national-helpline

• Xie X, Xue Q, Zhou Y, et al. Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei Province, China (published online April 24, 2020). JAMA Pediatr. doi:10.1001/jamapediatrics.2020.1619

• Berman MG, Kross E, Krpan KM, et al. Interacting with nature improves cognition and affect for individuals with depression. J Affect Disord. 2012;140(3):300‐305. doi:10.1016/j.jad.2012.03.012

Anxiety & Children

• How to Ease Children’s Anxiety About COVID-19 by the National Alliance on Mental Illness, March 25, 2020 https://www.nami.org/Blogs/NAMI-Blog/March-2020/How-to-Ease-Children-s-Anxiety-About-COVID-19

• Calming Your Child’s Anxiety About COVID-19 by Dr. Gerald Rakos at Stamford Health, March 24, 2020 https://www.stamfordhealth.org/healthflash-blog/pediatrics/children-anxiety-covid-19/

• Eifert, G. H., Forsyth, J. P., Arch, J., Espejo, E., Keller, M., & Langer, D. (2009). Acceptance and commitment therapy for anxiety disorders: Three case studies exemplifying a unified treatment protocol. Cognitive and Behavioral Practice, 16(4), 368–385. https://doi.org/10.1016/j.cbpra.2009.06.001

• Sargisson RJ, Li F, Lobo D, Roche M (2019) Using an Acceptance and Commitment Therapy app to Reduce Anxiety for Students and Employees. Int J Psychol Behav Anal 5: 164. doi:10.15344/2455-3867/2019/164

Toxic Stress & Children

• Franke H. A. (2014). Toxic Stress: Effects, Prevention and Treatment. Children (Basel, Switzerland), 1(3), 390–402. https://doi.org/10.3390/children1030390

• What we can do about Toxic Stress from the Center on the Developing Child at Harvard University https://46y5eh11fhgw3ve3ytpwxt9r-wpengine.netdna-ssl.com/wp-content/uploads/2019/07/ToxicStressInfographic_FINAL.pdf

• California’s Surgeon General on the Science of Toxic Stress https://www.kcrw.com/culture/shows/foxhole/covid-19-stress-management-trauma-coping-skills/stress-trauma-mental-health-coronavirus

• The Urgent Need for Nature During and After COVID-19 by Gail Christopher, Kim Moore Bailey, and Tyler Norris. https://www.gih.org/views-from-the-field/the-urgent-need-for-nature-during-and-after-covid-19/?fbclid=IwAR3CpAWcQ1cKm2LADfUPPvROxyjfXYLVec02z15FaaBkOGaZNDHRZFsuTvA

• Green Schoolyards can Provide Mental Health Benefits https://www.childrenandnature.org/wp-content/uploads/2015/03/CNN_2016GSY_MentalHlth_d5.pdf

• Wells, N. M. and Evans, G. W. (2003). Nearby Nature: A Buffer of Life Stress among Rural Children. Environment and Behavior, 35, 311-330.

Externalizing Behaviors & Children

• Saudino, K. J. (2005). Behavioral Genetics and Child Temperament. Journal of Behavior Pediatrics, 26(3), 214-223.

• Residential greenspace association with childhood behavioral outcomes https://www.childrenandnature.org/research/the-association-of-residential-greenness-with-behavioral-outcomes-depends-on-age-and-distance-of-green-space-from-homes/

• Impact of greenspace exposure on children’s and adolescents’ mental health: A systematic review https://www.childrenandnature.org/research/associations-between-green-space-exposure-and-the-mental-health-of-children-and-adolescents-warrant-the-attention-of-policy-makers-urban-planners-and-mental-health-professionals/

• Nature play: A prescription for healthier children by Terril Bravender and Lee Smith Bravender, March 13, 2020. https://www.contemporarypediatrics.com/pediatrics/nature-play-prescription-healthier-children