Dr. Rehman Abdulrehman’s six-year-old son recently asked him a difficult question that a lot of parents might have been hearing from their younger children.
"He asked me, ‘Papa are you going to die?’" says Abdulrehman, adding his son was worried his father would fall ill with COVID-19.
As the novel variant of coronavirus spreads, including now in Manitoba, many parents are likely facing these questions more and more.
And Abdulrehman — a clinical psychologist specializing in anxiety — says parents play a critical role helping children through a potentially frightening experience.
That’s where Abdulrehman and another psychologist, Leslie E. Roos, may be able to help. Both recently spoke with the Free Press about how parents can assuage children’s concerns and reduce anxieties about COVID-19.
Roos notes parents should approach the discussion much the same as discussing any serious matter with their children.
"It’s important to be honest, giving them accurate information when necessary, but it must also be age-appropriate," says Roos, a family and child psychologist, and investigator at the Children’s Hospital Research Institute of Manitoba (CHRIM).
Equally important is paying attention to your own actions, words and emotional state, as children often follow their parents’ lead.
"Addressing your children’s anxiety is often about addressing our own," says Abdulrehman, director of Clinic Psychology Manitoba and an assistant professor at the University of Manitoba.
"If we appear calm and sure, we can lend some of that confidence to children about these issues, and help reduce anxiety."
That doesn’t mean parents should answer their kids’ questions with general statements like ‘This is nothing to worry about.’
Rather, parents may first ask children what they know about the virus and how they feel about it.
"Some children may not think it’s a big deal; they may know about it, but they’re completely unfazed," he says.
"Other children will be more concerned, but that can sometimes be a case of them reflecting anxieties of others, notably their own parents."
Providing assurances regarding safety and security to children who are anxious is important. One way to do that is emphasize that grown-ups — doctors, nurses and scientists, for example — are working to keep everyone safe and healthy.
Roos says parents can help their children by explaining that school closures — Manitoba public schools will close for three weeks starting March 23 — are meant to keep them safe.
She also notes children are less anxious when they have routines in their lives. Parents should ensure children have a new routine once schools are closed.
"That way, they have some stability, providing a sense of safety," Abdulrehman says.
As with adults, children also feel more secure when they have a sense of control.
Roos suggests parents can do much to soothe their children’s fears by emphasizing their strengths.
"You can talk to them about how strong their bodies are and how great they are at fighting off disease," says Roos, who is also an assistant professor at the University of Manitoba.
"That’d be more helpful than saying, ‘Older adults are much more likely to get really sick from this than you or me,’ which might cause them to worry about their grandparents’ safety."
One way to give them a sense of control is emphasizing the importance of handwashing, and coughing and sneezing in the crook of their elbow or a tissue. But messaging is important because pushing these issues too much may lead to obsessive behaviour.
"We want to focus on a more positive message of safety as opposed to, ‘If you don’t do this, you’re going to get sick,’" Abdulrehman says.
It’s similar to how parents soothe children when they hurt themselves at the playground. We tell them they will be OK, help them clean up the "boo-boo," and put a bandage on it, he adds. Reassurance with instruction on how to cope helps reduce pain because it relieves the emotional distress surrounding it.
"Trauma is not just caused by an actual event, but also by the psychological circumstances," he says.
The more distress is tied to pain, the more difficult it is to cope with that pain.
While COVID-19 is unlikely to cause physical pain for children, it can certainly cause distress. And parents’ reactions to their children’s worry can either reduce anxiety or make it worse.
"It may be oversimplifying it a bit, but the talk about managing a ‘boo-boo’ is an apt metaphor," he says.
And once the coronavirus threat passes, what children learn from the experience has life-lesson potential.
"The way we walk children through these difficulties is the way they learn to manage these down the road," Abdulrehman says.
Still, even despite our best efforts, some kids are more prone to anxiety than others, and parents should look for signs they may need to seek help.
"A normal response to an event would be two weeks of concern after a risk has passed, and they should still be able to go on with activities in their lives," Roos says.
Parents whose children show prolonged avoidance of going to school and other day-to-day activities can contact organizations such as the Anxiety Disorders Association of Manitoba for guidance. They can also talk to a pediatrician, who may be able to refer them to a specialist.
Abdulrehman says parents can also find a number of useful online resources, including on his practice’s website, Worry Shrinker (clinicpsychology.com/worryshrinker), designed to deal with children’s anxiety.
He adds reaching out for help is often beneficial, and less involved than you may think.
"When we offer them the help they need, their ability to use that assistance to get better is actually greater than with adults."
As for answering the question from his son, Abdulrehman followed his own advice.
"I reassured him that I was not going to die, and said, ‘While there might have been people that has happened to, we’re very far away from it, and here are some things we can do to stay safe,’" Abdulrehman says.
"And that was all he really needed."