#YearofCOVID: Helping Kids Cope

Eleven-year-old Samantha Lewis is sad, and her mother says she's been sad for months.

"She misses her friends," said Lisa Cockrell, a business operations manager at Cedars-Sinai. "And the saddest part is that she might end up graduating fifth grade and moving to a new school without the opportunity to say goodbye."

Like so many other children, Samantha has been out of her Los Angeles classroom for nearly a year because of COVID-19 restrictions on in-person schooling.

It's no surprise to mental health professionals that the pandemic has left many children sad and anxious. Stay-at-home orders that began in March 2020 were rough on everyone, but perhaps toughest on kids, who lost an entire year of social and emotional growth that comes from being together on a daily basis.

School Is For More Than Learning

"Going to school isn’t only about education, but about socialization, friendships, navigating challenges and new experiences," said Itai Danovitch, MD, chair of the Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences. "Losing all that for a year, which is a long time in kid time, could have a profound impact."

Toddlers who no longer had access to playgroups, nursery school or kindergarten missed out on a great deal of foundational development over the year as well. While it may not look like it, children playing with and fighting over toys actually involves a great deal of social learning that's not easily duplicated at home.

"We know that when kids don't get social interaction in play, they are not learning to form relationships, and that's detrimental to good mental health," said Suzanne Silverstein, founding director of Cedars-Sinai Share and Care, a program focusing on children suffering psychological trauma.

By going a full year with minimal outside interactions, kids also were deprived of the opportunity to connect appropriately with authority figures, Silverstein said. For many kids, missing school meant going without something even more basic: a place they could count on for reliable meals and much-needed respite from stresses at home.

And it's not just the little ones who suffered. Although middle schoolers and teenagers might have had opportunities to connect with friends via social media, they lost the opportunity to experience more grown-up connections. "Learning to navigate social situations, even uncomfortable ones, is an important skill for that age group," Danovitch said.

Heading Back to School Safely

Now that some school districts are planning to re-open schools as early as this spring, children of all ages are anticipating a return to the classroom. But experts say even though kids may be excited, the transition back to school could be bumpy.

"Going back to school is going to look a lot different," said Jonathan Vickburg, a marriage and family therapist and Cedars-Sinai Share and Care program manager.

Classrooms will look different as desks are placed several feet apart, while teachers and classmates will be hidden behind masks. Children who are desperate for peer-to-peer contact may find strict new distancing rules difficult to follow in the classroom and on the playground, Vickburg said. Not being able to mingle, play contact sports or share snacks as they did before may add anxiety for children who are trying to adjust to ever-changing expectations about their interactions.

"As difficult as it has been, kids spent a whole year getting used to their new reality and now we are going to flip it again. It's a major change," Danovitch said. "Some children may have undergone physical changes over the year, such as going through puberty, and that may add to the anxiety of returning to the classroom. Others may not have progressed academically, or still may be dealing with challenges at home and may not feel ready to return."

School leaders will need help navigating the mental health stresses for returning students and teachers. It will be important for teachers to acknowledge the loss that many families have experienced, to normalize the adversity many have faced, and for mental health counselors to be on hand to help students deal with grief and mourning, Silverstein said.

Vickburg says that teachers could help students by encouraging them to share their feelings during class activities and assignments. Playing “Feelings Charades”—in which children act out their emotions while others guess the feelings—or other interactive emotional support games can help teachers better understand how their students are faring.

Emotional stability should be the primary goal. Parents would be wise not to pressure their children about grades, Silverstein said. Doing so likely will increase anxiety, especially among students who have fallen behind. Teachers will need to pay special attention to students who did not have computer access at home or parents available to help with online learning.

"Kids have tremendous capacity for growth," Danovitch said. "We lament what they missed out on, but we can have confidence that they will adapt and catch up and maybe even excel."

A Fresh Start

Samantha, the Los Angeles fifth grader, has been dutifully keeping up with her schoolwork at a desk in her bedroom at home. Her mother, Cockrell, working full time from home, says that Samantha has gained more independence during this challenging year. But the loss of friendships has taken a toll. One of Samantha's best friends moved and another might not return to school when classes resume.

 "I miss hanging with my friends and doing TikTok videos and dancing," Samantha said. "I also really miss my music teacher, Miss Molly. We do music on Zoom, but it's so not the same."

Still, mother and daughter say they are hoping for an end-of-year ceremony to mark the conclusion of elementary school, whether it's virtual or in-person. And Samantha is looking forward to a fresh, post-pandemic start to sixth grade.

"I'm really excited about middle school to meet the new kids," she said. "And I'm hoping my mom lets me take the bus to school."