Lockdown is a strong word, associated with disruption, restriction, mass quarantining, a situation so dire that it requires individuals to only leave their homes for necessary grocery shopping or emergency and medical needs.
The pandemic has not only caused changes among adults but children’s lifestyles too. As much as restrictions have loosen, necessary preventive measures for children are still needed to keep them safe from the SARS-CoV-2 virus, the virus that causes Covid-19. How do these changes and precautions affect the mental and emotional well-being of children?
To shed some light on this matter, we reached out to a Consultant Psychiatrist at Regency Specialist Hospital, Dr. Fabian Sunil Dass.
1Twenty80: How does the impact of lockdown affect children’s mental and emotional well-being?
Dr. Fabian Sunil Dass: Factors that we need to consider when talking about the mental health of children are:
- Developmental age
- Socioeconomic status
- Educational background
- Special needs
- Pre-existing mental health conditions
The lockdown’s influence has varied results on children depending on these factors. For anybody, adults and children alike, changes in daily routines due to a lockdown can have negative effects. As for adults, we can see that the numbers for people reaching out for help through psychosocial helplines have increased dramatically (Befrienders KL reported an increase of calls up to an average of 107 daily during MCO 3.0). Children on the other hand, who have yet to develop a mature ability to regulate their mental and emotional states, the impact of the lockdowns can be potentially worse.
For children, engaging socially with their peers, playing and having a structured routine such as going to school help to nurture and strengthen their mental and physical health. This also helps to blossom their personality and help them to understand their strengths and weaknesses. However, the pandemic has caused the government to restrict many people from leaving their home to avoid spreading the virus as well as emphasis on the need to wear masks, hand-washing as well as social distancing. Due to the pandemic, children’s necessary growth has also been restricted, resulting in some unwanted consequences such as the negative effects on their mental health well-being.
UNICEF Malaysia (Mental health alert for children in Malaysia (unicef.org), found during this lockdown that children experience emotions such as fear, loneliness, anxiety, depression and hopelessness about their future. If these negative emotions are not handled at its root and continue to grow, it can potentially stun the emotional and mental growth of children in the long-run.
1Twenty80: Do children with pre-existing mental disorders have a higher risk of severe illness due to being confined at home?
Dr. Fabian: Some examples of pre-existing mental health disorders are Autism, Attention Deficit Hyperactivity Disorder (ADHD), Development delays, learning difficulties as well as other emotional and behavioral difficulties. According to the Centers for Disease Control and Prevention, USA (CDC) and pre-existing neurodevelopmental, behaviour or emotional issues.
The stress of having their routine taken away from them, following strict instructions to just be indoors and not engaging with their usual outdoor activities can be too complex and difficult for them to comprehend. This situation can be a little more challenging among autistic children. Their inability to adapt quickly enough to sudden changes can trigger outbursts of temper and tantrums and could also lead to family conflicts.
1Twenty80: Could you share with us some common behaviours that parents may notice among their children?
Dr. Fabian: Common noticeable behaviours among children are generally age related. However, some common behaviours that are distinguishable include:
- Clinginess.
- Bedwetting.
- Change of appetite.
- Poor concentration.
- Nightmares and fear of the dark.
- Withdrawal from usual loved activities.
- Increased thumb sucking habits among preschoolers.
For the adolescent age group, parents may notice an increase of irritability in their children, refusal to go to school or attend online classes, delinquent behaviours and changes in their sleeping patterns. Do take note that these are just a few symptoms but important ones to look out for.
UNICEF encourages frequent story times with them to help them understand what is happening in the world in regards to the pandemic.
1Twenty80: How can parents or caregivers manage children at home during these tough times?
Dr. Fabian: Here are some ways parents or caregivers can manage their children at home:
- Constantly communicate with your child calmly, accurately, and depending on their level of maturity to speak to them about the current pandemic and allay their fears.
- Practice good hand hygiene and social distancing, mirror it to them so that they can see.
- Children are like sponges, they are constantly watching, absorbing and learning everything from you. So, be a good example to them on things like social distance, wearing masks and more.
- Apart from that, children with special needs care such as autistic often rely on routines. However, since their usual routine has been disrupted due to the pandemic, parents or caregivers need to help them out by creating a new routine for them, but do take note that having a new routine all of a sudden isn’t going to be easy on them, so do engage slowly.
UNICEF encourages frequent story times with them to help them understand what is happening in the world in regards to the pandemic. As a parent, give them time to process this information, it might require repetition and/or numerous stories. So, make sure that you take time to ground yourself, practice deep breathing frequently and reward them and yourself too!
On top of that, since most schools are currently having online classes, parents will need to find ways to help supervise their children as well as safely monitor their online activities and teach them how to use the internet safely. If you have adolescents, engaging them with housework activities and educating them about social responsibilities would be beneficial as mentioned by the World Health Organization (WHO, 2020).
1Twenty80: Apart from that, how does school closure impact children on their mental health and well-being?
Dr. Fabian: A study by Lee, found that 91 percent of the world’s student population has been negatively impacted by the pandemic. For children, the ability to engage, play, experience, learn and have routines, are important for their academic and creative mind. However, lockdowns have significantly reduced their ability to socialise, play and grow which further leads to a lack of stimulation.
In other words, it negatively impacts their ability to achieve their developmental milestones that could be detrimental for children.
A developmental psychologist by the name of Erik Erikson found that a person’s personality develops through completing eight psychosocial stages starting from infancy to adulthood. Taking roughly the ages of 5 to 18, virtues of competency and fidelity could be potentially negatively affected. What does this mean? It means that there is a potential loss of self-esteem, confidence and knowing who you are, your role in society. This is a potentially long-term negative effect on children’s overall psychological well-being and the blossoming of their personality.
Another aspect to consider is the way prolonged lockdowns affect families and their daily wages. Families that have experienced loss of income have an increase in anxiety, frustration and agitation. These feelings could be unfortunately displaced upon their children, increasing domestic risk of violence and abuse.
Finally, for children in the underprivileged groups, they might not have access to devices such as laptops, and/or sufficient internet speed to continue their online education, socializing. They are significantly disadvantaged resulting in reduced academic and creative stimulation, and increased risk of delinquent behavior.
1Twenty80: Are there any differences in terms of children’s patterns of screen use, physical activity, and sleep routine before and during the lockdown?
Dr. Fabian: Well, the Malaysian Communications and Multimedia Commission (MCMC) released their Internet User Survey 2020, which was carried out during the pandemic. They found that 88.7 percent of the population was on the internet in 2020, with children in the age group of 5-17 having a 155 percent increase since 2016. In 2016 it was 18.4 percent, 2020 it was 47 percent.
For physical activities, the lockdown strictly equates to confinement at home and a reduction in activities that children are commonly associated with such as outdoor activities with family and friends. Closure of schools also means there is an absence of physical education classes. Even before the pandemic, the National Health and Morbidity Survey 2019 found that among school going children, 39 percent of them were found to be physically inactive.
On the other hand, the lockdown has also caused some changes in children’s sleeping patterns.
They tend to sleep past their bedtime which results in waking up closer to the afternoon. Such a change of routine mixed together with having to be kept indoors and decrement in physical activity can lead to deterioration in both physical and mental health if experienced over prolonged periods of time.
Parents should constantly be alert of any signs or symptoms that may show their children are struggling or their mental health has been affected.
1Twenty80: Are there any particular methods that parents can use to help their children cope better?
Dr. Fabian: Good question! The most important thing parents can do is to be a good role model to their children. Children are like sponges and they learn everything from people around them, especially parents. So, practice good hand-washing hygiene and social distancing.
Apart from that, be calm, listen to what your child is saying and only then provide your response and they will learn this habit too. Offer reassurances and explain to them about Covid-19 following their maturity level. Give them structured routines and make sure you, as the parent, practice these routines too. To add on, there are a few other things you can do, such as:
- Demonstrate to them about focusing on the positive.
- Practice gratitude (which also has a lot of physical and mental health advantages).
- Teach them how to do deep breathing.
Additionally, it would be good to have time outs from electronic devices and spend time just talking to one another or have some family activities such as play board games.
Parents should constantly be alert of any signs or symptoms that may show their children are struggling or their mental health has been affected. Some of the signs and symptoms may include:
- Agitation.
- Bedwetting.
- Withdrawals.
- Poor concentration.
- Sucking of the thumb.
- Changes in their appetite.
- Delinquent behavior mostly among older children.
1Twenty80: Lastly, could you share a piece of advice for parents who are struggling to help their children feel better, emotionally and mentally?
Dr. Fabian: If you are struggling, we hear you and we want to help. All government and private hospitals have a pediatric/psychiatric unit that can provide you with professional assistance. However, if they’re unable to help you according to your issues, rest assured they can refer you to the closest one that you need. Additionally, do not be held back by the term Psychiatric services nor Psychological Medicine services as you only stand to positively gain help and support that can improve your quality of life.
Furthermore, you can always call the Ministry of Health Malaysia (MOH) Psychosocial healthline on 03-29359935, or other services such as Befrienders that have their respective phone numbers according to their location.
Remember to reach out, everyone in the family plays an important role. Take care and stay safe.
