Tips for families during the stay at home order

Emergency measures, such as requiring that children remain at home are critical methods to limit the spread of infection from the coronavirus (COVID-19) outbreak. Despite the positive public health benefits of COVID-19 quarantine, for an individual child, being homebound can serve as an opportunity to spend time with family, but also can result in insufficient physical activity, irregular sleep patterns, weight gain, and decreased fitness. As many parents know, boredom and frustration are common during time required to be home and inside. The lifestyle changes may also contribute to social isolation from peers and teachers, anxiety, and tension among family members due to a lack of personal space at home. Importantly, public fear about COVID-19 that stigmatizes and scapegoats specific populations can further increase a child’s and family’s sense of isolation. Clinicians and parents can consider the following approaches to better manage homebound periods for children and families – provided by The Center for the Study of Traumatic Stress (CSTS)

Support the Family Structure
Families can develop plans of action together. When appropriate, include children in the family planning and preventive behaviors to help support their sense of agency and control.

• Plan physical activities that can be done while homebound
• Maintain a healthy diet, good sleeping habits, and proper hygiene practices (e.g., regularly washing hands, covering mouths when coughing and sneezing, avoiding contact with face).
• Maintain routines related to bedtimes, meals, and exercise.
• Ensure basic supplies (e.g., food, water, soap, first aid provisions) and medications are readily available while homebound.
• Encourage children’s participation in household chores to facilitate their sense of accomplishment.
• Plan enjoyable family activities, such as games, movies, and exercise.
• Maintain a positive mood.
• Practice patience and tolerance, which can be difficult during this time and model healthy habits for the entire household.
• Engage in relaxation techniques to reduce stress.
• Avoid increased use of alcohol or tobacco.
• If a usual family activity, consider attending religious services online.

Communicate Openly
During times of uncertainty, open communication is critical to helping children feel safe and secure.

• Stay informed.
• Explain COVID-19 and the purpose of being homebound in an age-appropriate and positive manner to children. Parents must gauge what their children can understand.
• Create an environment where children feel comfortable expressing their concerns and asking questions.
• Remind children that being homebound is temporary.
• Promote children’s sense of goodness, or “altruism”, by explaining that being homebound helps to keep other members of their community safe.
• Reassure children they will receive appropriate medical care if they become ill.
• Check in with children frequently to address newly emerging fears and misconceptions.
• Limit and closely monitor children’s use of media to reduce potential confusion, worry, and fear.
• Address misconceptions regarding stigma. For example, avoid terms other than “coronavirus,” such as “Chinese virus,” as these increase stigma and perpetuate misconceptions about the disease.
• Clarify what is known and what is unknown to prevent the spread of misinformation.

Connect to Helpful Support
During periods of physical isolation, connect to important sources of social support to help alleviate stress. Families may also benefit from services provided by local community organizations and mental health professionals.

• Develop plans for maintaining children’s connections to friends and other family members via phone and/or internet.
• Ensure your child’s medical team is involved to help monitor any pre-existing conditions.
• Utilize available homeschool or distance learning opportunities that combine the educational needs of children with their physical and mental health needs.
• Contact a mental health professional if you notice signs of anxiety and depression in children including changes in appetite, sleep disruptions, aggression, irritability, and fears of being alone or withdrawn.