In the past few months, globally, we have had to make some drastic changes in the way we live our lives. Even the most routine things such as working, shopping for groceries, going to school and meeting family and friends have been severely impacted. This, amongst other worries, has also created an anxiety in parents ranging from how their children will learn virtually to how their babies might react to social contact without the experience of any. 

So, I reached out to Dr. Abhishek Bala, MD. to share with us his thoughts on some of these issues.

Hello Abhishek. Thank you for the taking time out to share some insight with all our readers. Please tell us a little about yourself.

Thank you so much. I have been reading Srishti and have found the blog to be insightful and supportive to caregivers. I truly appreciate the calming and mindful approach that you take to communicate such important topics. 

As for my background, I completed my MD and Masters of Public Health and am based in Michigan where I am doing my Psychiatry Residency and Fellowship in Child and Adolescent Psychiatry. I have been part of some global mental health ventures while seeing kids and families everyday as part of my training and practice. Just trying to keep busy and stay balanced during the pandemic like we all are.

Parents and children are in uncharted territory during this pandemic. As someone who works with children everyday, what are some common concerns you are seeing?

Currently, the main theme of my conversations with patients are surrounding reopening of schools.  There are several discussions happening at the dinner table these days where plans from fulltime schooling, hybrid schooling, and home schooling are all being explored. Indeed, these are difficult conversations with various pros/cons and without a seemingly satisfactory solution. Over these past few months, kids and parents have also expressed their concerns about being cooped up at home all day. As a result, I have seen some worsening frustration tolerance in kids who have difficulties with inattention and hyperactivity. Kids who find social interactions protective in overcoming feelings of depression have also been particularly affected. We’ve had to explore other avenues for them to facilitate interpersonal communication that helps maintain a level of motivation and energy conducive to daily functioning. An interesting trend I have observed is that some children with social anxiety disorder perceived a sense of improvement early on during the isolation. However, these kids are currently finding the uncertainties of the approaching school year to be a little more stressful. These families will likely need some additional support over the upcoming weeks. 

How will social isolation impact children under 6?

Kids in this age group are at a key stage in development driven by social interactions. Attuned parents don’t just notice their child’s physical and cognitive changes, but also become aware of their child as a budding personality, who is intelligent, socially curious and even quirky. Many of us don’t notice, but an average play date or birthday party can play a major role in developing that personality. Moreover, they are such precious avenues for kids to practice their social skills, unlearn and relearn behaviors, defense mechanisms and foster a sense of independence. 

Can children ‘catch up’ if they do not experience social interactions now?

This is a novel situation and the long term impact of such social isolation in pandemics is not well studied. However, neuroscience has given us significant evidence for neuroplasticity and the high level of cognitive flexibility in this age group. 

How can children under 6 learn virtually when they need plenty of concrete experiences?

Firstly, we need to remember that these are not “normal” times. Nothing can replace the experiences kids would get from “life as usual”. This is an emergency that warrants innovative strategies to ensure continued education and learning. E- Learning exercises, interactive videos, virtual story times, online field trips are all resources that might have to be utilized. Kids can be included in a whole bunch of activities that can promote creativity and curiosity even at home. Anything from cooking, doing puzzles, arts and crafts projects, taking care of indoor plants, raising butterflies, collecting rocks at a backyard scavenger hunt can all be enriching, concrete experiences.  

How much screen time is too much? 

As with everything else, rules surrounding screen time have also changed. The idea of 2 hours a day seems far-fetched due to how vital screens have become over the past few months.  Screens are extremely useful in this day and age. On top of several resources being made available online to continue education, parents working from home have also been flexible with screen time to help balance their “work from home” routine with childcare.  However, it comes with its fair share of risk as well. In fact, of the several kids I see with sleep difficulties, the primary issue appears to be sleep hygiene secondary to excessive screen time at night. Behavioral issues are also common especially when boundaries surrounding screen time are not established. Therefore, it is important to lay out the rules and expectations before giving the child the device (Ex: “I am now giving you the phone for thirty minutes to watch cartoons” instead of “Here is the phone. Now, stop bothering me.”) Of course, we must also remind ourselves that screens do not replace human contact. 

What can parents/caregivers do to help children during these times?

It is essential for caregivers of a household to stay united in their efforts. Sharing tasks, establishing routines, expectations and boundaries are all essential. However, I think the most important things that families can do are to be mindful, play and have fun.