When I first heard pediatrician and California’s current surgeon general Dr. Nadine Burke Harris speak about Adverse Childhood Experiences, I was floored. Her TED Talk has been viewed well over 7 million times to date and for very good reason. Adverse Childhood Experiences are traumatic events that occur in childhood that are responsible for a slew of mental, physical, and social problems, and they are pervasive. Dr. Harris reports in her TED Talk that 68% of people surveyed have had at least one ACE. The higher the ACE score, the worse the health outcomes.
What about for our children? Is it possible that being in quarantine as the result of a global pandemic is leading every single child to experience an ACE? It sounds extreme and frightening, but perhaps it’s a reality we need to prepare ourselves for. Scary Mommy checked with the experts to get their take on COVID-19 and our children’s well-being.
The CDC reports that an Adverse Childhood Experience, also known as an ACE, refers to “potentially traumatic events that occur in childhood.” This includes personally experiencing or witnessing violence, experiencing abuse or neglect, or a family member attempting or dying by suicide. Within a child’s household, there might be substance abuse, mental health issues, or separation from a parent who is in prison.
Dr. Harris told Scary Mommy, “A robust body of scientific research has shown that repeated or prolonged activation of a child’s stress response, without nurturing or buffering caregiving support, can lead to long-term changes in the structure and functioning of developing brains and bodies or even the way DNA is read and transcribed. This is known as the toxic stress response.” She added that “while the measures put in place to flatten the curve of COVID-19, such as school closures, stay-at-home orders, and physical distancing, cannot be considered an ACE, we do see it as a risk factor for toxic stress.”
Dr. Sanam Hafeez, a neuropsychologist in New York City, also weighed in, telling Scary Mommy, “More research and evidence would have to be discussed in order to really say what the long-term effects will be and unfortunately, we won’t know that right away.” Essentially, time will tell.
When a child experiences an ACE, or multiple, the fallout can be major. The CDC shared, “ACEs can have lasting, negative effects on health, well-being, and opportunity,” which includes “chronic health problems, mental illness, and substance misuse.” More specifically, ACEs increase a person’s risk of injury, STIs, teen pregnancy, maternal and child health problems, involvement in sex trafficking, and many chronic illnesses such as cancer, diabetes, suicide, and heart disease.
Furthermore, toxic stress, also known as extended or prolonged stress, can “change brain development and affect such things as attention, decision-making, learning, and response to stress.” The victim may have difficulty with attachment and forming appropriate, stable relationships. Essentially, experiencing toxic stress puts the child’s entire being at risk for physical, mental, emotional, and social issues.
The CDC reported that some kids may “face further exposure to toxic stress from historical and ongoing traumas due to systemic racism or the impacts of poverty resulting from limited educational and economic opportunities.” When we consider that some crucial support systems are no longer operating as they did before the pandemic, such as schools (which provide shelter and meals), some kids may be even more at risk of experiencing an ACE while in quarantine.
Dr. Hafeez agreed that some households will experience more tension than others. She stated, “Children could also pick up on parenting conflict due to loss of a job, financial instabilities, disagreements, and health risks.” However, COVID-19 is “a destabilizing event in terms of impact on the normalcy in every household.” Children having to learn virtually and socially distancing from family and friends puts “unnecessary weight on the children.”
What can parents do now to help their children navigate quarantine? Dr. Hafeez suggests careful shielding of children under age five, especially from the news. Older kids need to learn from their parents “why social distancing is important, and the essential nature of hygiene practices as well as their responsibility to school work while at home.” Teens and young adults are most subject to the realities of the situation, much like adults. They might justifiably worry about college, end-of-year events, and time away from friends. Parents should be aware of their kids’ struggles, no matter the age, and attend to them by partnering with their children.
Regardless of their age, says Dr. Harris, kids’ brains and bodies are even more vulnerable to the harmful effects of stress than adults, and most often, they aren’t able recognize or verbalize it. Stress in our kids may also show up differently than stress shows up for us, and she urges parents to keep a close eye. An onset of stomach aches or sleep disruption may be an indicator that your child isn’t coping well and needs help.
Dr. Harris offers parents some hope. “One of the best ways to help support your child’s health and development during times of stress is creating safe, stable, and nurturing relationships and environments in which children feel safe emotionally,” she says. “This can biologically protect children’s brains and bodies from the harmful effects of stress.” Don’t underestimate the power of good health choices, including healthy nutrition, regular exercise, restful sleep, practicing mindfulness, and building social supports. Getting mental health care can help to decrease stress hormones and prevent health problems.
Parents also need to remember that taking care of themselves is critical to their family’s overall health. Dr. Hafeez warns that children of all ages can pick up on the stress of the parents. She suggests self-care and planning as a family, and if parents are struggling with the stress of the situation, they should reach out to a mental health expert. Dr. Harris recommends that parents read California Surgeon General’s Playbook: Stress Relief for Caregivers and Kids during COVID-19. She reminds us, “The most important ingredient for healthy kids is a healthy caregiver.”
Where do we go from here? Once shelter-in-place mandates are lifted, and when work and school resume, what happens? Dr. Hafeez wants parents to be cognizant that their kids may struggle. If the child is struggling with socialization, poor appetite, or showing symptoms of angst, depression, or anxiety, they need professional help. If the family has lost someone they love to COVID-19, or witnessed a very ill loved one, therapy may be in order.
It’s too soon to know the degree to which quarantine will impact children in the long run. However, parents can be proactive in taking care of their children and themselves, perhaps lessening the damage and teaching their children healthy coping mechanisms along the way.
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