How to Support Children’s Emotional, Educational Needs while Remote Learning

Back to school: Experts answer questions about mental health, socialization, screen time, special learning needs and more.

September 9, 2020 2:47 PM

Author | Beata Mostafavi

Editor's note: Information on the COVID-19 crisis is constantly changing. For the latest numbers and updates, keep checking the CDC's website. For the most up-to-date information from Michigan Medicine, visit the hospital's Coronavirus (COVID-19) webpage.

For most families, this year's first-day-of school rituals were unlike any other.

Some children re-entered school buildings with masks, socially distanced classrooms and Plexiglas dividers. Others started a new grade at kitchen tables, in basements or in bedrooms, meeting their teachers and classmates on screens.

As parents face decisions about in-person school or navigating remote learning from home, many have questions about supporting children's mental and emotional health, managing screen time, accommodating special education needs and minimizing infection risk while still giving kids important social interactions.

Experts from Michigan Medicine C.S. Mott Children's Hospital recently answered parents' top back to school questions during a live Q &A.

The panel was moderated by Mott developmental behavioral pediatrician Jenny Radesky, M.D., and also included child and adolescent psychiatrist Sheila Marcus, M.D., pediatric psychologist Melissa Cousino, Ph.D., and pediatric infectious diseases specialist Alison Tribble, M.D.

Read the answers to common back-to-school questions from these top children's health experts below.

Most parents aren't educators. How can they ensure children are getting both the educational and emotional growth they need? Should parents be considering supplements?

Mott experts point out that educators have been working hard to design novel curriculums to match the new learning environment, with more time to prepare than they had in spring when many schools were suddenly closed.

What not to do: download every new app that promises to teach your child math skills.

What you may consider: If you do want to supplement children's learning, focus on life skills and emotional learning, experts say. Help them start a gratitude journal or bake apple goods this fall and deliver them to family or neighbors, for example, Cousino suggests.

Pick activities that strengthen "emotional health and resilience as opposed to putting that stress on your family about school," she says

"Children are still learning about kindness, working together with their community, problem solving and flexibility during the pandemic – values which we know are hugely predictive of future successes," she notes.

"When parents are feeling stressed about math or reading, it's helpful to remind yourself that even during a pandemic, children are learning many new things they've never faced before and that's important."

How should I promote socialization for my child during COVID, and should I limit interaction with other kids?

Tribble says that depending on risk and situations, some families may opt to allow children to socialize with children from households who follow the same safety practices as they do. But they should minimize risk by playing outdoors and keeping a safe distance.

The more families can keep interaction within certain pods or cohorts – whether that's through neighborhoods or classes – the better. The more you expand that social bubble, the more you increase potential exposure to the virus.

Open communication with families is key, she says. For example, families may agree in advance that if someone goes on vacation or engages in a higher risk activity like going to the movie theater, they should share that information. The same goes for transparency about learning someone in their family has had known exposure to someone who tested positive for COVID-19.

In those scenarios, families may ask children to wait a couple of weeks before playing together again.

How will not being around other kids during remote school affect children socially?

Panelists say parents should think about how they can replicate social interactions in socially distant, creative ways.

Maybe you look at old pictures together to remind you of friends you haven't connected with in some time and drop off a surprise gift or card to their house, Cousino says. Or set up a Zoom or Google hang out at an intentional scheduled time.

Radesky cautions against allowing children to open new social media accounts if they're not ready simply to give them more social access. "Liking" photos and posts isn't often a meaningful two-way interaction, she says.

Marcus points out that while the pandemic limits some after school social activities, families who homeschool have always found different ways to support social interactions for their kids. And children undergoing treatment for certain conditions often spend several months out of regular school.

"Children by nature are fairly resilient. Having six months to a year of distance learning is very unlikely to fundamentally change the development trajectory," Marcus says.

She notes that some of children's most important socialization comes from their own family, siblings and parents.

"The relationship with parents frankly is what we call the secret sauce – that's what sets children up for cognitive success or success with intimate relationships," she says. "Don't discount the relationship you have with your children."

How should parents manage screen time during COVID?

With children using screens for school and social interactions, it's difficult to stick to usual screen time rules. Some parents may also be working from home while children are there and find that screens help keep children occupied during downtimes.

Radesky's biggest message: Kids may be spending more time on screens right now. Don't feel guilty about it.

Parents should worry less about the amount of screen time and focus more on the content children are engaging with, she says. Focus on positive content, such as programs offered through PBS Kids or Sesame Street for younger children. For older kids, maybe it's content that promotes mindfulness or something the family can do together, like looking up recipes or Face-timing friends or relatives. Common Sense Media is a good resource for ideas for content based on age.

Parents may also consider reducing exposure to content that may lead to aggressive or irritable behavior afterwards, such as violent video games.

When possible, encouraging hands-on activities through the day to help children learn through other experiences is also a plus.

"We know this isn't a perfect way to engage kids with their classrooms," she notes about virtual school. "We have to do what's good enough right now."

How can families of children with special needs like ADHD or learning challenges, who usually rely on special services at school, navigate the remote learning setting?

For children with individualized education plans, or IEPs, and different learning styles or processing information, remote learning and engaging through a screen may be especially challenging. This may include students with ADHD and autism.

Radesky recommends ongoing communication with the teacher and special education team and advocating for some socially distant in-person sessions if possible. Some teachers may only be able to offer 1:1 virtual meetings.

"It's always worth asking if a child can get extra support," she says.

Keeping in touch with outpatient therapists or starting new therapies to strengthen life skills learning, self-regulation, frustration tolerance and flexibility are also beneficial.

She notes that many of the families she sees have reported defiance and behavioral issues cropping up in response to remote school. Therapists can help coach parents through positive behavioral reinforcement plans that give children more control. Some families, such as those whose children have autism, have found that doubling down on outpatient therapies is valuable during this period.

When parents are feeling stressed about math or reading, it's helpful to remind yourself that even during a pandemic, children are learning many new things they've never faced before and that's important.
Melissa Cousino, Ph.D.

Also be aware of your children's surroundings and potential distractions. One child may be fine working at the kitchen table, for example, while another may need a quieter learning environment.

Marcus recommends parents consult with learning specialists and revisit IEPs. Perhaps some children with shorter attention spans need frequent breaks. They may stay on the computer for online learning for 10 or 15 minutes and then run around the backyard before returning to "school."

Some tools, such as weighted blankets or chairs that rock, may also help certain children stay engaged.

How can you keep children on-task during remote learning?

Especially for children with attention challenges like ADHD, it may be tempting to start playing a video game or engaging with another activity on their screen when they're supposed to be in class. Families should go over plans ahead of time to clearly indicate the day's schedule and differentiate between "play time on the screen" versus learning time.

As much routine and predictability children can have in their day, the better. Parents should try to involve children in setting those boundaries in advance and avoid negotiating during the day once expectations have been set.

Positive reinforcement is also key, Cousino says. Parents may be more likely to notice the off-task times, but they should also try to catch them doing what they're supposed to be doing. If they're engaging with class properly or working on math, parents may put a sticker on a post-it note on their desk or provide some other positive reinforcement to promote that behavior.

Using timers, whiteboards and planners may also help children more independently keep track of tasks and aid them in transitioning from one activity to the next through the day.

What signs should you watch for to spot depression in tweens or teens or distress in children?

Marcus notes several states of alert readiness: the green zone (calmest), yellow zone (a little more reactive) and then the orange and red zone (highest alert.) She said in general it's normal for most people to not be in the green zone right now – they may not be as well-rested and have extra stresses during the pandemic era.

But red flags that a child may need more help may include pervasive changes in appetite (i.e. suddenly eating a lot of sweets or carbs or not eating at all), significant changes in sleep (i.e. awakening frequently, being unable to sleep or significant shifts in circadian rhythm) or no longer showing interest in activities normally enjoyable to them.

Pervasive irritability or passive or active thoughts about death, such as saying "I don't want to be here anymore," may also signal a child is developing a mood problem.

For younger children or those with special needs, when the nervous system is more stressed, it may also lead to more repetitive and controlling behavior or explosive emotional outbursts or ticks. These are other signs of distress.

Marcus says parents need to "be a detective" with their children and check in regularly as more changes and adjustments come along during an uncertain year. Give children regular opportunities to express these emotions and pay attention to not only their words but actions – since kids may not always be able to articulate feelings.

Parents should also be aware of their own anxiety and how that may rub off on their children, Marcus says.

Exercise, stress management strategies, cognitive and behavioral therapy and medication may be needed to help. Telehealth has also made more services more accessible and convenient for many families.

Could masks, Plexiglas dividers, desks spaced apart and other changes potentially stress out younger children who need the social interaction for development?

For families whose children are starting the school year remotely but expect to go back in person, parents can help prepare children for their new school environment to help normalize it as much as possible.

Practicing mask wearing for long periods at home or on walks may be helpful. Talking about not touching their face, washing hands and coughing into "cough pockets" like elbows and tissues will be helpful.

"Teaching kids basic preventive measures at home and modeling it for them will help it become second nature when they get to school," Tribble says. "Those things are important for parents to teach their kids so when they go to school those behaviors are already there and teachers can reinforce it."

Talking about why the school experience will be so different is also important, Marcus says because "not talking about it is sometimes bigger than talking about it." She says children need to hear that grown-ups are doing all they can to keep them and our communities safe.

"In some ways, this continues to teach us to be flexible and resilient and to embrace new things and adapt," says Tribble whose children recently returned to face-to-face school. "I tell my kids it's going to different, but we're going to figure it out. We're going do these things because we want to learn in person and see friends."

What advice do you have for families nervous about children re-entering face-to-face school?

After months of having children home and quarantined, it can be normal to feel uneasiness about a return to a new "normal" where they leave home without parents.

"The definition of safe is going to be different for every family and every situation," Tribble says. "It's really about assessing the risks and benefits of the given situation and making a decision that's the right fit for each family."

Parents should communicate with schools about what risk mitigation measures they're implementing, such as mask wearing, putting students in cohorts, rearranging classrooms for social distancing, using the outdoors for classes when feasible and enhancing sanitization practices.

"These are all great ways of lowering the risk of the virus spreading," Tribble says. "None of them is perfect by itself, but each one adds a layer of protection."

She highlights that risk mitigation measures are primarily in place for children with no symptoms, which studies indicate make up an average of 0.6% (or less than 1 in 100 kids.) She notes that this year in particular it's very important that parents keep kids home when they have symptoms that could be due to COVID-19 to help make in-person school successful. Families should call their pediatrician for advice on testing if their children develop symptoms and consult with their school on advice or policies about exclusion.

While children comprise 22% of the U.S. population, recent data show that 7.3% of all cases of COVID-19 were among children and less than 0.1% of COVID-19 deaths were among kids, according to the Centers for Disease Control.

A small number of children (up to about 600) have also experienced a potentially fatal, but it is usually a treatable, COVID-19 related disease called multi-system inflammatory syndrome (MIS-C.