Lehigh Valley Health Network conducted an educational webinar Aug. 18 titled “Because They’re Kids: Back to School Safety - Resiliency and Kids,” the first of its two-part “Back to School” virtual information series providing tips and advice for children going back to class.

To begin, Thespina Godshalk, clinical director of School-Based Behavioral Health, discussed emotional health and resiliency, defined as children being able to successfully adapt to change without taking on significant amounts of stress, going into the school year.

“We know that going back to in-person school has been anxiety producing for a lot of our kids, so what do we do for them to preserve their emotional health and bolster their resiliency?” she said.

Godshalk said there are four major components to building this emotional resiliency, beginning with acknowledging the emotional impact of a pandemic “that has been ever-changing and constantly stressful.” She said it is important to understand that “things are not perfect right now,” that one must make the best of the current situation and that it is important for parents to acknowledge and model this mindset for their children.

She also said adults should be aware of, and acknowledge, children’s emotional distress, as well as any effects from the past year like grief or loss issues. Godshalk said these could be brought on not only by death, but also by “loss of normalcy, loss of milestones, loss of socialization.”

The second major component Godshalk talked about was setting children up for success, which starts with understanding “what is and is not in our control,” and taking steps to “make ourselves feel the most comfortable in situations that could inevitably be stressful.” Godshalk said steps could include practicing basic self-care and health, taking advantage of preventive measures, such as masking, hand-washing and social distancing, to assuage fears about COVID-19 and preparing for stressful situations.

She said developing a “safety plan” to provide children with go-to skills to use in a moment of crisis can be very useful. Such a plan could include establishing coping strategies or behaviors, utilizing calming corners, asking for help from trusted adults, breaking down big tasks and giving extra time for work or extra timeouts.

“What we don’t want is for you to be struggling emotionally and silently,” she said.

Third, Godshalk said, it is important for children to maintain connections and keep lines of communication open. She said parents should have emotional check-ins with their child by asking them open-ended questions like “what is one good thing about your day” or “what is one thing you had trouble with today.”

Godshalk also said it is important for parents to pay attention to their child’s verbal and nonverbal responses and feedback and to also instill a sense of hope in their children by letting them know that “things won’t always be this stressful.”

Fourth, Godshalk said, it can be useful to involve supporting services or individuals when needed to better a child’s emotional health and said this is a “communal, multidisciplinary approach.” She said these services can include physicians, teachers and other school personnel, counselors, behavioral health support services, as well as trusted adults like a coach or activity leader.

The next speaker was pediatric specialist Dr. Sanjeev Vasishtha, who opened by acknowledging that parents have become “free teachers” over the past year and that “we need to recognize that these kids are hurting.” Vasishtha said, in his practice, he always tries to ask children, “what is one good thing that happened to you last week,” in order to “get them into the habit of recognizing a positive trigger.”

“We know and we recognize that they are stressed out, so we try to make them think of one thing that made them happy,” he said. “What’s good in your life today, what can you be grateful for, what’s gone well?”

Vasishtha noted that as physicians, he and others monitor children during checkups for anxiety, depression, mental health issues or other stressors and spoke about ways he engages with his younger patients. He said even pre-COVID, he asked children to make a “gratitude journal” and document one positive experience each day, and Vasishtha said studies showed that happiness levels increase - and anxiety decreases - after using the journal for a month or two.

Additionally, Vasishtha explained he asks children if they have found their passion yet in life, which encourages them to open up.

“What’s the passion in life? What have you found that you want to do for the rest of your life? It’s just amazing how easily they open up and they want to talk about all their dreams and their hopes and their fears,” he said.

Vasishtha also made note of some positives that have emerged over the past year, namely telehealth services, which he said has made it easier to connect with patients in their homes, while easing families’ concerns about possible COVID-19 exposure. He also said telehealth has opened the door to allow teenagers to contact physicians and speak privately about their experiences.

“That opened a whole new way for physicians to solve problems and make an effort,” he said.

Furthermore, Vasishtha said another way of reducing children’s anxiety and nervousness is by practicing mindfulness exercises, particularly with their families, and also encouraged children to mask up and get vaccinated when eligible.

“That’s a fantastic, scientifically proven thing that can prevent them from getting sick, so why not do it?” he said.

Lastly, Vasishtha reminded parents to remember that “you are their (children’s) mentors, you are their support system. Always, whatever they go through, make sure you end the conversation with, ‘No matter what, you will be fine. You will be OK. I’m here for you.’

“Just that kind of repeated reassurance is really helpful to them,” he added.

Dr. Hatim Omar, a specialist in adolescent medicine, then spoke about emotional health and resiliency in teenagers.

“Generally, teen years are the most difficult in anybody’s life; it is the bridge between childhood and adulthood, and it has to achieve specific goals for these kids to get to their adulthood and be productive adults,” he said.

Omar said a common misconception among adults is that teens today “are different than teens 50 years ago or 100 years ago; the fact is teens are exactly the same today like they were 3,000 years ago.” He said while teenagers have not changed, their surrounding environment has, adding that, in the past, teenagers had more family connections and cohesiveness.

For example, Omar said, in his practice, he asks teenagers when the last time was they had a family meal and noted 10 to 20 years ago, teens would say, “yesterday or a week ago.”

“Now the vast majority of teens look at me like I’m from Mars or something. ‘What does family meal mean?’ they’d ask. Families are not getting together. They are not doing something together,” he said.

Omar said research shows that teens, regardless of background, will do fine if they have three basic things: a trusted adult, a safe place to interact with that adult and something useful to do. He said teens who have these three components will be less likely to turn to negative behaviors and will have a greater likelihood of succeeding as a productive member of society.

“We cannot build the future for our teens, but we can build our teens for the future,” Omar said, quoting former president Franklin D. Roosevelt.

He went on to speak about how preparing teenagers to be able to adjust to their surroundings is challenging under “normal times,” adding that in “not-normal times” of war, disasters or COVID-19, “all of a sudden that 13-year-old who is just starting to experience what peer group means, what is fun and what is not fun, (then) all of a sudden, we tell them ‘you can’t get out, you’re stuck at home.’

“They’re missing their friends and their activities, practically their entire lives have changed overnight, and they’re missing out. Every month that goes away, that’s one month that they would have used to develop their brain to continue to grow,” he added.

As a result, Omar said it was no surprise physicians working with teens are seeing an increase in anxiety, depression, sleep and eating disorders, suicide rates, Internet addiction and other conditions exacerbated by lockdowns and the pandemic. He also said, as teens go back to school, he expects to see an increase in anxiety and issues with restoring pre-existing relationships and said parents need to “assure their teenagers that it’s OK to be stressed out. There’s nothing wrong in feeling stressed out because it’s a legitimate feeling.” Omar encouraged parents to speak to teens, though he noted that a common error parents make is trying to be too formal when speaking.

“Just don’t make it formal,” he advised and said the most effective way to talk to teens is while doing something else, such as cooking a meal or taking a drive.

“Let them tell you what they feel. Give them a chance, don’t interrupt them (and) let them talk about all that,” Omar said.

Additionally, Omar said society has “lost some of our controls” particularly around Internet usage, noting that pre-pandemic parents may have limited children’s Internet use, but “now they’re on the Internet 18 or 19 hours (and) not sleeping at all.” Omar said many websites talking about health issues and stress “are not scientific places, so I’m seeing massive amounts of misinformation out there,” and he encouraged families to seek out reliable, accurate information and begin regulating the amount of online time once again.

Most importantly, Omar said, “We need to make the teen part of the solution, not a problem. Make the teen part of your decisions. Don’t just say, ‘here’s how we’re going to do things.’ Let the teen share what they want to do.”

He also explained the easiest way of doing so is telling teens “how much we love them, how much we care about them, that we as adults make mistakes as well, and it’s OK to be wrong.”

Following the presentations, a question-and-answer session was held with the three speakers, along with Dr. Nathan Hagstrom, chair of the department of pediatrics, answering audience questions.

Questions included advice on assuaging a student’s concern about being confronted while wearing a mask in school, the most effective mask types and fits for children, how to get in-school professional, mental or behavioral support to students, preventing mask contamination, keeping children encouraged and in good mental health and more.

The full webinar and follow-up questions are available to view at lvhn.org/because-theyre-kids.