Hello friends,

Just as I finished up writing how to reset summer, emails, DM’s and posts are flooding every inbox with a cry for help around how to answer the question – What about school this fall?  Some of you have to make decisions within weeks while others have a month or so. Regardless, the decisions surrounding school are complex and multi-layered. Add to that a lack of leadership around next steps and messaging that vacillates between terrifying and overwhelming to the point of paralyzing and one aspect becomes crystal clear: We need a way to make a thoughtful decision.
 
Even as I write this, I fear excoriation. Perhaps half of you will stop following me. Maybe you’ll love me more. But one observation I’ve made is that, while there is plenty of information (and misinformation), there is a paucity of professional opinion and guidance for next steps. Fear is flooding the news and social media. Teachers and parents are terrified. So, I feel compelled to offer some thoughts and direction.
 
To that end, I’ve partnered with a colleague, Dr. Kristin Valerius. Jointly, we have over 40 years’ experience working with children and families. We are also working in collaboration with medical experts to carefully digest ways to support children and families. What follows represents two psychologists’ (and moms of 5 kids between us) humble, but thoughtful and informed opinions, about next steps for our kids this fall.
 
First, let us engage in some level-setting:

1. Avoiding risk is a privilege. As we think about return to school, deciding “whether or not” we should go back and how that might look represents privilege. When our nation shut down in March, no one asked the Safeway stockers if they wanted to return to work. No one asked physicians and nurses if it felt “safe enough” for them. We expected our mail to be delivered, our garbage to be picked up, our homes to be safe in the event of fire or robbery, and our health to be our physicians’ number one priority.

To the mamas out there working second shift as an essential worker and the first responders who go to work without a second thought, we thank you. We recognize that you had no choice but to step into the burning house.

1. Any exposure to risk might be non-negotiable for you. Perhaps you or someone you live with has a disease or health condition that puts you/them at risk. Even for those essential workers, those who fell into a vulnerable health population were often given concession. If that’s you, we get that too. In no way are we encouraging parents, family members or children to gamble with their health.

2. Policy should be proximate to the pain. I wish we were so wise, but this quote is from Dr. Jeff Duncan-Andrade, professor at SFSU. What he was encouraging educators and leaders to consider was that we most focus on what is best for the most vulnerable people and that will help lead us to the best policy. We recognize that, for some families, being away from school – the structure, safety, nourishment and resources it provides – is deleterious to children’s health. When weighing risk and needs, our most vulnerable families – those with food insecurities, homelessness, physical safety concerns and lack of adult supervision – are in most need of systemic supports and resources from our schools. It is imperative for schools to creatively consider ways to support our most vulnerable students. And it is equally imperative that if you are a family with privilege that does not consider yourself vulnerable, it is upon you to look out for those families too. They are all of our children.

Second, let’s be sure our decisions are based on scientific, researched information.

1. Get informed. Much of the delirium and angst that parents, teachers and schools are facing are coming from opinion and others’ fears; and, unfortunately, not educated scientists who specialize in the areas of mental health, school, and medicine. Two websites that we have found quite helpful and informative are:

   1. COVID Explained. https://explaincovid.org/

   2. Don’t Forget the Bubbles. https://dontforgetthebubbles.com/evidence-summary-paediatric-covid-19-literature/

   3. ACES Connection. https://www.acesconnection.com/blog/a-better-normal-education-upended-the-return-to-school-episode

1. Guided recommendations.

   1. Infection and disease burden. A review of the research shows that kids are not getting infected with COVID-19 at the same as older populations. And when they do, their symptoms are mild and often asymptomatic.

OK, perhaps that’s not reassuring b/c you’re still worried about them being asymptomatic and getting teachers and staff sick, right?

1. Transmission. Increasingly, the available research suggests that kids are less likely to spread the virus to others, as well. Across multiple countries, children have rarely been the “index case” that started a cluster of infection (even though asymptomatic adults have frequently been identified as index cases)…nor have they been the first one in a family to be infected. Several studies from schools re-opening have shown that when COVID+ children or staff attended school, the people they came in contact with did not get COVID. There is still much work to do in replicating and reviewing this research, but there is good reason to believe that protecting children and teachers from transmission is possible.  

To note – it’s not helpful that there are hundreds of IG stories and funny FB satires on teachers’ expressing worry about kindergarteners picking each others’ noses, middle schoolers swapping spit, or teenagers being buffoons regarding social distancing. The research is clear – while kids spread a lot of other diseases (the flu, for instance) they’re not spreading COVID at the same rate! So, please stop watching these and terrifying yourselves!!

1. Mortality. As well, their mortality rate is less than 2% of the entire mortality rate of “all things that children die from each year.” Read that again, because many of you are listening to news that takes a student population (let’s say 2,000 kids in a high school) and saying that 40 kids (2% of 2000) are going to die. That’s simply not true! The CDC reports 42 deaths out of the 53 million school age children in our country (a rate of .0001%). Applied to our state of 583,000 school age children we would expect less than 1 student death! Indeed, out of the 1700 pediatric cases in Oregon we have had no deaths. The likelihood that our children are going to die from COVID is less likely that many other illnesses, natural disasters, or events such as a school shooting.

We’re all terrified of losing someone we love. We are not minimizing loss and grief at all and we recognize that many of you have experienced this loss first hand. At the same time, we don’t want parents inappropriately worried about their child dying because the research simply does not indicate that as a likely outcome.
 
What is clear is that adults are transmitting the virus at high rates. Although we’re not concerned about rates of transmission b/w kids based on a literature review, we remain concerned about teachers and other adults infecting each other. We highly recommend schools have systems in place for adult behavior. For instance, precautions in teacher lounges, offices, supply rooms, libraries and other common spaces. It’s likely not a good idea for teachers to share supplies, classrooms or other physical property whenever possible.
 
Finally, now that we have had some level-setting AND we’re guided by factual information, let’s dig into what many of you are overwhelmed by – the multiple decisions regarding how school might look this fall. We recognize, that we are faced with less-than ideal options and that there is no “right” answer. There are no absolute truths; and, decisions you make will be multi-layered. What we encourage you to ponder involves decisions that are genuine to you and your family. No one else’s circumstances are quite your own – so asking friends and neighbors might be validating and help you process; but those are simply opinions. Consider the following when deciding what is best for your family:

1. Consider your relationships. We truly believe that many parent-child relationships were strained this spring. Parents limped by for 6-8 weeks of schooling with threats, fatigue, lack of information, angry conversations and crying kids. Parents felt overwhelmed in balancing work demands and home demands in addition to creating learning plans at home. No one signed up for the crisis we faced and we all did the best we could for spring school. That said, it’s our professional opinion that utilizing the same model for the 2020 school year may be detrimental to your relationship with your child. If you or your child struggled to adjust to schooling this spring consider an alternate plan. The attachment and quality of relationship you have with your children is one of their most important wellness resources!!

2. Kids mental health has and continues to suffer. In May, we saw a huge rise in depression, helplessness, suicidal behavior, anger and withdrawal. We are seeing another rise this summer as uncertainty about the future, including but not limited to, the future of school and social isolation. From early childhood to teens, we are seeing a spike in sadness, anger and isolation. We witness similar symptoms in parents. Children require consistency, structure and predictability to thrive. As well, they are meant to be social. However that might look, it is important to begin to craft a “best practice” plan so that children may realize those themes.

3. Ask a medical and/or mental expert about your unique situation. Just because your friend’s child has asthma, does not mean that your child’s asthma will present the same way or have the same outcomes in a school environment. The same is true for mental health, chronic medical conditions, learning difficulties, or special needs. Reach out to your pediatrician and/or psychologist to glean information about what is best for your unique child. That professional can help you wade through the complexities of your child and family and help you come to a decision that is best for you and your child.

4. Children are resilient. There is a lot of information out there that returning to school for children will be traumatizing. That wearing masks, asking children to socially distance themselves, or not hug/touch each other will create acute fear and trauma. As an expert on trauma and resilience – I want you to consider the following:

   1. Kids will rise up to the expectations that adults set out for them. If we explain masks, hand-washing and social distancing to them in developmentally appropriate ways, they can and will understand. If I can explain executive functioning to kindergarteners, you bet we can explain mask-wearing and “sneaky germs” in a way that doesn’t escalate fear but builds compliance.

   2. Kids are born to be resilient. Working through crises and problem solving actually creates resilient children. Kids have now gone through active shooter drills in our schools. Kids face bullying, isolation, failure and peer pressure in schools. And yet, kids show us every day that they will rise up.

   3. Resilience can be taught, modeled and improved upon.

   4. Kids regulate their emotions based on relationships with healthy adults. We tend to agree that if teachers and administrators model angst and overwhelm this fall, kids will emulate those behaviors. But if teachers model best practice, regulating behaviors and have genuine talks about fears, concerns and overwhelm, kids will mirror us. Equally, parents set the tone for whether all of this is OK. Your children need to hear the calm consistent message that “This is hard and is really a bummer, but we can adjust and deal with hard things…our flexibility and making smart choices will get us through!”

5. Create a village of homeschool collaboration. We believe it’s critically important to begin to reach out to other parents right now. Whether you’re participating in a full-time homeschool option or some type of hybrid option, this next step is imperative.

   1. Find a small group of parents with whom you can homeschool and collaborate. 3-6 families total.

   2. Make an agreement about health and safety concerns and how you might handle kids behaviors consistently.

   3. Invite them to create a “collaborative” of sorts where each parent takes a turn being in charge of a day.

   4. When it’s “your day” – you’re in charge of creating structure, support, meals & snacks, physical outlets and inspiration. Then you get to be done!

   5. A collaborative allows structure, support and predictability as well as socialization with peers – critical ingredients to success! As well, it allows parents a chance to work and have breaks – another critical ingredient.

6. Wrap in another kid. Remember what we said before? There are kids whose parents may not be in a position to offer a full day of support. Wrap another child into your collaborate. Invite their parent to participate or contribute in a meaningful way. Perhaps that parent can make healthy snacks or lunches. Maybe he/she can review papers at night or provide an outing for the kids on the weekend? Don’t lose out on an opportunity to be inclusive. It is our hope that once the cohort groups are built in your child’s classroom that parents can review their cohort and see who may need an invitation to join their collaborative on the “off-days.”

7. Use numbers. To this end, Dr. Valerius has create a decision tree that might help you in your process. This tool will drive a decision that is filled with emotion to become more quantifiable. See, anxiety loves “what ifs” and “look over here.” It cringes at observable numbers and data. So, we thought a decision tree would be quite helpful for those of you that need help weighing pros and cons.

 
Stay tuned! The decision tree is coming! We’ll post it next week. Take time digesting this information first.
 
We hope this helps you find calm within chaos. We hope that you feel direction and support. Please know we are guiding families through these decisions every day and we are making decisions for our own children as well. None of these choices do we take lightly.
 
Please do not hesitate to comment below with thoughts and questions.
 
You can always reach me at awstoeber@hotmail.com and Dr. Valerius at ksvalerius@sundstromclinic.com.  
 
In the meantime, we stand with all of you as we walk through difficult times. We cherish your children and want only the best for our children, communities and schools.
 
With humility and kindness,
Dr. Amy & guest contributor, Dr. Kristin Valerius

P.S. Join our FB group here – see you soon!

Hello friends- How are you? If you’re like me, you’re great one moment and then in tears the next, only to be followed by confusion and utter boredom. No? Just me?
 
I hope you had a chance to read last week’s blog about managing worry. If you haven’t, you can check it out here. If you’re a teacher and you’re feeling overwhelmed, be sure to check out this free resource.

We must, as adults in children’s lives, manage our own stress and worry first – dysregulated adults cannot help children regulate their own feelings – and they need us right now. It’s OK to not be OK right now; but if you’re an adult who’s suffering, please reach out for help – from me or another trusted provider. I want all of us, as adults, putting on our oxygen masks first.
 
Now, on to the children. What does stress look like in children? How does it present itself? What should we look for? And when we see it, what do we do? I’ve got you covered. Here are 5 ways stress presents in children and how to help kids manage worry.

1. Sometimes stress comes out as anger. Anger can look like mean words, eye rolling, loud voices, isolation, slamming doors, complete withdrawal and stonewalling, or refusal to engage – and all of that was just my 13-year-old this morning! But seriously, when kids don’t have a way or the experience to express more complex feelings, often anger is the go-to defense mechanism. Anger presents itself as a mask to more complicated, vulnerable feelings that usually can be identified as: SAD, WORRIED, OR CONFUSED.

2. Helplessness is another way that stress presents in children. Feeling out of control, in despair and overwhelmed are typical ways that children experience worry and stress. There is so much that they cannot control right now, which leads to a feeling of helplessness. They’ve been removed from their normal routines, their friends and many people around them are stressed too. Enter overwhelm.

3. Perhaps your kids seem completely exhausted right now… fatigue is another way that stress presents in children. My 15-year old said it best the other day. “I’m underwhelmed and overwhelmed all at the same time.” Guess what that does to your energy levels? It zaps them! Monotony, overwhelm and disconnect all lead to feelings of tiredness and fatigue.

4. Numbing out or dissociating is another way that children experience stress. This might look like playing video games non-stop, zoning out on screens, disappearing into their bedrooms, looking bleary-eyed and disconnected, seeming “meh” or disengagement with regular activities. It’s kind of like their brains have decided to go on strike because all of this is simply too much to handle. Anyone else feel this way?

5. I’m so bored!! How many of you have heard that? Boredom presents itself in whininess, clinging to us, and complaining from children. Some kids over eat, check out, wander or will complain of other feelings like lonely, tired and isolated. They really have not had a lot of chances prior to this pandemic to be THIS BORED… me neither! We typically have children so overscheduled and overstimulated that boredom rarely enters into their vernacular. Whew!

 
Now, what’s a parent to do? How do we address stress in these young people we love? Here are a few practical ways to intervene to address stress.
 
Anger – First, help your child regulate. Regulation before redirection or consequences for angry outbursts will lead you to more connection with your child. Help your child do some belly breathing or get to a calm space. Acknowledge the anger and then give him/her some other feeing words that will more readily address the more complex feelings.
 
“You seem sad right now and it’s coming out as withdrawing from your family. Do you want to talk about it?” Or, “I bet you’re confused about why all of this is going on right now. I can help you talk through some of it if you’d like.” Or,
“Sometimes anger and worry come together – I know there’s a lot on your mind right now. Can we make a list of your top 3 worries?”
 
Helplessness – Because there are so many things that feel out of control to your child, lend them some opportunities for control. Can your child choose their bed time or when they’re working on school work? Can he/she decide what’s for dinner and help you? Can your child have some control of their space – maybe some privacy or fun redecorating a space to feel cozy? Or, can you simply provide more choices throughout the day – choices that might not matter to you, but lend your child a sense of control.
 
Fatigue – Structure, predictability, and consistency – repeat. Structure, predictability, consistency – repeat. Remember, that your daily schedule, pre-pandemic, had a lot of structure to it. Try to replicate structure and predictability where you can. I’m encouraging my kids to go to bed and wake up at the same time, exercise regularly, and get dressed every day. While it might seem fun at first to take a “summer camp approach” or “vacation-mind” to this time, our kids actually thrive on consistency. As well, encouraging lots of mental breaks balanced with physical activities and embodied time – both will combat fatigue.
 
Numbing out – While some amount of this is normal, a lot is not healthy. Try to help your children recognize the difference between passive and active coping tools. Passive coping will lead us to numbing – video games/screens, sleeping, and mindlessly eating are all passive coping tools. Active coping tools such as journaling, exercising, engaging with friends, listening to music and reading will bring us back into the present and away from numbing.
 
Boredom – First, validate what’s happening. Acknowledge that our kids haven’t had this opportunity and that boredom can actually provide a lot of time for creativity and pondering. Second, help your child find purpose. Encourage him/her to sit in the feeling of “being bored” and ask questions about what he/she would like to do – hobbies, interests, cooking, etc. can all decrease boredom. You might also ask about loneliness, which is often mistaken for boredom.
 
That’s all my friends. I hope this helps you and your children address some of the overwhelm you’re facing right now.
 
Speaking of overwhelm, if you’re a teacher or love a teacher, grab this free resource on how to create mindset shifts and manage feelings of overwhelm.
 
Let’s keep learning together – I’m here for you.
 
Dr. Amy
 
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