Dr. Chirban Releases Research with Dr. Phil  on Effects of COVID-19 for Children 

Dr. Chirban's Discussion with Dr. Phil on the Results of their Survey and suggested Interventions 

This survey was designed to understand the impact of the shutdown of COVID-19 for children and adolescents as reported by parents.  Parents revealed significant changes in the behaviors and lives of their children in response to COVID-19.

QUESTIONS

Survey Question: Are children experiencing more boredom during COVID-19?

Dr. Chirban:   “Almost 80% of children were described with boredom resulting from the COVID restrictions, loss of activities, and schedules, which established breeding grounds for numerous problems—from depression to substance use.”

Survey Question: Are children experiencing more anxiety during COVID-19?

Dr. Chirban:  MORE THAN 50% report more “worried, anxious, sad.”

 

Survey Question: Are children experiencing negative physiological effects as a result of quarantine?

Dr. Phil:  “Some aren’t sleeping as well, 45.2 Q/M, and more disrupted and not surprisingly and very possibly linked 52.7% reported to be experiencing Q/M more difficulty concentrating. I’m not implying cause and effect or even correlation but when we see 55.83% and 54.23% Q/M more anxious and worried respectively.” 

 

Dr. Phil: 68.02% reported Q/M more loneliness with and sad (52.1%).

55.1% reported their children Q/M more argumentative and 55.3% reported them Q/M more irritable. These reactions tend to coincide with increased frustration.

“Both overeating and undereating, as well as excessive and inadequate sleep correlate with anxiety and depression.  Parents identify overeating rather than their children presenting difficulty with appetite, which may result from the greater accessibility of food during the shutdown.  Sleep affects cognitive functioning and brain development in children, and emotional regulation have been corelated with behavioral problems resulting from inadequate sleep.  During COVID, wake and sleep schedules have been dysregulated for children, as parents often don’t feel the necessity for maintaining ‘regular schedules.’”

Survey Question: Are children engaging in more relational conflict with friends and family during COVID-19?

Dr. Chirban:  The study identified argumentativeness, crying, anger, and irritability consistent with the significant increase of distress reported by parents concerning their children.  The levels of difficulty reported attest to the inability in home settings to counter the distress and discomfort in the face of the protracted isolation of COVID and resonate with the other reported sleep and emotional symptoms reported in this study.

 

Dr. Phil:  These finding may also pre-date the family/psych-social conditions in which we find ourselves during this quarantine.  We must account for possible increased stress levels with parents in pre/post quarantine in comparison of interactions with children.  Parents are under tremendous pressure that changes them. Financial ruin looming ahead, pressure of teaching for which they are not trained or equipped, too much togetherness, fear of the unknown, fear of parents and grandparents getting infected, etc.”

 

Dr. Phil:  “When these findings are considered as a cluster: Boredom, argumentativeness, irritability, loneliness what comes to mind is that these kids want to “bail” from this situation! And I bet the parents do, too.”

 

Survey Question: Are children experiencing negative consequences [academic, relational, etc.] from remote-learning during quarantine?

Dr. Chirban: “While schools have offered children directives to work at home, frequently there are limited resources for helping children to assimilate material.  Parents are not trained teachers and often unable to provide academic support for their children, particularly with children requiring special needs support.”

 

Dr. Phil: “Taken as a whole I conclude PARENTS do not think this is working for their children.

Many school districts nationwide are likely to continue the ‘remote learning’ model in the fall for some if not all of the grades.

 

Dr. Chirban: “While many schools have determined cancellation of classes or very minimal instructional alternatives, health experts have weighed in strongly about kids returning to school and the serious repercussions of continued interruption of class schedules.  While there may be situations where children should not attend classes (as the CDC has outlined), educators and school programs have a responsibility to prepare substantive academic alternatives for more rigorous instructional programming at home, through long-distance learning, and with appropriate testing.  Continuing an extended recess for students and teachers does not seem responsible, as the long-term costs of such actions have not been considered.  The CDC and most doctors agree that it is a health danger for children not to return to school.”

 

Dr. Chirban: “Continuing an extended recess for students and teachers does not seem responsible, as the long-term costs of such actions have not been considered.”

 

Dr. Phil: “A DCFS official confided in me that referrals for all kinds of child abuse are way down, in some cases as much as 80%. The belief is so many mandated reporters do not have eyes on these children at school to observe physical or psychological evidence of abuse and the children have no one to report the abuse.  This is VERY CONCERNING. Our respondents did not self-report on child abuse.”

 

Dr. Phil: “I fear developmental delays in social areas from lack of interaction. Problems with self-worth, self-image, and confidence.”

Dr. Chirban:  “The lack of structure and engagement accounts for difficulty in providing direction and focus for concentration.  The absence of structured activity, inherent in academic programing, both disengages concentration and raises concerns about deficient habits and discipline required for study, academic growth, and future academic performance.”

 

Dr. Phil:  Additionally, kids are expected to learn in an environment that WAS their “soft place to fall” their safe haven, their home. Parents are the “task masters”. So environmentally, relationally, and expectation-wise there are problems. What I have found is that it is not what happens that upsets people, it is violating what they expect to happen that upsets people.

Dr. Chirban: “The limited access to friends is an added distress for children.  Although texting and phone exchange remains a possibility for many, this is less accessible for smaller children and certainly physical contact is greatly reduced. Particularly when children become older their social engagements beyond the family expands, and COVID disables access to their chosen groups.” 

INTERVENTIONS 

Communications

General communication dysfunctions—many parents and children do not really communicate effectively—characterized as “Ships passing in night.” Outside of logistical exchanges, “Did you get your lunch?’  “Did you sleep well last night?” minimal telegraphic exchanges: “I’m home.”  I’m going to my room.”  “I’m all right.”  There is a need for development of improving bonding experiences, and, paradoxically, COVID creates an opportunity for parents to deepen bonds over the extent of such connections previously:

  1. Improving communications—read about how to communicate.  Many teens indicate that they cannot speak with their parents. Making family time, separate from watching a show together to confront connections can be invaluable for the moment and long term.

  2. Share worlds (If son is interested in marijuana and parent finds this inappropriate or unacceptable, engage in “educational” exchange where both share in each other’s evidence, e.g., YouTube, podcasts.

  3. Share preferred music and discuss, invite discussions, and be led by each other and affirm interests of other.

  1. Communication concerns within families may invoke a total wake-up call over restricted family dynamics.  In order to engage investment of family members, skills of effective communication-- listening and responding need to be employed so that there is investment and power in unified family dynamics.  This may address basic rituals of eating, playing, and communicating as a unit that have dwindled or need construction.

 

Self-Care

Everyone’s needs to identify a doable self-care routine.   Routines require restructuring during COVID: helping each other with schedules, exercising together, reading, group engagement, meditation, music, etc. 

  • Educational Needs

Need for responsible and monitored school engagements.  Academic closings have enormous impact on family functions, but more fundamentally on well-being of preparation for children academically going forward, as well as physical and emotional development.  Families can brainstorm and actively consider plans to replace the void of school absences (e.g., family discussions of topics following reading on issues, structured academic programs through the internet).

  • COVID AS A PHYSICAL, EMOTIONAL, AND SPIRITUAL MATTER—During the COVID crisis imminent death and intensive care interventions have taken center stage (while untreated physical illness related to postponing medical evaluations and treatment for cancer and other catastrophic illness have been placed on the backburner.  Elevated and untreated depression, anxiety, and other mental disorders have also been sidelined). Particularly striking elements from our Parent’s Study are findings to other studies.  

  • “POSITIVE IMPACT” OF QUARANTINE    

    • New situation permits call to action for assessing and resetting family function:

    • --What can we do to live better—larger identity questions of our purpose and fulfillment as a body, what do we like and not like—how can we change unpleasant dynamics?  Let’s experiment.

    • --Need for self-examination:  what could be better, what is realistic for a systematic improvement:  e.g., assessing ruptures, generating means to improve, engaging a therapist (third party) to demonstrate seriousness and commitment.

 

When medical and emotional symptoms related to and resulting from COVID have been highlighted, attention to spiritual matters requires more direct attention as an invaluable resource and antidote to both psychological and medical concerns.  The shutdown of COVID results in the opportunity for reflection on basic identity questions of who am I, what am I, and where am I going—existential matters that are often unattended and ignored in modern culture.  While attention to such basic identity concerns may be supplanted by political or social engagement, political agendas, these may not provide   sustaining meaning and fulfillment.  COVID has stopped routine, patterns, and agendas, inviting reexamination and potential wrestling to reawaken these basic human drives and needs to define self, direction, and purpose that both addresses medical and psychological problems and speaks to essential needs to reclaim identity.  In this way, COVID may provide an opportunity for the individual and family to address our basic search and discovery of our true self.”

 

 

 

Dr. Phil:  “I don’t disagree with any of the above but I fear it is too abstract for the average parent. I find folks need “Verbs” in the sentences of instructions as opposed to philosophical musings. When it is a Tuesday night and they are tired and frustrated and their child or teen is stonewalling them or worse yet being in your face rebellious, heightened awareness of the need to share worlds is not always impactful although almost always correct.

I think if we get this granular this is going to be a very looooong article and needs to include specific “To Do” list in terms of “Ice Breakers” and ways to engage the child or teen without making them feel conspicuous or judged.

Role play scripts showing empathy and interest vs judgment and condemnation come to mind.

Shared problem solving “let’s work this out where we both get what we want,” type conversations, etc. 

 

I question if we can do this justice in the space allowed or if it is a separate undertaking. Bullet point action step list are a good use of real estate.”

 

*The survey is based on a wide, representative cross-section of parents across the country.  As children’s ages were not reported, variations in some questions (e.g., substance abuse, suicide) and may relate to age-specific questions and parental response bias (e.g., disclosure of domestic abuse).

Dr. Chirban's responses to Q & A with Dr. Whyte for WebMD

1. What’s the impact on children as well as parents when schools reopen and then a few days later close? How does that impact anxiety and stress?

     

Most kids really want to get back to school.  The possibility of school closing back up would usher in a disturbing setback and induce stress—whether from the shutdown of classes or the fear of COVID-19, again, rearing its ugly head.  Of course, such a setback would induce anxiety for kids, but it would for parents as well.  Many parents work away from home even during these days of the virus.  For parents, this may also escalate distress from juggling childcare and the role of homeschooling, for which they don’t usually feel prepared, and elevate stress levels for everyone in the home. On the positive side, managing such stress invites meeting the test for developing resilience.    While no one likes to encounter resistance, difficulty, or defeat, mastering our response to uncertainty is a life-skill that neutralizes the paralyzing impact of anxiety.  Our ability to endure, retain composure, and maintain a positive disposition, in the face adversity from yet another disappointment from COVID, can provide a critical learning moment for refining maturity and developing an ultimate winning quality, and experiencing the healing gift of peace.

2. Are schools putting too much focus on the impact of infections and less of an impact on mental health?

 

Schools in the States have been “emotionally” at the forefront of attending to concerns regarding COVID-19, which is good; yet, they have appeared relatively silent regarding costs to the intellectual and emotional impact of closing schools for students.  This is not an either/or situation of mental versus physical health; mental health effects physical health and physical health effects mental health. We are whole beings.  This task requires attending to the physical and mental health consequences from school closings—which involve physical, emotional, and intellectual—as well as social and spiritual.  Studies from around the world already indicate that quarantine, home confinement, sedentary life style, and lack of constructive brain stimulation, related to COVID school closings, result in multiple detrimental emotional, physical, and learning effects that have long term consequences.  While the social impact appears evident for children and adolescents, measurable increases of anxiety, depression, in addition to an escalation of a myriad of emotional and physical illnesses, including domestic and substance abuse.  While educators, as well as all of us, need to heed healthcare authorities regarding the impact of this physical infection, most healthcare specialists advocate the importance of students returning to school because of the detrimental consequences from school closings. Most countries around the world have proceeded accordingly.  It seems imperative that if teachers are not instructing in traditional classroom formats, collaboration is required by governmental authorities with mental health professionals in conjunction with other inter-disciplinary specialists to fill the classroom void so that substantive alternatives replace the dangers that are otherwise filling this school vacancy gap.

© 2023 by Anthony Chirban

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