【Parent Webinar】Ask The Expert – How to deal with pandemic-related child behavioural problems?

April 8, 2022

The COVID-19 pandemic and associated school shutdowns have disrupted education, socialization and family life. These disruptions have caused an increase in child behavioural problems. What help exists for parents and children dealing with these issues?

In this interactive session, Ms Liu Liu, Educational Psychologist, from Sprout In Motion discusses child behavioural issues and provides practical advice to parents.

Ms Liu Liu is a nationally certified school psychologist in the US and has many years of experience working with children, their families and their teachers in an educational context.

 

Key takeaways:

→ What are the child behavioural issues you are seeing exacerbated by the pandemic?

→ How is remote learning impacting the mental health of children?

→ What are practical tips on dealing with child behavioural issues and stress levels?

 

Follow up materials:

→ Family Media plan from American Academy of Pediatrics 

→ PEERS program from Psynamo

→ Mindfulness App for parents to stay calm

→ Visual schedule

→ Changes in children and parents’ mental health: March 2020 to February 2021

 

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Transcript of the webinar

Bizibuz host

Welcome to the Bizibuz webinar on Covid-related child behavioural issues. Thank you for joining us today. I'm a Hong Kong parent of two children, and so equally concerned with today's topic. I’m also the founder of Bizibuz which is an after school activity platform for parents – we use technology to optimize parent’s selections of after school activities and completely automate the purchase and management of those activities – even the admin nightmare of reschedulings and cancellations. If you’re interested in joining our community, please follow the link pasted on the chat or follow us on social media to receive parenting tips.

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Now I'd like to welcome Ms Liu Liu, who is a nationally certified school psychologist in the US and holds a Specialist Education degree in School Psychology and a Bachelor of Psychology. She also has extensive experience working with children and their families specifically in an educational context.

Welcome Ms Liu Liu. The reality of covid parenting in Hong Kong through the past month or so has involved being confined to an apartment, scared that if you step outside you’ll inadvertently expose your children to illness, fighting for internet bandwidth to make a living and ensure your children are receiving an education. And for children, it has involved long hours in front of screens, minimal exercise and peer social contact, disruptions to a typical schedule, exposure to parental stress. It’s not surprising that this environment has been ripe for mental and behavioural problems for both parents and children.

Focusing on the impact on children for a minute – as someone that has a lot of experience in treating children at home and at school, have you seen an increase in behavioural issues recently?

Ms Liu Liu

Yes absolutely. Recently in the past year, a lot of parents have come to us with concerns about their kids’ attention spans, especially because of the increased time spent in front of screen. And the parents often describe this issue by describing how their children don't really focus much doing online school. They may be chatting, watching videos or doing something else when the class is going on. And also at home, they won’t sit down for an extended period of time to complete homework. So we have complaints from teachers about missed homework and incomplete projects and we have also some concerns from parents about emotional difficulties such as anxiety and depressed mood.

Bizibuz host

 In terms of the behavioural issues, are you saying they’re manifesting more in the form of attention and anxiety. Are you seeing any other kind of behavioural issues more recently that you haven't tended to have seen as much in the past and that you feel are directly related to the pandemic?

Ms Liu Liu

 I think the pandemic has exaggerated a lot of things that we see in pre-pandemic life but they're definitely getting more heightened, so more severe and more frequent. The attention difficulties that we see the most could be caused by a lot of underlying issues including by merely asking them to sit in front of a computer for an extended period of time. It's really challenging even for adults to just sit down in front of computer and focus for 30 minutes. So when kids have online classes that are 45 minutes to an hour in length, and we ask them to sit there and not move, this is asking a lot of them. There is a lot of research out last year and this year about the impact of the pandemic including what happens to children if they go to quarantine, if they can’t go out and don’t have social connections, and all these aspects are taking a toll.

Bizibuz host

Right.

Ms Liu Liu

So what I’ve found is an increased level of anxiety, depression, and a combination of both. And this is specifically occurring in Asia for children from the age of three to eighteen. Parents are worrying more and observing more irritability. So with irritability, I want to talk a little bit about depression because they are often connected. Anxiety is not unsurprising because there have been many abrupt changes in routines. Kids are in school one day, then the next day they are told they’re going to do online schooling. They’re participating in activities with their friends one day and then the next day they’re not. This is abruptness and a disruption to their routine. Predictability in our life has gone and that creates a lot of anxiety for kids and for adults as well. If we think about, if you go to a different place, or if you go to a job interview, there's a level of anxiety involved. A little bit anxiety is good, but too much anxiety over an extended period of time will lead to problems and impairment. So kids are more anxious and that's not surprising. But another thing with depression is when we think about depressed moods in adults, we see people being sad, they can’t get out of bed, they have really little energy, but in children depression may look a little different. When kids experience a depressed mood, what they may show is irritability. They get angry more easily, more defensive and they shoot responses back quickly to their parents.

Bizibuz host

That’s interesting. And have you noticed that certain age groups are impacted more than others? You mentioned difficulty with attention and also comfort tied to a specific schedule. Are those characteristics you notice more with the younger age group. Are you seeing adolescents for example coping a little bit better. What's your experience in terms of age?

Ms Liu Liu

I feel like all ages are being affected. They just present a little bit differently. So think about child development, One thing that we think about is their social development. So when kids are younger their main social support is their parents. If they have a problem, they go to the parents. If they have something they need, they go to their parents. But when become teenagers, they shift their social dependence to their friends. So they step away from their parents a little bit and they go more to their friends. However with the pandemic, kids are stuck at home all the time. They don't have that valuable social interaction and they don't have as much social support, so older kids are also having difficulties. And the pandemic is also impacting parents who may lose their job and have reduced income. There is a lot of stress constantly and changes to policy every day. It's hard for parents to keep up with the change too in the world. This creates stress and the kids feel it. So all ages are affected, just a little differently.

 

Bizibuz host

Are you seeing a difference along socioeconomic lines? Are you noticing for example, more behavioural issues in say, lower income families because of the smaller living space that people may be subject to or if parents are suffering more stress because they're living a little bit more hand to mouth or maybe there are more technology access challenges. What are you observing in that sense?

Ms Liu Liu

That’s a complicated question to answer and the answer depends on whether the children are already disadvantaged in terms of being in really good schools. Good schools have a lot of support available during online learning, or they have really good parental support. However for kids who are dependent on the school for their personal growth, they will get hit the hardest. When we think about school, generally it revolves around attending to get good grades but school provides additional support as well. For a child with an unstable family, school can be a refuge for family dramas. School gives them routine and gives them an opportunity to participate in different activities. It also gives some a sense of community. So if suddenly the school is closed, this disrupts these supports and the child does suffer from the effects of the pandemic more.

Bizibuz host

You would have heard the saying children are much more resilient than we give them credit for. Having lived through what you've lived through over the past few months and seeing this exacerbation that you mentioned with the pandemic - do you agree with this statement and think kids will bounce back quickly if things normalize or do you think that parents should not gloss over the consequences of the pandemic. What’s your perspective here?

Ms Liu Liu

It's unknowable unfortunately at this stage. I think children in many ways are resilient. If children have been in their rooms for three weeks in a row, I’m not too concerned. But this is a fine line for parents themselves to discern about their child. They must find their own balance of managing nerves about every change versus being overprotective. One aspect that gets impacted is social interaction because online activity simply can’t replace the complexity of offline interaction. For example, if I'm here on screen talking to you and you're not interested in what I'm saying so you look somewhere else, I can’t tell if it's, because you're not interested or someone has walked around in the background and distracted you. You lose a lot of this communication nuance online which means there may be reduced social support as well.

There is some research in Europe of prosocial behaviour which looks at how young people direct their need for help towards their families or friends. What they’ve found is that for teenagers aged 15 to 17 years old, they actually start to offer a lot more support to their peers to the point of checking on them online and making positive comments. For the age group of 18 to 25 years old, they swing back to have more social experience towards their families. The summary from this study is that yes there are a lot of difficulties created by the pandemic but our children adapt. They develop new skills to cope but at the same time we are all experiencing stress and they have more emotional challenges. What I would say is that parents should be hopeful because our kids can adapt but also be cautious because they tend to have more difficulties during this time.

Bizibuz host

You’ve mentioned a range of different behaviours that you've seen more of and that are a concern, such as inattention, irritability, anxiety, depression etc. Are there particular behaviours that you find more concerning and that parents should more quickly escalate? For example, increased aggression versus the more frequent poor attention span? Are there certain behaviours parents should be watchful for that may require earlier intervention with the assistance of professional help?

Ms Liu Liu

Yes increased aggression we don’t see much of in my personal experience unless the child had aggressive behaviours pre-pandemic which are more prevalent among kids with language difficulties that cause a lot of stress. If a child can’t express how they feel or think, then the easiest path for them is to act out. One way as a parent you can help your child is to give your child the language they're looking for. So if your child has a hard time describing how they're feeling you could say “you look like you're really angry and are getting agitated”. By doing this you are giving them that vocabulary and they can express themself a little bit better which should help with aggression. But sometimes children get really big and can injure the parents when they get physically aggressive and that's a stage that requires help because you need to protect yourself and protect your child.

Now I want to combine online aspects and child development together. A parent would have observed many changes in their child during the pandemic. When a child enters puberty and teenage years, you will see they have a shorter temper. Their emotional state is quite heightened. So maybe one day they’re discussing something with their friends and they have a disagreement and it ends with the comment “I'll never ever talk to you again”. Things gets escalated very quickly. Also a child’s brain is still developing. Their prefrontal cortex area that helps them make their decisions, filter what they're thinking, and understand consequences, is still developing. So they may make really impulsive decisions and may demonstrate some risk-taking behaviours. Parents are really terrified that they might try alcohol with their friends. You might think “Oh, my child is really good. They have always behaved. I can’t imagine why they would do something so outrageous”. However their brain hasn’t full developed yet so they make rash decisions and also because their friendship group is shifting slowly from parents to friends, parents may feel as though their child is withdrawn from family interactions. All of this can be normal but it can also be a sign of difficulty that requires assistance so my rule of thumb is whether parents feel that the child’s changes are impacting his or her school performance and impacting their daily life. For example, it is easy for everybody to get sad once a while, but a parent may become concerned that their child is in the bedroom laying on the floor for three days and not getting out. Also if my child is not sharing as much with me about his or her life, but is spending a lot of time sharing her stories with her friends. I wouldn't be as concerned compared to a scenario of my child shutting out everyone. My rule is it all depends on whether the behaviours are impacting their daily functioning. If there's a significant disruption then that is the point to ask for help.

Bizibuz host

In your view, do you think there is one cause above others that may be contributing the most to these behavioural issues. Is it the disruption to the day-to-day schedule? Every few weeks when we go from remote learning to in-person learning and then back to remote learning. Or is it too much screen time? Is it parental stress? What do you think is the biggest contributor?

Ms Liu Liu

I feel like all of them are contributing. A lack of a routine is a big thing because without that stable routine, kids don't know what is going to happen and that creates a source of anxiety. We worry if we don't know what is going to happen. Too much screen time is also contributing. If a child spends all her free time on her iPad or computer and her parents don't know what she's doing, then the social connection with the parents has been lost. Children are using their screens for different purposes but the reality is that is unavoidable. More children have started to play games because of the pandemic. Last year globally, 70% of youth played computer games. So if your child is playing computer games, they are just one among many. And also, in the past we tended to think that all boys like to play games and girls don’t do that but the ratio has now shifted to around 50/50. So your daughter is just as likely to play online games as your son. And there are different motivations for that. Some play games because they are experiencing too much stress in their surroundings. They don't know what to do. The only way they know to cope is to play games and as a source of escape for them. Some kids are very extroverted and enjoy social bonding since they get their energy from there. They probably play games to get that social interaction. Other kids are just really high achievers. They really like that game. They want to get to a certain level and achieve that reward so they play for an extended period of time. If we know why children are playing games, we can teach them other ways to achieve the outcome they’re seeking and replace the computer games.

Bizibuz host

Before we run out of time, the big question is what can parents do to cushion the negative impact that the pandemic may be having on their child's emotional well-being? What pragmatic advice can you offer to parents.

Ms Liu Liu

That's an awesome question because parental support is one of the biggest protective factors to prevent a child from developing severe mental health difficulties. The first thing is to keep an open communication channel with your child, so that they know when they have some difficulty and when they're experiencing stress, you are available to talk to them. I hear parents say “but my children are teenagers and they don’t talk to me” but everyone wants connections or needs some positive experience of connection. And children often tell me they don't want to share this with parents because they don’t want to burden them as they are already very stressed. At other times, children feel like parents don’t understand them. So I would recommend to take just 10 or 15 minutes a day to sit down and talk to your kids. Let them talk to you about whatever they want. And as a parent you are probably really very eager to give advice when they come to you with problems. In order to create a positive experience, just let your child talk to you and listen to what they have to say and how they feel. If you emphasize words that they’ve said to you, they know you have heard them and then they will come to their own conclusion. When they need help, they will come to ask you for help.

And another thing, if you're looking for ways to help your child with technology use and screen time, you can go to healthychildren.org. That's a website developed by the America Academy of Paediatrics. They have a family media plan and you can look through the plan with your child to establish technology use boundaries in your home and also teach them good technology manners.

Bizibuz host

What would you recommend in terms of trying to supplement the lack of peer interaction? It's tough because you can’t substitute for unstructured play but could a parent organize an online playdate or something along those lines?

Ms Liu Liu

Yes, absolutely. Having something is better than nothing and sometimes even if we don't have online interactions with peers, interactions with adults can also be helpful. We can create social opportunities for kids to practice their skills and then once the world opens up, they can interact with their peers.

Bizibuz host

Are there particular socio-emotional learning opportunities that a parent can sign their child up for to help them build a toolkit for dealing with these stressful times or build social skils? What would you advise on that front?

Ms Liu Liu

Yes there are several programs that I'm aware of. Sprout has a program called Social Bee Adventures that I would recommend https://www.sproutinmotion.com. If your children are between the age of 6 and 7 years, it is really the time to begin to learn to build social skills. Social Bee Adventures teaches children how to communicate with others, how to respond appropriately. For older kids with more social communication challenges, I would recommend the PEERS Program from Psynamo

https://psynamo.com/we-support-you/teens/peers-adolescent-and-young-adult/. PEERS is an acronym for the Program for the Education and Enrichment of Relational Skills. It was designed for children with autism but it’s useful for broader social difficulties and is an online program.

Bizibuz host

And now let’s turn to some of the questions in the chat. You had mentioned that depression can manifest in children in the form of low energy. What should a parent do in this case?

Ms Liu Liu

Thank you for the question. Yes low energy can mean not being able to get out of bed. Sometimes though a child’s depression can look like irritability or getting defensive. If you suspect your child may be suffering from depression, first consult with a psychologist, psychiatrist or a paediatrician. Sometimes just having signs of depression and anxiety may not mean they are depressed. There are many reasons why a child could have low energy such as their diet might not be very good or they don’t exercise regularly or they are having sleeping difficulties. This could all look very similar. So I would first recommend consulting a professional to investigate the source of the problem and then sort out ways to help your child. If you feel your child is suffering from severe depression, they may need therapy or medical intervention, but that's a discussion to have with your child's paediatrician or psychiatrist.

Bizibuz host

We have another question. If I see inappropriate behaviour from my child, should I try to stop it immediately? Or should I try to address it in a more gentle way?

Ms Liu Liu

It depends on the age of your child. I would always recommend addressing issues in a gentle way. If parents adopt a harsh approach, it becomes a punishment and may make the child feel like they are getting attention which may defeat the purpose of disincentivizing the child from the behaviour. You could talk to your child to find out why they are acting in a certain way. Your child might be acting out for attention and sometimes ignoring the behaviour can be much more effective to prevent it. If your child is acting a certain way to escape from something, you could try to figure out the source of the discomfort. So there are different options but I would always recommend parents address these sorts of issues in a more gentle way rather than harshly which may itself create additional issues.

Bizibuz host

And a final question. Do you think that these mental and behavioural issues that are popping up in children during the pandemic are going to be long lasting?

Ms Liu Liu

This comes back to the question of whether we believe children are more resilient that we give them credit for. I like to think a lot of issues are transient because if we can source the support for children that they need, they can get through it and not have it impact them for life. Stress does have an impact on brain development but my hope is that these issues are transient. And as parents, there are many ways we can support our kids through these challenging times.

Bizibuz host

Thank you so much for all the practical advice Ms Liu Liu. Your time is greatly appreciated. And thank you also to Sprout in Motion for agreeing to participate in this webinar. I hope our parents have found it useful.