The following piece was originally published on Alexandra Harrison’s blog entitled Supporting Child Caregivers in September 2020, which can be found here.
Panel on school reopening
I participated in a great panel at the Cambridge Ellis School last night. It was a remote meeting for parents and teachers in preparation for the opening of school during the COVID-19 crisis. The panelists included Dr. Michael Yogman, the school pediatric consultant, Tal Baz, an occupational therapist and specialist in sensory processing, Dr. John Mazzotta, and me, the school child psychiatric consultant.
Most of the questions the parents sent to the coordinator before the meeting concerned safety. That is what would be my primary concern if I were sending children back to school during the pandemic. Some of us feel relatively protected, working from home, somewhat insulated from the illness and financial insecurity others are suffering. Many parents of preschool children are more aware of the burden of caring for children while attempting to work from home than they are of the threat of physical illness. But when they prepare to send the children to school, that is when they are confronted with the dangerous reality of life outside the home.
Early on, the panel talked about the need to balance the threat of illness against the preschool children’s need for socio-emotional growth. Both are extremely important. How can we balance the two? The question of how to balance the need for protection and the need to support socio-emotional development is stressful to parents. Yet, parents are the foundation of their children’s sense of security. How can parents manage their own nervousness and be calm for their children in the transition back to school? Many studies have documented the “contagion” of anxiety in the parent-child relationship (Murray, Cooper et al, 2007; Nicol-Harper et al, 2007). How can we protect our children from parental anxiety that is based in legitimate fear?
One way of managing parental anxiety is to identify concrete measures to protect their children. We talked about the use of masks, hand washing, and constraints on behaviors that could potentially increase contagion– physical closeness and singing.
Masks are challenging for very young children, but there are ways of helping children feel comfortable wearing masks. Games can be played wearing masks-peekaboo games, games about guessing the emotion being displayed by the person wearing the mask. Children can decorate their masks, enhancing their sense of control and agency when unusual demands are being placed on them. Especially masks representing superheroes can allow the child to—in their imagination—inhabit that superpower and feel safer and more in control. It is important to emphasize the individual differences among children in terms of the tolerance for wearing masks; some children with tactile sensitivity, for example, may need extra support. In terms of the emotional distance conferred by masks, since emotion is communicated more by the top of the face than by the lower part of the face, this should not be such an issue. In fact, authentic smiling is communicated by the orbicularis oculi muscle of the eyes more than by the facial muscles around the mouth. While it is true that children who are learning to talk may find the muffling effect of the mask problematic, this may be an opportunity to learn to enhance communication through gestures.
We talked a lot about hugging and other physical contact and the constraints imposed by concerns about contagion, especially in the case of the youngest children. Can the toddlers not sit in their teachers’ laps? What about teachers attempting to calm a dysregulated kindergartner? What about the children who have a hard time “keeping their hands to themselves” while waiting in line? This again seemed to be an issue of balance that will depend in part on the comfort of the individual teacher and in part on the comfort of the parents of that particular child.
An important emphasis of our discussion was on self-regulation. I have already talked about how to manage parents’ anxiety through concrete steps of protection. Another way is to work on self-regulation. The first step is to slow down. Meditate if that is a method you can practice. Slowing down and behaving in a calm, well-regulated manner will be very helpful to your child. Mental health in the pandemic has been strained both for children and parents (Gassman-Pines et al, 2020).
The issue of self-regulation brings up another salient theme of the panel—the stimulus to innovate, create. For a long time I have thought that self-regulation should be an even more important focus in preschool education than it is at this excellent preschool. I have written about my visits to a school in South India in which each school day is begun with chanting prayers, a highly regulating activity, followed by dancing for the young children. These repetitive rhythmic motor activities, as Bruce Perry explains, engage the “bottom-up” stress regulating system. They create an organizing force in the nervous system–and like all activities–if they are repeated, they reinforce the neural circuits that govern them (Perry, 2006, CTA). Similar self-regulation activities include marching, drumming, clapping and other organized hand games. We talked about games that build regulation of the motor system—games that involve stopping and starting like red light, green light, like “Simon Says”. The more outside time the better during the pandemic. One of the most enjoyable and organizing activities of the school day in preschool is singing. An alternative to this potentially virus-spreading practice is humming, which—through the exercise of breath control—is also self-regulating! Perhaps the urgency generated by COVID-19 can spur us to create new practices that build self-regulation into the curriculum.
We talked about a new emphasis on imagination. Remember that preschool children are in the “magic years” (Fraiberg, 1959). Their most effective way of making meaning of their world is through pretend. Pretend play offers the preschool child a means of representing the insecurities, the anxiety, the desires, and ambitions in their inner world and to master them. The frustration and sadness associated with the constraints of freedom, the limitations of socialization, and the demands to take precautions—these can be represented and mastered in pretend play. Preschool teachers are experts at scaffolding this developmentally enhancing play, and parents can also facilitate it at home—by encouraging it, providing the space and props for it. Although parents can contribute to the effectiveness and enjoyment of children’s play by helping them elaborate the themes that the children introduce and by helping the child maintain regulation when stirred up, parents do not have to actively engage in pretend play with their children all the time. Parents’ affirmation and appreciation of pretend play in itself is helpful.
Finally, we talked about community building—for the children, of course, but also for the parents. Remember the question about how to manage the anxiety generated by the real threat to our safety? We can do that through the support of the school community. We encourage regular meetings—to share information about medical advances, to share ideas about how to help parents, children, and teachers cope with the ongoing challenges, and to share emotional experience—because no matter how hard the journey, it is easier when you have traveling companions.
Gassman-Pines A, Oltmans Anant E, Fitz-Henley J (2020). COVID-19 and Parent-Child Wellbeing, Pediatrics, e2020007294; DOI: https://doi.org/10.1542/peds.2020-007294
Fraiberg S (1959). The Magic Years: Understanding and Managing the Problems of Early Childhood, NY: Simon & Shuster.
Murray L, Cooper P, Creswell C, Schofield E, Sack C, The effects of maternal social phobia on mother-infant interactions and infant social responsiveness, J Child Psychol Psychiatry(2007). 48(1):45-52.
Nicol-Harper R, Harvey A, Stein A (2007). Interactions between mothers and infants: Impact of maternal anxiety, J Infant Behavior & Devel, 30(1):161-167.
Perry B (2006). The neurosequential model of therapeutics: Applying principles of neuroscience to cinical work with traumatized and maltreatment children In Working with Traumatized Youth in Child Welfare(Nancy Boyd Webb, Ed.) The Guilford Press, N.Y., pp. 27-52.
Training Series 2: Six Core Strengths for Healthy Child Development, Overview, The Child Trauma Academy.
Alexandra Murray Harrison, MD is a Training and Supervising Analyst at the Boston Psychoanalytic Society and Institute in Adult and Child and Adolescent Psychoanalysis, an Assistant Clinical Professor of Psychiatry, Harvard Medical School at the Cambridge Health Alliance, and on the Faculty of the Infant-Parent Mental Health Post Graduate Certificate Program at University of Massachusetts Boston. Dr. Harrison has a private practice in both adult and child psychoanalysis and psychiatry. In the context of visits to orphanages in Central America and India, Dr. Harrison has developed a model for mental health professionals in developed countries to volunteer their consultation services to caregivers of children in care in developing countries in the context of a long term relationship with episodic visits and regular Skype and video contact. Her blog Supporting Child Caregivers gathers important information on parenting and education of children during the pandemic. Listen to Dr. Harrison’s helpful tips about child development and parenting issues in her new podcast The SCC Pod.
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