31 March 2020
It is unconscionable to ignore the immediate and longer-term psychological impact of this global situation, especially for children and young people who account for 42% of our world’s population
Research1 shows that sensitive and effective communication about life threatening illness has major benefits for children and their family’s long-term psychological wellbeing.
A Comment authored by experts at the University of Oxford is published today in The Lancet Child and Adolescent Health, highlighting specific developmental principles that should guide conversations with children about COVID-19. These principles include:
- Children’s need for honest information about changes within their family; when this is absent they attempt to make sense of the situation on their own
- Consideration of children’s developmental stage helps to make communication more effective
- Communication with young children should not just rely on simplifying language or concepts, but take into account children’s comprehension of illness and causality
Professor Alan Stein, Department of Psychiatry, University of Oxford, said, ‘In this rapidly changing situation, media and social conversations are entirely dominated by the coronavirus and children are being exposed to large amounts of information and high levels of stress and anxiety in the adults around them. This is occurring at a time when children are also experiencing significant changes to their daily routine, and contact with friends and grandparents, which are often key to children's resilience.’
Parents would do anything to protect their children from distress and consequently may avoid talking about difficult feelings and events. However, research1 shows that even very young children are aware of things changing around them and that their understanding evolves throughout childhood and adolescence.
This Comment highlights some important concepts to help parents and care givers communicate with children:
- Magical thinking - a concept that describes a child’s belief that thoughts, wishes or unrelated actions can cause external events; for example that an illness can be caused by a particular thought or behaviour (e.g. “Daddy got sick because I was naughty and didn’t go to bed nicely.”)
- Adults’preoccupation with the financial, practical and emotional impact of COVID-19 may compromise their ability to sensitively recognise and respond to signs of children’s worries and distress
- Adults need to provide a model of sharing some of their worries, without overwhelming children with their own distress
Prioritising effective communication with children about COVID-19 is an essential component of a universal, community-led response to the pandemic to protect the intermediate and long-term psychological wellbeing of children.
For further information, please contact: Chris McIntyre, Media Relations
Manager (Research and Innovation), University of Oxford, firstname.lastname@example.org, phone 01865 280534.
Notes to editor:
- This new Comment is published (post embargo) in The Lancet Child and Adolescent Health http://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30097-3/fulltext
- The team, led by Dr Louise Dalton and Dr Elizabeth Rapa, have developed resources to:
o 1. Guide healthcare workers who need to inform families by telephone that a relative has died of COVID-19. A key part of this is to identify if the deceased was a parent. https://www.psych.ox.ac.uk/files/research/contacting-relatives-by-phone-to-communicate-death-of-a-patient.pdf
o 2. To support caregivers with the unenviable task of telling children of an adult’s death (e.g. parent or grandparent) https://www.psych.ox.ac.uk/files/research/how-to-tell-children-that-someone-has-died.pdf. In the forthcoming weeks, we hope to personalise these to specific disciplines who are moving to telemedicine rather than face to face consultations.
- The University Department of Psychiatry’s mission is to conduct world-class research, teach psychiatry to medical students, develop future researchers in a graduate programme, teach doctors in training, promote excellence in clinical practice, and develop and provide innovative clinical services. It supports research in four key areas: neurobiology, psychological treatments, developmental psychiatry and social psychiatry. The Department is committed to the translation of scientific discovery into benefits for patients.