Children ages 7 to 11 have had different problems with the pandemic than older kids, noted Army Lt. Col. (Dr.) Bonnie Jordan, program director of Madigan's developmental-behavioral pediatrics fellowship, who also took part in the webinar.
"In our elementary (school) age group, we start to see increased rates of anxiety and depression," said Jordan. "You can see that they are still rather low, but significantly increased from our preschool age group. In this age, children are expecting to go to school, they are expecting to be physically active during the day at the playground, at recess, running around with friends. The pandemic caused this sudden shut-down of that, where not only did they lose their social interaction and school ... but kids at this age are not really developmentally able to fully understand what's going on, so there's probably a lot of fear associated with that as well."
The result is often more frequent emotional outbursts, Jordan added, as well as increased boredom and lack of interest. For kids in the 'transitional' age group of 11 to 14, this is even more pronounced, and increased episodes of 'acting out' can be a sign of depression or anxiety.
"For teens and young adults, we see a dramatic increase in mood disorders," Jordan said. Even pre-pandemic, some 10% to 20% of those aged 14 to 21 experienced depression, and 32% were listed as having anxiety. Mood disorders in girls are twice as common as those in boys and are seen at adult rates.
"Anhedonia, or loss of interest, is one of the biggest red flags, but also sometimes a lot more difficult to recognize, especially during the pandemic," she said. That's because going to the park for a ball game, participating in a club, or just socializing after school with friends are all things that have been mostly off the table for a year now.
Most alarming is the rate of suicide among teens. It is the second leading cause of death in that age group, Jordan said, and has increased over the past 10 years.
The news is not all bad for military kids, who are generally considered resourceful and resilient to constant change, due to the many permanent change of stations (PCS) that a career military parent goes through. The average military family moves about 10 times while their kids are growing up. For some, it is more frequent.
"It is hard to compare parents and kids in terms of adaptability and the level of responsibility for a PCS," Blasko said. "That said, kids take cues from their parents, so if the parent is overwhelmed or anxious, the child may pick up on that and experience similar feelings."
In a recent article that Blasko wrote for Sesame Street for Military Families (in partnership with the DHA), she suggests creating a 'COVID-19 family rules' cheat sheet, because there is so much variability in COVID-19 restrictions based on location.
"It can get confusing for both parents and children," Blasko wrote. "Establishing a visual checklist of the precautions can help everyone remember what needs to happen. It could include ideas for different situations such as leaving home to go to the store, going to daycare, visiting with friends and family, or even at-home quarantine."
So, what can parents and caregivers do, especially for 'tweens' and teens? Jordan explained that they must be models of resourcefulness and mindfulness. From a planning perspective, she said a 'flexible routine,' one that fits with school schedules, would be valuable, along with planning ahead for transition and down time.
She also said to encourage kids to talk - about everything, from their emotions, to the pandemic itself, and risky behaviors. Staying busy is also key, with activities such as exercise, reading, volunteering where possible, engaging in family projects, or just watching TV together. Taking an active role in a child's education is important, and giving positive feedback that might be absent because of closed schools.
Of course, getting kids needed behavioral health care as soon as possible is paramount, Jordan said.
"Regardless of age, we want parents to stay positive," she said. "We want parents to stay active, stay scheduled ... stay connected, stay informed, and stay safe."