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Children's Behavioral Health Services

Talking to Children about the Swine Flu

 

By David Fassler, M.D.

Parents and teachers are faced with the challenge of discussing the rapidly evolving swine flu, or H1N1, epidemic with young children. Although these may be difficult conversations, they are also important. There are no "right" or "wrong" ways to talk with children about such public health emergencies.  However, here are some suggestions you may find helpful:

  1. Create an open and supportive environment where children know they can ask questions. At the same time, it's best not to force children to talk about things unless and until they're ready.
  2. Give children honest answers and information. Children will usually know, or eventually find out, if you're "making things up". It may affect their ability to trust you or your reassurances in the future.
  3. Use words and concepts children can understand. Gear your explanations to the child's age, language, and developmental level.
  4. Be prepared to repeat information and explanations several times.  Some information may be hard to accept or understand. Asking the same question over and over may also be a way for a child to ask for reassurance.
  5. Acknowledge and validate the child's thoughts, feelings, and reactions. Let them know that you think their questions and concerns are important and appropriate.
  6. Remember that children tend to personalize situations. For example, they may worry about their own safety and the safety of immediate family members.  They may also worry about friends or relatives who travel or who live far away.
  7. Be reassuring, but don't make unrealistic promises. It's fine to let children know that they are safe in their house or in their school. But you can't promise that people won't get sick.
  8. Teach children about common sense precautions, such as appropriate hand washing and covering your mouth when you cough.
  9. Let children know that lots of people are helping the families affected by the swine flu epidemic.  It's a good opportunity to show children that when something scary or bad happens, there are people to help.
  10. Children learn from watching their parents and teachers. They will be very interested in how you respond to news about the epidemic. They also learn from listening to your conversations with other adults.
  11. Don't let children watch too much television with frightening images. The repetition of such scenes can be disturbing and confusing.
  12. Children who have experienced serious illness or losses in the past are particularly vulnerable to prolonged or intense reactions to graphic news reports or images of death. These children may need extra support and attention.
  13. Monitor for physical symptoms including headaches and stomachaches. Many children express anxiety through physical aches and pains. An increase in such symptoms without apparent medical cause may be a sign that a child is feeling anxious or overwhelmed.
  14. Children who are preoccupied with questions or concerns about the swine flu should be evaluated by a trained and qualified mental health professional. Other signs that a child may need additional help include: ongoing sleep disturbances, intrusive thoughts or worries, recurring fears about illness or death, reluctance to leave parents or go to school. If such behaviors persist, ask your child's pediatrician, family physician or school counselor to help arrange an appropriate referral.
  15. Although parents and teachers may follow the news and the daily updates with interest and attention, most children just want to be children. They may not want to think about what’s happening elsewhere in the world. They'd rather play ball, climb trees or ride bikes.

Public health emergencies are not easy for anyone to comprehend or accept. Understandably, many young children feel frightened and confused.  As parents, teachers and caring adults, we can best help by listening and responding in an honest, consistent and supportive manner. Fortunately, most children, even those exposed to loss or illness, are quite resilient.  However, by creating an open environment where they feel free to ask questions, we can help them cope with stressful events and experiences, and reduce the risk of lasting emotional difficulties.

David Fassler, M.D. is a child and adolescent psychiatrist practicing in Burlington, Vermont. He is also a Clinical Professor of Psychiatry at the University of Vermont.