Back To School Anxiety In Kids

Children have been staying home for a while now due to the coronavirus (COVID-19) pandemic. With schools finally opening up, parents likely have concerns about how their child might handle back-to-school anxiety and homesickness. Below we present some strategies for parents to reduce anxiety and homesickness and help ease the transition from being at home to being back in the classroom.

Strategies for parents to help reduce back-to-school anxiety and homesickness

  1. Practice coming up with a list of things your child would like to share with their teacher and classmates (e.g., unique interests or talents, fun things they did this summer).
    • For kids who feel shyer and more anxious, parents can practice these brief “sharing statements” so their child feels more comfortable talking.
    • Help your child with keeping their sharing time short (since the teachers may need to cut them off if it’s too long), speaking up so others can hear and making eye contact.
  2. If you know any of your child’s classmates, reach out to their parents and schedule a playdate. Getting time with friends or peers before school can ease some worries, help your child practice their rusty social skills and help all the kids feel more excited about return to school.
  3. Consider taking a tour of the school (especially if it is a new school) before the school year begins, if possible. Even driving around the school or taking a short walk or a picnic in school grounds may help kids re-familiarize with the school environment or feel comfortable with their new environment. Some schools may have a virtual tour, videos or pictures on their websites that could be helpful if going to the school physically is not possible.
  4. Tell your kids it’s normal to feel nervous or sad.
    • Ask your kids how they are feeling about return to school (open-ended questions are best, or prompt by saying “sometimes kids feel excited or nervous or happy or worried…sometimes they feel multiple things at the same time”)
    • Let them know it’s normal to feel nervous about going back to school and about doing any new things.
      • Talk about things that have helped them feel braver in the past when they started something new.
    • Children may be worried about getting sick when they go to school as they have been hearing a lot about germs and hygiene.
      • Discuss use of masks, hand hygiene and physical distancing rules and what they can do to keep themselves safe.
      • Practice wearing mask, washing hands (at least 20 seconds, making a “white glove” with the bubbles), and not touching eyes, mouth, etc.
    • Create a “Bravery Chart” in which they can earn stickers or points for managing their anxieties in a healthy way.
  5. Increase excitement about return to school.
    • Talk often about the exciting things to look forward to, like getting to meet kind teachers, finding out who will be in their class and the fun things they will get to learn.
      • Ask your child what things they are looking forward to with return to school.
    • Back-to-school shopping: new school supplies often help kids feel more excited, even though they are nervous about return to school. Get some new school supplies (new pencils, markers and a new pencil kit) to help your child feel excited about starting a new year.
  6. Help your children anticipate the change that comes with going to school. Before school starts, talk to them about the changes that are coming with the return to school. Be sure to discuss routines — schoolwork, learning, recess, lunch, etc. Focus on the positives and fun!
  1. Reassure your child that you are interested in their welfare and know that they might feel homesick. Let your child know that you will check in with them at the end of each day, and that they can share anything with you!
  2. Help your kids get used to being away from home.
    • Practice spending time away from your kids at home. Working/playing in different rooms, having structured small amounts of time on their own, and doing tasks by themselves may help them feel confident about not needing to be always with parents.
    • Spend more time outside the house with the kids – running errands, going on outing, etc. to help them feel comfortable with being away from home.
    • Remind children of the times prior to the pandemic when they were in school without parents and how they handled being scared or missing parents.
    • Talk to teachers about creating a plan for your child to feel comfortable at school if they have separation anxiety – planned video or phone calls to a parent, writing notes or letters to parents or having a special toy they can use for comfort.

Respiratory Syncytial Virus (RSV)

Respiratory syncytial virus, or RSV, is a common virus that usually spikes in cases during the winter months. Unfortunately, this summer it’s unexpectedly spreading, especially in the Southern United States. The outbreak has been so concerning that the Centers for Disease Control and Prevention (CDC) recently issued a health advisory about the spread of RSV in the country.

What is respiratory syncytial virus?

Respiratory syncytial virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Infection with RSV is common among young children and usually begins as a mild cold, but can cause severe breathing problems in premature babies, as well as infants and toddlers under the age of two who have chronic lung disease and chronic heart disease.

RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 year of age in the United States.

What are the symptoms of respiratory syncytial virus?

Early symptoms of RSV include:

  • Coughing
  • Sneezing
  • Fever
  • Runny nose
  • Decrease in appetite

Because it’s often difficult to distinguish RSV from a common cold, here are some signs to look out for if you suspect your child’s cold may be more serious:

  1. Difficulty breathing: After one or two days, the virus can travel to the lungs, affecting the small airways (called bronchioles) that allow your child to breathe easily. Once the airways are affected you may notice faster breathing, flaring of the nostrils, sinking of the neck and sucking in of the ribs while breathing. These are indicators that your child is having difficulties moving air into and out of the lungs and needs to be seen by a doctor.
  2. Unusual behavior: RSV may cause your child to be more irritable, sleepy or uncomfortable than normal. Another cause for concern may be if your baby is not feeding well.

How is respiratory syncytial virus treated?

Most RSV infections go away on their own in one or two weeks. While there is no specific treatment for RSV, some things you can do to relieve symptoms are:

  1. Manage fever and pain with over the counter fever reducers and pain relievers such as acetaminophen or ibuprofen.
  2. Keep your child hydrated.Make sure your child drinks a lot of fluids to prevent dehydration.

How do I prevent my child from catching respiratory syncytial virus?

Preventing RSV can be very difficult, especially because it is spread in droplets of fluid from sneezing, coughing or laughing. Since the virus travels and lives on surfaces, washing your hands often and keeping infants away from children and adults who are exhibiting common cold symptoms can be extremely helpful. Breastfeeding and avoiding second-hand smoke also show natural benefits to possibly preventing RSV.

Summertime Travel With The Kids

With all the hardships and emotional stress we’ve faced throughout the past year and a half since the outbreak of COVID-19, a relaxing family getaway might be more than needed. Though the threat of COVID-19 is decreasing with millions getting vaccinated, it’s still not quite safe to return to the pre-pandemic type of travel, especially with regulations in place that continue to restrict smaller children from receiving the vaccine. How can you be sure your family stays healthy and safe while traveling this summer, and what steps can be taken to further ensure everyone’s health and safety while doing so?

What should I think about while planning our trip?

Traveling with young kids can be hard enough on its own but traveling with younger passengers during a pandemic poses even more questions and risks for parents to think about. It’s important to do some pre-planning before booking any trip to make sure your getaway is as enjoyable as possible.

“Every decision we make about our kids is always risk-benefit. We always have to look at the best way to mitigate the risks and increase the benefit,” says Children’s National Hospital clinical pediatrician Dr. Boogaard. “At the beginning of the pandemic, we had this false-safety mindset regarding children and COVID-19. There are still consequences with COVID-19, and children can definitely still get it.”

As we continue to learn more about COVID-19 heading into the summer, Dr. Boogaard says, “When you think about traveling with young kids, the first thing that I would really encourage is that anyone allowed to get the vaccine should get it. The vaccine is very effective and safe and decreases the risk of hospitalization and death.”

However, this may not be possible for everyone in the family just yet, as clinical trials for the COVID-19 vaccine are still ongoing for children under 12.

“For unvaccinated kids there are a few rules you should follow: do not travel if you’re sick, if you have symptoms, if you’ve been recently exposed to COVID-19 or to someone with symptoms or if you’ve tested positive recently and thus have COVID-19,” Dr. Boogaard notes. (For further help making decisions about traveling with people who are unvaccinated, check out the CDC wbsite.)

Dr. Boogaard explains that, “If you’re unvaccinated the CDC recommends wearing a mask (if over the age of 2), avoiding large crowds and seeing people outside your household, and washing your hands for at least 20 seconds routinely.” Preventative actions such as these are one of the best ways to protect your family both before, during and after any travel.

What should I do before we leave?

There are direct actions that can be taken before departing for your vacation to further ensure everyone’s health and safety, as well as important questions to ask yourself and your family before you book your flights.

“There are things to consider before traveling: could you quarantine before seeing someone who is at a higher risk? Could you get them or yourself tested?” Dr. Boogaard explains.

Keeping questions like these in mind while planning your travel will offer a deeper sense of security for all traveling with you. Furthermore, Dr. Boogaard highlights the importance of preparing contingency plans before you leave to help you feel more confident and prepared before arriving.

“Be prepared when you go for the situations that might arise, for example if someone gets symptoms. This person should quarantine whether they are vaccinated or not until it can be confirmed that it is not COVID-19.”

Dr. Boogaard further notes that it may be helpful to research COVID-19 testing locations near the area you’re staying and put them somewhere accessible prior to departing so you already know where to go if something like this were to happen in an area that you and your family are not familiar with. Researching your destination’s specific COVID-19 policies and/or COVID-19 nearby health centers is a beneficial step to take before deciding to hop on a plane!

My family wants to get together, but we all have differing opinions regarding the safety of COVID-19. What should I do?

“What’s human nature is when you put a big group of people together, they all have their different anxieties around this, and you want to make sure everyone’s comfortable. So, just practicing that flexibility and resilience that we’ve practiced all year are good things to continue going forward,” Dr. Boogaard explains. “Just to be transparent about your own concerns, and your own risk-assessments, and be aware someone might have a different risk-assessment and comfort level, and plan on how to work through that.”

Communication regarding comfortability levels and everyone’s varying health concerns, before seeing them, is the key for all reunions this summer.

Can my unvaccinated kids see their vaccinated grandparents?

Although it has been important to quarantine and try to limit contact with others throughout this pandemic, Dr. Boogaard also emphasizes that, “There has been a lot of trauma associated with COVID-19 over the last year, a lot of loneliness, self-isolation and other mental challenges.” When thinking about traveling to see family during this time, important factors such as those are just as vital to consider when weighing them against the potential physical health risks that may be present. “If this is a grandparent you and your children are not able to see often and you get a chance to visit them this summer, you have to make that decision for your family because it’s different with every situation.”

Just as the pandemic has affected every single family differently, learning how to reincorporate things like travel and family gatherings will look different for every family as well. Ultimately, planning, communicating and cooperating with your own family and your individual family circumstances are some of the most important things to do to ensure you and your family’s getaway is as safe and enjoyable as possible.

Keeping Your Kids Hydrated This Summer

You’ve probably heard the phrase “hydration is key,” more than once. It often pertains to your exercise regimen, digestion benefits and, in general, your overall health. But what does hydration look like for young children?

Now is a good time to find out with summer coming and kids will be frequently spending time at playgrounds and in backyards.

What are some basic things people should know about young children in summer heat?
The key thing for the summer is really knowing all of the dangers that children can be exposed to. Avoid heat exhaustion (which can be caused by, or lead to, dehydration), administering sun protection (sunscreen, loose-fitting clothing and getting shade) and practicing water safety are really the three big issues to know about. Drwoning is the number one cause of death in children 1 to 4, so it’s essential for parents, guardians and caregivers to be aware of each of these risks individually, but also how they can all relate on a hot summer day.

How long should children be outside in the summer heat?
There’s no one single rule, but the middle of the day tends to be the hottest, so earlier in the day or in the evening can be better for getting outside time. It also depends on how extreme the physical activity is. They can be outside playing as long as they’re drinking enough water. It’s good to get outside and have some fun, and to get some exercise, but even before kids recognize thirst, they should be drinking enough fluids throughout the day.

How should children be getting their fluids?
Infants need to drink their breast milk or formula in order to stay hydrated. All of the water they need is in those two options, and that’s through about 6 months of age. Once they begin having solid foods or other foods beyond formula, that’s when they really begin drinking water. One rule of thumb for toddlers (and older) is 8 ounces of water for every year of age per day, until you get to the age of 8. For example, if a child is 3 years old, they should be drinking at least 24 ounces of water per day. And we’re all losing a typical amount of fluids through breathing and urinating, but then when we sweat, that’s our mechanism to stay cool, so that’s when we’re losing additional fluids.

How common is dehydration in young children?
It’s fairly common, but a careful and vigilant caregiver should be reminding children to drink, to take a rest, to have a break from the heat with some air conditioning and to just find some shade. Luckily for infants, they are not going to get dehydrated from the typical running around like toddlers could, since they’re not exercising in the same ways. They are much more likely to get dehydrated from illness that causes more output (stool and vomiting). But once a toddler is running around and exercising, that’s when they are getting more at risk for dehydration from the heat itself.

What are the dehydration symptoms caregivers should look out for?
In terms of symptoms, take notice if they’re not acting like themselves. When you know your child loves to play but then they start to be a little more sluggish, you might want to check in. They might have some cramps in their legs, and then when you see them sweating a lot, it’s a good sign to get them inside and to have more fluids. It’s really how they’re acting more than anything, although you might see dry mouth or lethargy. They just won’t be as interested in playing as they typically are because they’re starting to get exhausted from the heat and lack of fluids.

What To Say To Children When They Are The Only Family Members Without A COVID Vaccine

We are feeling so grateful and fortunate that vaccines are now offered to all individuals ages 16 and older. There is a collective sigh of relief that the end of this pandemic is in sight. However, it’s important to note that not all individuals have access to COVID-19 vaccines yet…the majority of our pediatric population at Children’s National (children ages 0-15) continues to wait for vaccines. So what should you say to a child who is the only unvaccinated person in the house and may be worried?

Validate that it’s hard to be patient

  • We know that it is hard to wait. This pandemic has changed our lives for more than a year and it is normal to be hopeful for a vaccine that helps us feel confident that we can remain safe and get back to our regular activities.
  • Parents can express that the COVID vaccines have yet to be tested/approved for kids through research studies; most studies have been focused on adults and older teens. The good news is that the research is underway – so kids can be hopeful that vaccines will be accessible to them soon!
  • Ending on a positive note when explaining things to kids helps to reduce anxiety/worry and set expectations for hopefulness.

“Why do I have to wait so long?”

  • Provide kids with education about how some individuals are more vulnerable than others, especially older individuals or healthcare providers, which is why they are being vaccinated before kids.
  • Remind them that kids have to wait their turn but might get the vaccine last because it is unusual for kids to get very sick even if they do get COVID:
    • Children infrequently get the severe symptoms that are more common in adults.
    • Scientists and doctors are focusing on getting vaccines to those who need it most first…but vaccines for kids are coming!
  • Continue to validate disappointments.
  • Kids may be missing exciting milestones with friends, achievements (sports championships, competitions, recitals), birthday celebrations – try to find ways to get as close to these experiences as possible while balancing safety.

Validate child worries about their own safety (because they haven’t gotten the vaccine)

  • Create open communication. Families should discuss any changes they are making to their family precaution plan now that most of the (more vulnerable) family members are vaccinated:
    • Be sure to review with the unvaccinated child your family’s continued precautions to keep them safe.
    • Also remind children that the members of your family that were most at risk of getting very sick are now protected, and that adults being vaccinated also means that kids will not spread COVID to their parents or vice-versa.
    • Reassure children that you are not forgetting about them and that your family is considering risks to that child (including risk of COVID and also psycho-social risks associated with prolonged isolation) as you make your plans.
    • Discuss any changes that you/vaccinated adults and that children will make and discuss how/why you believe this plan will keep everyone safe. For example, parents may choose to go to visit another vaccinated friend. Discuss how coming home to their child after this visit is still safe – vaccines help to reduce spread of the virus.
  • Give children a voice. Each family member, including children, needs to be given a voice to share and discuss their concerns, desires and goals with the family precaution plan.
    • Parents should ultimately make the choice about the family precaution plan, using CDC recommendationsand family physicians as needed (if there is a family member with underlying health conditions).
    • Every family member, including the youngest children, needs to be included in the discussions about any changes and reassured that each family member’s concerns and health are being considered.
    • Knowing the plan in advance helps children feel more safe and secure. Changes to precautions that we’ve told kids for a year are “keeping us safe” can make kids feel very anxious. Be sure to explain that it will take time to re-teach our brains what “being safe” means now (and at each change we make related to this virus).
  • Help provide children with language to express their concerns about other family member’s actions given that kids can’t be vaccinated yet.
    • For example: It makes me feel _____ when you _____. Please ____.
    • Role play using this language.

Deciding on a new “Safety Plan”

Vaccinated parents with one or more unvaccinated children may struggle deciding which precautions to keep and which to change. Can some things return to normal?

  • Parents should remember that there is no risk-free option. The extreme COVID precautions come with social isolation that impacts overall physical and mental health.
  • Each family will need to make their own educated choices…and there is more than one reasonable approach:
    • Some families may continue to be more cautious due to unknowns related to the novel coronavirus (particularly long-term effects) or due to concerns for a young child with underlying health conditions.
    • Other families may choose to increase their family’s activities, but using a thoughtful and educated process. Remember to reference the latest CDC Guideline frequently as recommendations change frequently, particularly with new variants emerging.
  • Families should consider their unvaccinated children when making decisions in their family’s best interests.

Validate when kids express they want things to go back to normal

  • Validate frustration if children are upset to learn that they will not immediately go back to their normal routine.
  • Continue to find ways to increase routine and structure for children.
  • Seek fun, new activities that change up the routine and fit within your family’s safety guidelines.

Allergies or COVID?

As we enter another pandemic spring, pollen counts are on the rise and the coronavirus continues to circulate in our communities. There is some overlap between seasonal allergy symptoms and COVID-19, so sometimes it can be hard to tell the difference! Here is a quick review of allergy symptoms versus COVID-19 symptoms.

Overlapping symptoms of allergies and COVID-19

The most common overlapping (meaning these can happen with allergies or COVID-19) symptoms of allergies and COVID-19 are:

  • Cough
  • Shortness of breath
  • Headache
  • Tiredness/fatigue
  • Sore throat
  • Runny or stuffy nose (this is less common in COVID-19)

Cough and shortness of breath happen less often with allergies unless the person has a history of asthma which can be triggered by pollen.

Allergy symptoms

Individuals with seasonal allergies frequently experience the following symptoms:

  • Sneezing
  • Itchy nose
  • Itchy and/or watery eyes

These symptoms are NOT associated with COVID-19, and generally get better with over-the-counter allergy medications (antihistamines) such as Zyrtec, Claritin or Allegra. Nasal corticosteroid sprays, such as Flonase, Nasonex or Nasacort are also often helpful for seasonal allergy symptoms.

COVID-19 symptoms

COVID-19 infection most often involves the following symptoms:

  • Fever/chills
  • Body aches
  • Loss of taste and/or smell

If any of these symptoms are present, your child should be kept home in quarantine as a precaution until a COVID can be arranged.

Functional Abdominal Pain

Many otherwise-healthy children who repeatedly complain of abdominal pain or stomach aches for two months or more may have something called “functional abdominal pain.” The word “functional” just means that there is no underlying disease, obstruction, blockage, infection or inflammation causing the abdominal pain.

However, it is very important to recognize that the pain is 100 percent real, and is caused by something called “visceral hypersensitivity,” essentially meaning the digestive organs are extra sensitive and are perceiving pain even when digestion patterns are normal. Given that the pain is very real, it may cause the child to cry, break into a sweat or turn red or pale.

While we do not understand the exact cause of functional abdominal pain, the sensitivity in the digestive tract can be triggered by various things. These could include stress, anxiety, viral or bacterial infection or even an episode of constipation. The abdominal pain the child is experiencing may even interfere with school and play.

Functional abdominal pain in children is quite common — it is estimated that around 10-15 percent of school-aged children experience it. If you notice that your child’s abdominal pain complaints seem to be related to anxiety, functional abdominal pain is certainly a consideration. However, to be sure, it is always a good idea to discuss the issue with your pediatrician, and then further with a pediatric gastroenterologist if needed.

Your pediatrician or gastroenterologist will take a detailed history — where the abdominal pain is, when and how often it is happening, other symptoms such as changes in weight and bowel movements — to determine if any further testing is needed.

“Red flag” gastro-intestinal symptoms that would likely warrant further testing include things like:

  • bloody stools
  • weight loss or lack of growth
  • unexplained fevers
  • difficulty swallowing or painful swallowing
  • vomiting that is persistent or otherwise worrisome
  • diarrhea that is severe and chronic (more than 3 loose or watery stools per day for more than 2 weeks)
  • awakening at night with abdominal pain or bloody stool

Your provider may also ask about any urinary symptoms, back pain, family history (such as any family history of inflammatory bowel disease or celiac disease) and skin changes.

Together with your child’s healthcare clinician, and if needed, with the help of a pediatric gastroenterologist, a plan can be created to evaluate and help your child manage their abdominal pain.

Winter Safety and Kids

With temperatures near freezing, you may be wondering what you need to know to keep your child safe for the rest of the winter season.

Playing outside in the cold

Check the weather before heading outside for play or travel. This helps your family prepare to be safely dressed to prevent cold weather injuries like frost bite and hypothermia.

During cold months dress warmly for outdoor play in several layers including an appropriate coat or jacket, hat, gloves, scarf (to cover face) and boots. For children who don’t tolerate hats, fleece headbands or earmuffs are great alternatives!

When playing outside, shivering is a danger sign! If you or your child starts shivering, go inside and warm up! Remember to come in every 30 minutes to an hour to get warm and conduct a mini check.

Winter Warm Up Checklist:

  • Check fingers and toes
  • Change wet clothes
  • Drink water

If you are participating in winter activities like skating or skiing, always wear appropriate safety gear to prevent injuries. Always remember to wear sunscreen outside, even during winter months as the sun can reflect off snow and ice and cause sunburn. You might want to consider a hat and sunglasses too!

Traveling in car during the cold

Wearing a thick coat in a car seat can make it very hard to buckle in snugly. A loose car seat harness means your child is at risk of serious injury during a crash. No bulky coats and car seats.

Instead, buckle your child in their clothes without the coat on to get a snug fit. Place a blanket over the seat or put their coat on backward, overtop of the fastened harness.

For children that use a wheelchair, keep extra blankets to use over their legs in the wheelchair or car seat as they can get colder quicker.

Cold weather safety at home

Carbon Monoxide (CO) is a colorless, odorless gas that is made when appliances burn fuel. CO poisoning occurs by breathing in this gas. The risk for CO poisoning is higher in the winter months because of closed windows and heating homes.

Activities that may seem harmless can raise the CO levels in our homes. It is important not to use an oven or stovetop to heat the house. Check vents for the dryer, furnace, fireplace and stove to make sure they are not blocked, including by snow. Generators, grills and other things that burn gas for fuel should stay outside of the home.

Check your home to ensure that you have a carbon monoxide detector. Detectors can be combined with smoke alarms or can be a separate device. Detectors should be on every floor and especially where people sleep. If there are children or family members in the home who are deaf or hard of hearing, there are carbon monoxide detectors with visual warnings.

If the alarm goes off, quickly leave your home as carbon monoxide can make you confused. Once outside, call 911. It is helpful to have a family meeting place to ensure everyone is the home is accounted for. Wait until emergency responders arrive.

New Year’s Resolutions

After January 1, it seems everyone is working to improve their diet or workout regime as they proclaim their New Year’s resolutions. A great way to bring your family closer in the coming year is for everyone to take part in those resolutions.

Tips for Family Resolutions:

  • Setting reasonable goals
  • Make them specific and concrete
  • Follow-through

For example, if your goal is, “we should spend more time together as a family,” you should be more specific like, “Every Friday is game night.” Then, every Friday, decide on a specific time that the whole family will get together. Details like time and day of the week help you keep track and accomplish your goal.

Older children may become interested in setting their own resolutions. If they have a hard time coming up with resolutions, you can help them by asking a series of questions, such as, “Are there things you want to learn or are there things you want to change?”

It’s important to make sure you are not pushing the child into a goal because they are less likely to meet it, if they feel pressure. You can, however, guide them. If you have a young child who has trouble with sharing, you can tell them you will help them work on this goal.

The  American Academy of Pediatrics has put together a list of resolutions to help families come up with ideas:

5 to 12 year olds

  • Do a sport or activity three times a week
  • Wear a helmet when bicycling
  • Make friends with someone new, especially a kid who is shy or new to school

13 years old and up

  • Eat two servings of fruit and two servings of vegetables a day
  • Play only non-violent video games or watch only non-violent televisions shows for only one or two hours a day
  • Help out in the community by volunteering
  • Never text or use a cellphone while driving

All of these resolutions are beneficial to the whole family. Parents can even accomplish multiple goals of improving diet and exercise together as a family, just by planning to eat a healthy dinner together every night, followed by a family activity.

Suicide In Children During COVID-19

The coronavirus (COVID-19) pandemic has shaped 2020 in countless ways for children and teens. What started as “sweet, two weeks off school!” for many youth has turned into increased stress, isolation and sadness. Rates of anxiety and depression have been increasing and with that, providers have seen an increase in suicidal ideation. Now more than ever it is important to know the suicide warning signs and to feel comfortable talking about suicide and safety with your child.

Suicide risk factors and warning signs

Certain suicide risk factors are important to be aware of including presence of psychiatric illness, a previous suicide attempt, history of trauma or abuse, bullying and others.

Beyond risk factors, it helps to be aware of some common warning signs including:

  • Increased thoughts of suicide or self-harm
  • Discussion of death or feelings of emptiness/hopelessness
  • Changes in mood (anxious or agitated), behavior, eating or sleep
  • Increased isolation or withdrawing from others
  • Risky behaviors or saying goodbye

Protective factors for suicide

There are several protective factors which can be encouraged to help your child:

  • Life skills (problem-solving, coping)
  • Social support from family, friends and others
  • Positive school experiences

Since the COVID-19 quarantine began, it has been more difficult for children to do the things they love. Staying active, going to indoor activities and seeing close friends are just a few things that children have not been able to do in the same way as before. Parents are encouraged to find creative ways to help kids stay connected with peers (i.e. video calls, virtual game nights) and to help kids stay physically active (i.e. socially distant walks, at home workout videos).

Dos and don’ts when talking to your child about suicide

Talking to your child about suicide may feel scary but there are some helpful dos and don’ts that can make this process a little easier! You can use these tools yourself and share them with other parents!

  • DO stay calm. This helps your child see that you are not upset at them and that they are not in trouble.
  • DO be direct. Ask them, “Have you wished you were dead? Have you had any thoughts about killing yourself?” Being able to openly discuss these thoughts and feelings is critical. Asking directly builds connectedness and helps to communicate that you care.
  • DO reassure. Let your child know that there is help and that this feeling will not last forever. Ask your child what you can do for them during moments of distress, whether it is sitting with them, giving them a hug or doing a shared activity together.
  • DO remove means for self-harm. Work to keep the home environment safe by removing unsafe items such as weapons, sharp objects, medications, belts, ropes and cords. If these items cannot be removed, having a safe place where they are locked is an alternative option.
  • DON’T judge. Create a safe space for your child and show them that that talking about suicide and safety are things they can do with you. The thoughts and feelings they are experiencing reflect the pain they are experiencing. As a parent, you can show empathy and validation which will help your child feel heard and increase their comfort talking about these difficult feelings.
  • DON’T leave them alone. If your child is expressing thoughts of harming themselves, do not leave them on their own. Encourage your child to keep the bedroom door open and monitor them regularly. If your child is expressing thoughts of suicide, stay with them until they receive a safety assessment.

Sometimes you may feel uncertain whether your child is safe or you may be unsure how to talk with them. If this occurs, call 911 or take them to the emergency department for a safety assessment. You can also contact the National Suicide Prevention Hotline for help: 1-800-273-TALK (8255).