Transcription:

Dr Kim Sirl: Hi, I'm Kim Sirl. And I'm a clinical psychologist at St. Louis Children's Hospital. And I'm a Mom Doc.

Melanie: Hey, welcome to Mom Docs, the podcast from St. Louis Children's Hospital. Today, we're talking about how to help your child adjust to going back to school during the pandemic. I'm Melanie Cole. I'm going through this myself. So this is going to be a really timely and important discussion that we're having today.

Dr. Sirl, I'm so glad to have you with us today. So before we get into this, what are our children going through right now that's unprecedented and nothing that any of us have ever experienced before? I mean, when we went away or went back to school in the fall, it was like, "Oh. Okay. Summer's over. Get new clothes, school supplies." But this is different now. There's different supplies and different feelings. What are our kids going through right now?

Dr Kim Sirl: Well, yes, every transition, particularly ones where you're going to a new school, middle school, high school, college, is exciting and stressful, and those feelings feel the same in our body. So the fight or flight response, a physiological arousal happens when we're both excited and nervous.

So you're right, any time of major transitions in particularly kids who have kind of anxious temperaments can cause some nervous excitement. However, this year, things are taking on a whole new level. Last year with a pandemic, there were a lot of concerns and last minute changes about going to virtual and now this year with the Delta variant. We thought we had things figured out and schools had figured out how to do in-person schooling safely, but now the Delta variant is probably increasing everyone's anxiety about this transition and making it another unprecedented opportunity for going back to school.

Melanie: Well, I certainly am feeling the anxiety myself and I know my kids are as well because, you know, these kids have been online school for the last year. And now, even as you say, with the variant, everybody's planning to go back in-person. We don't know yet if that's going to change, but as we start into this conversation, what can parents do now before the kids go back to help lessen that back to school anxiety, especially when there's so much we still don't know. Some schools are saying they don't even know if they're going to be in-person yet. Or if they are, it's limited. We don't know what's going to happen. What can we do, Dr. Sirl?

Dr Kim Sirl: And anxiety is all about dealing with uncertainty. And so we do have a lot of uncertainty right now about what's going to be happening, and I think most anxiety-provoking for the children and teenagers who were virtual all last year. So they haven't been in school for a year and a half and so that that is a big change.

What can parents do? First of all, they can check in with their child. Just kind of see what are you thinking about going back to school, going to college, going to high school? We're trying not to ask leading questions like, "What are you worried about?" Because they'll be like "Worry?" But ask about what they're looking forward to, what are they not so sure about, what do they think might be challenging? Listen and validate concerns. We want to make sure that our children are feeling heard and validated, but then emphasize resilience. You can ask them if they want help problem-solving, but sometimes kids just want to be able to vent, like "I haven't seen my friends much. I'm not sure. Are they going to still like me?" And you know your kid and you know their friends and you can offer some resilience about how well they are able to manage their friendships and then offer if they want some assistance with problem-solving. Would you like to schedule outdoor play date before we go back to kind of get used to things?

One thing about anxiety is it's about dealing with uncertainty. And so we have a lot big physiological response, fight or flight response, when we're expecting some kind of physical threat. That doesn't work so great as a response in terms of a psychological threat. So to manage our anxiety, we have to be in a situation to realize that it is safe and manage our physiological response.

The old axiom of get back on the horse, there's some truth to that. We want kids to start to get back into feeling comfortable with being in public and getting into the routines. So things I think parents can do, listen, emphasize resilience, manage their own anxiety, and get back to normal sleep, eating and responsibility routines.

Melanie: Well, so I want to discuss some of those behavioral routines that we can use to help ourselves. And I think resilience is a great word. We've learned a lot about the resilience of this country and certainly our kids in the last year. My goodness. What do you want parents to know for parents? And I know that this is a show about children, however, we're anxious too, Dr. Sirl. I am anxious too, and even though my kids won't be here where they'll bring the virus back to me, the variant, we're all vaccinated, but I'm anxious too. What do you want us to know about our kids even if they're going to elementary school?

Dr Kim Sirl: Right. My daughter's going back to elementary school after a year virtual. And we do know kids do seem to learn better in in-person learning. That's what the American Academy of Pediatrics has recommended and, clinically, I've seen that as well as personally. Virtual schooling is tough. But How to manage our own anxiety, that is huge. We're paying attention to the science? We're listening to the experts. We're trying to make the best choices for the physically, emotionally, academically best choices for our kids. And we just do the best we can in the moment with the data that we have, knowing that the virus is changing, society is changing, our kids are changing and growing up.

So we have to do some self-care big time. and this may include doing things like continuing to exercise, continuing to eat healthy, regular meals, continuing to get enough sleep. Again, the old axiom of parents need to put the oxygen mask on themselves on the plane first is so true. If we're not taking care of ourselves, our anxiety is going to leak and kids are going to sense that, and that's going to make them a lot more anxious. They look to us to see how big a threat is this and how to react. So if we're modeling confidence and resilience and safety practices, then our kids will too.

Melanie: And that's really important. The role modeling is so important. And now, these aren't long podcasts, so we don't have a lot of time, but I would really like you to sort of give us a brief overview of some tips for teens and preteens, elementary aged kids and even toddlers. I'm not sure that toddlers have to adjust to much change really. I mean, depending on what their daycare situation has been, but can you tell us a little bit about the elementary and teens and preteens, and really how to help them make the adjustment as it's happening right around the corner?

Dr Kim Sirl: Again, I would say check in with them, listen, validate, give them some opportunities to visit their school or playground or meet their teacher. Some schools have had especially elementary schools, I think have had some opportunities to meet the teacher or to see the school, especially for children who are like transitioning into middle school or high school or kindergarten, I would take advantage of those opportunities for sure.

If those opportunities aren't available, you can go to the playground. You can meet with some of your children's friends. You can call the school and ask if they can meet the teacher or come in before school starts just so they can take a look around and know what to expect and feel like they can make a connection with the teacher before school starts.

It's often really helpful to have a point person or a special person that they know. If you think your child's going to have particular difficulty separating, you can arrange for them to come a few minutes early. So they're not there in the rush of the first day of school with all the kids and the noise and have them start a little bit early. All of those things can kind of help kids feel more self-confident and know a little bit more what to expect.

Melanie: Well, that certainly is very good advice and something that we all really need to hear. Now, I'd like some red flags, Dr. Sirl. Can you give us some indication? I mean, parents, we know our children. However, some of this stuff is different in a lot of our kids, especially our preteens and teens have been caving in their rooms for the last year, you know, doing school online. How can we recognize some red flags that things are going wrong, that they're not adjusting very well? And where can we turn to help?

Dr Kim Sirl: Sure. So fight, flight and freeze actually are the responses to stress. So if your child's becoming increasingly withdrawn from the family, never leaving their room, not talking to friends like they used to or enjoying things that they used to do, that's a big red flag. If you're noticing any self-harm behaviors, that is a huge red flag.

You may also notice some fight symptoms such as crying tantrums, often actually are a symptom of anxiety, irritability and also complaints of feeling sick, headaches, stomach aches, school refusal is a concern. So if your child is having some of those kinds of issues, or they're refusing school, talk to your pediatrician, make sure there's nothing medically going on.

So if your children are struggling, always start with your family physician or pediatrician, but then some important numbers you should know are 454-TEEN that's (314) 454-TEEN. That is a Monday through Friday support line where you can get information about children's mental health and development and get referrals if you need to. Then, also a couple other numbers, BJC Behavioral Health, you can reach out to them, (314) 747-7491 and Behavioral Health Response, which is a 24-hour crisis line, (314) 469-6644. There's also a text option for youth, BHEARD to 31658.

Melanie: So Dr. Sirl, and what a great topic we're talking about today, wrap it up for us with your best advice for parents. Even if our kids are not necessarily struggling, but maybe they're dealing with rebellion against COVID rules or they're not showing necessarily, but they are withdrawing a little bit, nervousness. And for parents that are nervous as well, give us your best advice and wrap it all up for us.

Dr Kim Sirl: I would say the best thing you can do right now a few weeks before school starts is have a little bit of fun and enjoy your summer before we get back into the slog of homework, start working on getting back into your sleep schedules and healthy eating. Make sure your children eat breakfast and get back into those healthy schedules. Use a visual schedule to help them get back on track if they need to. Getting to bed on time and getting up in the morning and doing the things they need to do to take care of themselves.

It's going to be okay. Kids are resilient and this is a strange year. But one thing we've learned is we, as a nation, are very resilient and kids and parents are resilient. If we can handle last year, we can handle this year.

Melanie: One-hundred percent.. Thank you so much, Dr. Sirl, for joining us. Certainly true. And parents, you know, share this show with your friends and family on your social channels because we're learning from the experts and the Mom Docs at St. Louis Children's Hospital together. And boy, we sure do need to learn this information and help our kids adjust to whatever's coming up this fall as they had back to school in person.

And that concludes another episode of Mom Docs with St. Louis Children's Hospital. For more advice and articles, check out the Mom Docs website at childrensmd.org. I'm Melanie Cole. Thanks so much for tuning in today.