Child anxiety
A mother complains that her child has regressed socially over lockdown Image Credit: Shutterstock

A Dubai-based reader, who asked to remain anonymous to protect her child's privacy, asks for help with her little boy, who she says has been exhibiting some challenging behaviour since being at home over lockdown:

“My 4-year-old son seems to have regressed over lockdown and appears to have completely lost many of the skills he had before. Not only academically, which I am hoping he will regain quickly, but emotionally.

"Whereas he used to be fully toilet trained, he now regularly has accidents. He says he forgets to go, or that he doesn’t notice, even when we remind him regularly.

"He also seems to have lost the ability to regulate his feelings and is regularly having tantrums or meltdowns about things if they are not exactly as he expects. For instance, my husband made him a drink that wasn’t created exactly how he likes it; he became extremely distressed, screaming that it was ruined forever now and it was a real challenge to calm him down.

"He’s also struggling with sharing his toys again and has huge arguments with his siblings if they ever try to use his toys or if they don’t follow the ‘rules’ of his game. He seems to have become very inflexible, and I am worried that this may make the return to school very stressful for him and his new teacher. Do you have any advice?”

Tanya Dharamshi, Clinical Director and Counselling Psychologist at the Priory Wellbeing Centre Dubai, says, “The COVID-19 lockdown will have had a significant impact on the mental health of many children. They thrive on structure, predictability and routine, and a need for constant reassurance as they grow. As a result, many are experiencing a range of emotions - confusion, anxiety and even anger at how the situation has developed. Young children in particular will struggle with how to manage or express such emotions and often this can be displayed as tantrums or meltdowns as mentioned above. They have not yet developed the skills or understanding required to deal and verbalise complex, overwhelming situations.

As a result of isolation and home-learning, many children are now used to having at least one parent with them 24/7, often responding to their needs in a timely manner. Naturally, during these unprecedented times, many parents may be more responsive to their children. They are keen to help ensure they remain happy and contented at home, when all around there seems chaos and a fear of the unknown as far as the pandemic is concerned. As a result, many children’s expectations and needs have grown considerably.

Aggression and a regression in potty training is completely normal in the current circumstances

- Tanya Dharamshi, Clinical Director and Counselling Psychologist at the Priory Wellbeing Centre Dubai

Aggression and a regression in potty training is completely normal in the current circumstances. There is limited understanding as to the implications of COVID and the ways in which we have had to isolate to keep safe. Naturally this can cause stress and anxiety for many of us, including young children who are not immune to these emotions. Many children are also feeling additional stress as they prepare to go back to school and, once again, adjust to significant changes in their structure and routine.

How to help a child who has regressed socially over lockdown

• Engage with your children as much as possible. Whether it’s over a meal, or when out for a walk, make a point of asking about their day, their friends, what they would like to do at the weekend. It’s so important to keep the lines of communication open and to show a real interest in their lives. Using words to describe how we are feeling and validating and normalizing all of our feelings will encourage our children to feel safe in expressing themselves.

• Be vigilant on the effects of media and social media and pay special attention to the sites children are exposed to. Regular monitoring, blocking access to specific sites, and imposing a time-limit on electronic devices is key, especially during lockdown. When on ipads etc, always encourage children to be among family and actively discourage them from locking themselves away in their bedrooms.

• Encourage children, no matter their age, to have hobbies and interest. Sport and exercise can help improve mental health and increase resilience to mental health problems. Just 20 mins a day can have a dramatic impact on mood and sleep patterns.

• Remind your child it's absolutely normal to experience strong emotions such as sadness, anger, fear and anxiety, but these don't last, and you can do things to help them such as watching funny YouTube clips, talking things through, taking exercise together, even if just going for a walk around the block.

• Create a ritual with your child, reading a book together as part of the bedtime routine for example. This creates a safe space which is calming and allows for communication and dialogue for both you and your child to explore various feelings, thoughts and concerns that your child may be experiencing.

• Remind your child you love them unconditionally and express this regularly and without prompting

• It is normal for young people to 'catastrophise'; always thinking the very worst will happen. Help them to manage negative thinking and gain a realistic perspective by focusing on their skills and qualities, and by discussing problems or situations from the past which they have successfully overcome.

• Encourage them to develop a plan of when to think about specific worries and concerns for a maximum of 10 mins every morning and evening. Then put them away in a metaphorical ‘box’ until the next day. This will encourage them to compartmentalise and ‘switch-off’.

• Seek professional help - it is hugely important to seek professional help if you think that your child is depressed. This will ensure that your child receives the dedicated support that they need, in order to prevent their anxiety or depression from becoming a long-term problem. You can visit your doctor to talk through your concerns and worries about your child, and they may be able to refer them for specialist treatment.

How to help a child who has regressed with potty training over lockdown

• Reinforce potty training in a calm and reassuring manner

• Do not punish or vent your frustrations in front on your child

• Understand that structure and consistency are key for children yet both have been missing from their lives for the past few months. Move towards re-establishing these in a gradual and gentle manner

• Offer positive reinforcement on a regular basis

• Use words to describe how you are feeling and to help validate and normalize these feelings. This encourages children to feel safe in expressing themselves too

• Create a daily ritual with your child – for example, read a book together as part of the bedtime routine. This creates a safe and calm space which allows both you and your child to communicate and explore various feelings, thoughts and concerns that your child may be experiencing

• Children may regress with potty training if they are being trained too early or if there is a medical reason. Ensure you have ruled these out and seek medical support if needed. If these have been ruled out and you are still struggling, seek support with a specialist therapist

In terms of anxiety about going back to school, the following steps may help ease the transition:

• Chat about all the fun times they have had both in school in the past, prior to ‘lockdown’. Whether it’s assemblies, theatre productions, sports events, class trips – these happy memories will help them to recall school-life pre-lockdown and how much they enjoyed it all.

• Set them small and achievable targets which they can focus on in the early days and weeks. These could include preparing their school stationery, laying out their uniform, and chatting about those subjects they enjoy the most. Gradually introducing old routines is key to helping children adjust at their own pace and reduce the likelihood of stress.

• Try to meet with the new teacher, if not in person then over a digital platform. This will help to familiarise the child with who will be looking after them and help them to feel safe and comfortable with their new environment.

• Encourage children to meet up with their friends again. Some friendships may have deteriorated during lockdown, so parents should encourage playdates – within the rules – at the park or in a garden. This will help them to re-establish friendships and turn their focus away from their family ‘bubble’, helping them to become more independent again.

• Teachers can discuss all the plans they have for the forthcoming academic year – highlight any exciting projects and themes the children will be concentrating on. Emphasise how much fun the class will have and ensure they have lots to look forward to and plenty of goals to achieve.

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