These specific developmental principles include:
- Children's need for honest information about changes within their family; when this is absent they attempt to make sense of the situation on their own
- Consideration of children's developmental stage helps to make communication more effective
- Communication with young children should not just rely on simplifying language or concepts, but take into account children's comprehension of illness and causality
Research shows that sensitive and effective communication about life threatening illness has major benefits for children and their family’s long-term psychological wellbeing.
In this rapidly changing situation, media and social conversations are entirely dominated by the coronavirus and children are being exposed to large amounts of information and high levels of stress and anxiety in the adults around them. This is occurring at a time when children are also experiencing significant changes to their daily routine, and contact with friends and grandparents, which are often key to children's resilience. - Professor Alan Stein, Department of Psychiatry, University of Oxford.
It is unconscionable to ignore the immediate and longer-term psychological impact of this global situation, especially for children and young people who account for 42% of our world's population.
Parents would do anything to protect their children from distress and consequently may avoid talking about difficult feelings and events. However, research shows that even very young children are aware of things changing around them and that their understanding evolves throughout childhood and adolescence.
This Comment highlights some important concepts to help parents and care givers communicate with children:
- Magical thinking - a concept that describes a child's belief that thoughts, wishes or unrelated actions can cause external events; for example that an illness can be caused by a particular thought or behaviour (e.g. "Daddy got sick because I was naughty and didn't go to bed nicely.")
- Adults' preoccupation with the financial, practical and emotional impact of COVID-19 may compromise their ability to sensitively recognise and respond to signs of children's worries and distress
- Adults need to provide a model of sharing some of their worries, without overwhelming children with their own distress
Prioritising effective communication with children about COVID-19 is an essential component of a universal, community-led response to the pandemic to protect the intermediate and long-term psychological wellbeing of children.
Read the full Comment published in The Lancet Child and Adolescent Health.
The team, led by Dr Louise Dalton and Dr Elizabeth Rapa, has developed resources:
- To guide healthcare workers who need to inform families by telephone that a relative has died of COVID-19. A key part of this is to identify if the deceased was a parent. Contacting Relatives by Phone to Communicate the Death of a Patient
- To support caregivers with the unenviable task of telling children of an adult’s death (e.g. parent or grandparent) How to Tell Children that Someone has Died. In the forthcoming weeks, this guidance will be personalised to specific disciplines which are moving to telemedicine rather than face-to-face consultations.