Kids may not be able to identify and communicate their feelings as we go through uncertain times. Last July 25, we held a live webinar with Dr. Colleen Carlos-Viray and learned how to identify the signs of stress in young children and what to do about it.
Check out Dr. Colleen's responses to questions from our audience during the discussion.
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What are the early warning signs if a child is experiencing stress or just regular tantrums?

It will also depend on the age of your child J Usually a child will start having less tantrums when he or she is able to regulate himself, usually by 6 years old (but could be different depending on the child’s temperament also).  You can check if the regular tantrums are increasing in frequency, or the child is more easily triggered, or takes a longer time to calm down—if you observe these things in your child it could be that he is going through a stressful situation in his life.  But if you have a toddler (as mentioned in the social emotional milestones in the lecture), at 18 months old that’s when temper tantrums become more frequent, so his tantrums could also be due to his developmental age.

Do you have suggestions on how we can explain to smaller children the need to stay home? My 2-year old keeps on trying to get out and cries every time he sees his dad going out to buy essentials.

You can try saying, “right now there is a rule that families, especially children have to stay home for a little while so we can all be together and be safe.  Daddy just needs to go out to get food and other things we need so we won't go hungry.  Staying home will help us to stay healthy.  You can try making him wear a cape, to show that when you’re at home, he is strong and like a superhero.  You can also say I know it's sad when we can't go out and be with our other families, but we can have a lot of fun here at home too. Also, check if he might also be anxious about daddy leaving the house, so you can try establishing a routine that shows daddy leaving and coming back safely.  

My daughter is 7 years old and recently she has been expressing to me and her dad how worried she gets for both of us, her parents, as well as her pets. She asks me and her dad repeatedly where we are going, even if it's just here inside the house. I once fell asleep 1 afternoon and she was close to tears because I wasn't responding when she was trying to wake me up. Could this be an effect of the pandemic? 

Yes it could be an effect of the pandemic, she may be anxious and fearful for her safety and the safety of her loved ones, which is a common reaction to this pandemic. You can try doing the techniques mentioned in the lecture --acknowledging her feelings, and constantly reassuring her – but if this becomes persistent and seems to be impairing her daily activities, or if it goes on for a long time despite your interventions, kindly seek consult with your pediatrician, as she might need to seek help with a child specialist.  

My 7-year old daughter has her own Facebook messenger account and she has used this to connect with a couple of kids from her class. However, when she messages/calls them, and they do not answer, she gets angry. One time we caught her using bad words against one of her classmates whom she considers her BFF. We confiscated her iPad and grounded her; but when we gave it back to her, after a few weeks she repeats it again. Is this a sign of aggression resulting from stress or an attitude problem?

If your daughter was not like this before the pandemic, yes I think I would say that the stress from the pandemic could be a probable explanation of her behavior. I agree that what she did was wrong and she should be reprimanded.  Another way of dealing with it is talking to her and asking her about how she’s feeling when they don’t answer—sometimes kids feel like they are losing their friends because of this pandemic, and her age is the age where peer relationships become important.  You can also teach her anger management techniques (deep breaths) when she feels upset.   Anger is a normal and valid emotion, we all feel it it’s just that for kids they sometimes don’t know how to express anger in an appropriate way yet.  Also monitor the shows she is watching, sometimes they also imitate the behavior they see on TV, especially the bad words. If no one says it at home, they could be learning it from the shows they are watching. 

How do you explain a passing of a loved one to a child?

Thank you for this question and I am sorry if this has happened to you or someone close to you.  Children’s understanding of death differs depending on their age.  If a child is between 2-6 years old, they are still what we call egocentric, and are still unable to separate themselves from the environment, at 4-5 years old they are also bound by fantasy or magical thinking.  At 4 years old they still have no understanding of the finality of death,  so don’t be alarmed if they ask, when is (name of the person who passed away) visiting us again?  At 5 years old they may begin to personify death, and may draw ghosts or skeletons, and at 6 years old they may often ask about the technical aspects of death.  

When you do tell the child, tell the truth about what happened right away, (____ died because he got very sick).  when something bad happens, they more often than not feel like it’s their fault (magical thinking, they may think that it’s because they were not good, or they shouted at them, etc,).  Please make sure to use the word dead or died (please NEVER use the phrase going to sleep), because some evidence shows that realistic words to describe death helps with the grieving process.  You can cry together with the child, and maybe try to set up a ritual with the child, maybe bury an object that belonged to a loved one, make a scrapbook for the casket, because this may give them a sense of control over the traumatic loss, especially if it was sudden.  Also acknowledge the child’s emotions—don’t try to distract the child when he is crying about the loved one, because it’s important for them to go through the grieving process. 

What will happen to a child if there were unmet needs on each social-emotional milestone? 

They may manifest with difficulty in emotional regulation and stress regulation, and when they get older they may have trouble with forming relationships.  But it is never too late to repair the child’s social emotional regulation—the brain of a child is plastic (neuroplasticity is the capacity of the brain to rewire and repair itself), and if we make up for it by being nurturing and responsive, there is still hope for that child. 

The kids are resorting to online activities. The kids are refusing to do other things and just want to stay in the room. Is that a sign of stress? What can we do to encourage physical activity with a limited space?

As mentioned in the lecture, making them do chores can be a way of encouraging physical activity, but then again, chores are not fun. We can try to make chores fun by doing it together, putting the music on and dancing while doing the chores.  You may exercise together, do jumping jacks, planks, together, follow YouTube videos of Zumba and yoga online, for younger kids you may play charades (act out movements of animals which is a great workout) or piko/hopscotch (draw a box in the house) or stop dance in the house.  Their refusal to do other things and just do online activities may also be because online games and shows are very stimulating, so they may choose that activity over doing something else.  Please make sure also to limit the time for online activities, since it has effects on language, memory and attention.  For young children (2-6 yrs, it is recommended to limit digital media use to 30 mins to 1 hour a day, with high quality programming, and should be supervised) and for children older than that digital media time should be limited to 2 hours per day.

My 23-month old son makes a specific sound when he's focusing on something. Is that normal? The sound that he makes is similar to the sound of when you play with a toy car. I'm actually trying to make him sing a song instead, it somehow works, but he's still doing it from time to time.

Its hard to imagine what is exactly happening based on the description, what you may do is try to take a video of your concern and you can show it to your pediatrician. You may also have your child undergo developmental screening if you are concerned about this behavior. The Medical City Center for Developmental Pediatrics has online services which include developmental screening and developmental assessment.

When my daughter gets anxious or is stressed, facial tics manifest. It is a sign for me to ask about what stresses her out. However, should I point out her facial tics so she is aware to control them? 

I would like to ask if your child has been evaluated regarding her tics?  Yes I would agree that you can point it out, but tics are involuntary, meaning they cannot be controlled.  You can tell her gently about the tics. If the tics are disrupting or affecting her motor or speech patterns, or interfering with her social/emotional relationships (children usually become conscious when they’re friends point it out), maybe she will need treatment.  Please consult your pediatrician also.

My teenager refuses to attend her Zoom class and I’m getting so upset and stressed but she acts more stressed. It becomes so upsetting for me and I’m having a problem to deal with her. Emphasizing it’s a privilege but she is used to attending a small class and she said she doesn’t want to be in a zoom class with other students she doesn’t know.

This online learning thing is a big change for all of us, especially for the kids--- her feeling of not wanting to be in a zoom class is valid, so you can try to acknowledge that feeling and tell her I know our situation is hard right now, this is not an ideal set up etc, but maybe you can just try it out.  Try to talk to the teacher also that your child is having a hard time adjusting to the set up.  We really have to be patient at least for the first few weeks about how our kids will react to this new online set up, since school is really not meant to be that way. 

What is your comment on young parents and their social-emotional milestone and their coping skills when it comes to handling children?

Teenage parents may have trouble with managing both their social emotional milestones together with the drastic changes of having a child of their own. They might really need guidance, and children are at high risk for unintentional abuse or neglect because of this.  However, majority of these young parents also learn to mature quickly to adjust to the needs of their child. It also sometimes depends how young they are, but if they are in their middle teen years (14-17) they may really need the guidance of other adults.    

How do I deal with my kid when he does not eat fast?

This is where a routine might help, and having good feeding practices set at an early age may help with this.  Make sure to always eat at the dining table, model ideal eating with your child, limit the meal time to 30 minutes and make the child help pack away after so he knows the beginning and end of the meal, and make sure to serve an appropriate amount of food for age.  For a young child the size of the stomach is the same as their fist, so do not put more than that because the child may feel overwhelmed and do not force them to take food more than that if they say they're full.  Make sure there are no distractions on the table (TV, iPad, toys), and to make independent with his feeding (by 2 years old a child can eat with a spoon, by 3 years old can eat with spoon and fork already.  

Can my stressed teenager take magnesium glycinate?

Hi! There have been some studies about the benefits of magnesium glycinate in stress and anxiety, since it has a calming effect and may help with sleep, but personally I have not prescribed it so I cannot speak for it because I have no experience regarding it.  However, this still cannot replace regular exercise and movement, healthy eating, adequate sleep, and regulation techniques like mindfulness and meditation, which all have strong evidence against stress, anxiety and other mental health disorders 



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