Post on 01-Jun-2020
ASN Module 1:
Explaining coronavirus and
managing children's health
anxieties
Menti code : 11 82 56
About Three Sisters Consultancy
Today’s session will...
● Help parents and carers answer the question “should I be honest?” and
explore what children and and young people to know about COVID19
● Introduce resources that can be used to help explain what the virus is,
including visuals and social stories
● Explore how we can use positive language to promote hygiene and safety,
rather than focus on anxiety-led language
● Identify the sensory issues some children may have around hand washing
and how we can facilitate better hygiene.
Working together● This webinar format is new and might be an adjustment for all of us
● We will not be able to answer everyone’s questions, but feel free to ask any
questions in the MENTI evaluation.
● Cat and Svenja will take a few minutes half way through and at the end of
the webinar to ask Corrie a few questions.
● We will be suggesting a few activities to explore at home due to limited time
● These slides will be sent to you after the webinar.
● Be kind to yourself!
Tell me about you!
In the question section…
Please tell me where in the
world you are tuning in from
And in one word, what you
hope to get from this session
“This is not a disaster movie but we all at times might feel
like that”
Dr John Goldin
What is our role as supporters during this pandemic?
● Reassuring parents/carers so they can support their children and young
people
● Making sure any and all information we share is valid (NHS, gov.uk)
● Giving them advice based on our expertise and resources that reflect the
needs and outcomes of the people you support
● Giving parents/carers a space to express their concerns, but without adding
to them
● Signposting to specialist services where needed
In the comments, answer this
question:
Should we be talking about COVID-19
with children and young people with
additional support needs? Why or why
not?
ACTIVITY
Why we should be talking about COVID19
1. Children and young people are getting information - but we don’t
know how much, from where and how well they understand it
2. Young people, no matter their support needs, are perceptive to
changes in routine and changes in parents, carers and supporters
3. Parents and carers need to be trusted by their children to be open and
honest
4. Personal responsibility is a big part of our fight against COVID-19
5. Anxiety can come from fear of the unknown
But, we need to be age and stage appropriate!
Where to start: how we can support our parents/carers
1. Find out what the child already knows (including misinformation,
rumours etc)
1. Plan out what you think you should tell the child
1. Centre your conversation on the facts (not what ifs or maybes)
1. Prepare the child for what happens next (in relation to their immediate
world)
Do not rush this process!
How do I explain COVID-19? Key phrasing by
age/stage
Early Level (typically age 3-6):
Coronavirus is a germ that makes people sick. I can make sure the germs stay
away by washing my hands with soap and water. The grown ups who love me will
make sure I am safe.
First Level (typically age 6-8):
Covid-19 is an illness like getting the flu. Some people call it Coronavirus. It is
caused by germs that spread from person to person. I can make sure the germs
stay away by washing my hands with soap and water. The grown ups who love
me will make sure I am safe.
Second Level (typically 9-12): COVID-19 is a virus also known as the
Coronavirus. It is caused by germs that spread from person to person. Most
people who have the virus will stay home and get better. A very small number
of people will need more help to get better. I can make sure the germs stay
away by washing my hands with soap and water. The grown ups I trust will help
keep me safe.
Secondary age: COVID-19, or Coronavirus is a an illness that is like the flu.
Most people who have the virus will stay home and get better. A very small
number of people will need more help to get better. I can keep myself and other
people safe by staying at home, washing my hands with soap and water and
covering my mouth when I cough using my elbow. The grown ups I trust will
help keep me safe.
How do I explain COVID-19? Key phrasing by
age/stage
Setting the scene for a conversation
Environment: noise, setting, smells, other
distractions (ie. younger sibling watching
tv)
Time: Tiredness, interruption to routine,
medication, processing time
Personal: State of mind, worries,
motivation, engagement, wellness
“Panic is not helpful...children will be noticing” - Jon
Goldin
‘Social Distancing’, ‘Social Isolation’, ‘Lockdown’These phrases are complicated and made up
For young people with ASN, it’s best to describe the
situation by describing what we are actually doing
“Staying at home” and “Staying away from people
who don’t live in this house”
“Staying at home, going to the park for 30 minutes”
Best practice: “Andy stays at home and doesn’t go
to school. Andy walks to the postbox and back with
mum once a day. If Andy needs to go to the doctor,
Mum can take him”
We are superheroes!
Reframing social distancing and self isolation from things we are not
doing to the things we are doing can make a difference
“We are going to stay away from Granny’s house today even though
its Tuesday. You can draw granny a picture of her instead. By doing
this you are helping her to keep safe and stay strong. Well done!”
“Washing our hands might feel weird, that’s because you're fighting
all those millions of germs with your superhero skills”
“By learning at home instead of at school, you’re making sure
*favourite school staff member* is happy and healthy! That is really
important!”
Staying far away from people: what does 2m look like to you?
● Physically showing what two meters looks like can help a child or young
person understand how far away they need to be from other people
● Ask children and young people to guess what 2m looks like. This is a good way
to test their proprioception
● Using a visual such as a broom, a 2m dog leash, or even identify the amount of
steps the individual has to take to be two meters away can help visualise
● Remember to prompt it is not just 2 metres in front, it has to be from every
angle. Asking what people can see of other people at 2 metres is a good
indicator (can see someones glasses but not freckles on the face etc)
● Finding a key prompt word for public allows for quicker communication.
● Identifying that some people aren’t very good at social distancing but we can
help with that (i.e. moving further away with someone with mobility issues)
Social distancing visual
https://accesseasyenglish.com.au/wp-
content/uploads/2015/12/We-need-space-between-us-
Version-2-Easy-English.pdf
https://www.talkingmats.com/wp-content/uploads/2020/03/20200324-coronvirus-easy-read-v3_.pdf
Sensory issues with washing hands
Washing hands can be a sensory difficulty
Parents and carers can:
● Explore different smells, textures and temperature of water.
● Use a large bowl/bucket if running tap water is too overwhelming.
● Making it interactive with social interest. I.e. a song from their favourite tv show,
Thomas the Tank Engine needs a wash can you help him.
● Giving each child a role: soap manager, water temperature manager, towel manager
● If a smell is too strong, giving a young person a strong tasting/minty sweetie/chew can
help distract from the process
● 2 stars and a wish; ask them to rate each others handwashing with two positives and a
wish. I loved the way you got in between your fingers and got bubbles on your wrist.
Next time we can try rubbing the bubbles into our wrists as well”
The Epic Handwash
Parody - Peter
Hollens
https://www.youtube.com/watch?v=
-gfOHEaHdjo&feature=youtu.be
Resources
What is Corona
https://www.mencap.org.uk/sites/default
/files/2020-
03/Information%20about%20Coronaviru
s%20ER%20SS2.pdf
How we stay
healthy
https://accesseasyenglish.com.au/
wp-content/uploads/2015/12/Look-
after-yourself-Coronavirus-20-
March-2020-Easy-English.pdf
https://www.tes.com/teaching-resource/covid-social-story-school-closing-and-virus-12270054
https://blogs.glowscotland.org.uk/ea/public/newcumnockprimaryschoolea/uploads/sites/1808/2020/03/18130857/Social-story-on-corona-virus.jpg
Supporting parents and carers to notice anxiety in their
children and young people
Please be aware that this guidance is adapted from British Institute of Learning
Disabilities (BILD), The British Psychology Society, The Association for Child and
Adolescent Mental Health (ACAMH), Child Mind, NHS Scotland and other sources.
For best practice guidance or questions please refer to these sources.
Mental health and COVID-19
Why should we be thinking about mental health?
In Scotland, children and adults with Autism and learning disabilities are statistically
much more likely to have mental health conditions
(Hughes-McCormack et al, 2018 and Rydzewska et al,2016)
The current pandemic adds more stress and can limit our ability to manage
anxiety
Children and young people with ASN may
● Be more prone to anxiety in general
● Have less ability to process complicated information about the pandemic
● Struggle to identify their own feelings of anxiety (particularly as it becomes the new normal)
● Struggle to understand why they’re anxious
● Not have the communication to tell us their worries
● Have black and white thinking which makes it hard to work through the ‘grey areas’ of
COVID19
● Be more impacted by changes to routine
● Be more socially isolated without school
We may see more health anxiety, which is anxiety that centres around health and illness
We might also see increased general anxiety
Discussion: what might anxiety ‘look like’ for young
people with additional support needs?
ACTIVITY
What does anxiety look like?
Clinginess, need for reassurance and fear of
being alone
More need for control
Overplanning
Tearful, withdrawn Nightmares
Bed wetting Increased irritability, angry outbursts
Trouble sleeping Lack of concentration
Sore tummy or feeling generally poorly
(sometimes with no evidence of symptoms)
Avoidance of activities (even ones they used
to love)
Lack of appetite or overeating Lots of bad thoughts, feelings of doom,
thinking of the worst case scenario
Repetitive behaviours Behaviours played out in play (toys are getting
poorly)
Hi Cat!(Question Time)
Noticing worry in children who may not notice
Worry schedules/charts (organised by
time of day or activity) are a tool we
can use with children where possible
to try to understand patterns of
behaviour.
These are useful for children who may
not know they are worried or why
We might notice at certain times of
they day (bedtime) or during
transitions (going out for exercise) and
change how we approach these
https://www.pocketot.com/product/r
ate-worry-chart/
This is a paid resource, we
recommend building your own (ie.
traffic lights)
Key messages for parents and carers
● Expect stress
● Stay connected to friends and family
● Normalise the experience
● Reduce access to rolling news
● Supervise children with screens
● Don’t make promises you can’t keep (ie. “things will be back to normal by your
birthday”)
● Focus on things that reduce anxiety: routine, open communication, exercise,
connecting to others
● Sleep, sleep sleep!
● Talk about who’s job it is to worry and ‘fix’ the issue: “There are a lot of scientists,
doctors, health professionals etc. who are working very hard to make sure that we get
through this, which we will do” (Dr John Goldin)
(British Psychological Society, 2020)
Focusing on what we can control
Worry chartMy worry Why I feel worried What I can do to worry less
I am worried about
Nana
Nana is old and old people get
Coronavirus and die
I don’t see Nana so I’m worried she’s
dead
My nana and I do things together like
baking a cake, I miss Nana
Remember that not all older people get
COVID-19, and not all people with COVID19
die
See nana on facetime or have a phone call
with nana
Send nana cards to show her I care about her
Bake a cake with mum and phone nana for
help with how to stir the cake
Take a helpful role “I remind nana to take her
tablets before bed”
My hands are
always dirty
Germs are invisible
Germs give you Coronavirus
The TV man said wash your hands to
save lives
I wash my hands before and after each meal,
after I use the toilet and after I go outside
I put a sticker on my washing chart
I don’t watch the TV man anymore
ACTIVITY
● Think of some of the worries you have heard from parents/carers.
● Can you think of a way of using the previous format to help alleviate them?
My worry Why I feel worried What I can do to worry less
My hands are
always dirty
Germs are invisible
Germs give you Coronavirus
The TV man said wash your hands
to save lives
I wash my hands before and after each
meal, after I use the toilet and after I go
outside
I put a sticker on my washing chart
I don’t watch the TV man anymore
Jumping jacks
Positive Coping Skills
Worry relief visuals (like a coping wheel)
The coping skills are things a child has chosen that help relieve the
worry like:
● a hug from mum
● going into the garden
● 10 jumping jacks
● singing a song
The child/young person is encouraged to find a coping mechanism
and use it when they feel worried, and praised when they do
Try to mix it up to avoid repetitive behaviours
Worry tokens: carving out time for worries● With any anxiety, it’s important to try and make
the thoughts less catastrophic in nature,
providing alternative narratives as much as
possible.
● Having a system where there is assigned “worry
time” where children and young people are able
to ask any questions to a trusted adult is helpful.
This can help compartmentalise
● Having a visual, whether they are “worry tokens”
or question time once or twice a day allows
children the opportunity to talk unprompted.
● You dont need to have the answers today! Its ok
to say you will look that up and get back to them.
The parents/carers I support feel worried!
It’s ok for parents/carers to express that they are anxious, and that these are strange times
for everyone
You can support parents/carers to present a calm, resilient front by:
● Promoting parents/carers to have someone to talk to outside of your children (a friend,
family member, telephone counsellor). For some practitioners, that might be you.
● Ask parents to take time to process the news before they speak to their children and
young people. Our urgency can affect our delivery of information
● Reassure families that it is ok to ‘circle back’ on a conversation that they are too
anxious to respond to right now. This is true for you too!
● Help parents and carers understand what worries are child appropriate (for example,
global death toll is not relevant, children should not have to carry the burden of
financial concerns)
In conclusion● Having a heightened state of anxiety during this time is completely
normal
● Explaining COVID-19 in an age and stage appropriate way is vital
● We should focus conversations in the world of the young person
● Finding creative ways to promote handwashing and being positive
with our language is key.
● Helping parents/carers to manage their own mental health (as much
as possible) is key to keeping their children calm
● Identifying anxiety is key
● Focusing on facts not fear gives children/young people more control
● Allow for worry time and focus on coping mechanisms
Self Hug - Sesame Street
https://www.youtube.com/watch
?v=Xa_qNH8u3OM
To read● https://www.acamh.org/podcasts/dr-jon-goldin-on-the-coronavirus-and-child-mental-health/
● https://accesseasyenglish.com.au/wp-content/uploads/2015/12/We-need-space-between-us-Version-2-Easy-English.pdf
● https://www.talkingmats.com/wp-content/uploads/2020/03/20200324-coronvirus-easy-read-v3_.pdf
● https://www.youtube.com/watch?v=-gfOHEaHdjo&feature=youtu.be
● https://www.mencap.org.uk/sites/default/files/2020-03/Information%20about%20Coronavirus%20ER%20SS2.pdf
● https://accesseasyenglish.com.au/wp-content/uploads/2015/12/Look-after-yourself-Coronavirus-20-March-2020-Easy-English.pdf
● https://www.tes.com/teaching-resource/covid-social-story-school-closing-and-virus-12270054
● https://blogs.glowscotland.org.uk/ea/public/newcumnockprimaryschoolea/uploads/sites/1808/2020/03/18130857/Social-story-on-
corona-virus.jpg
● https://www.pocketot.com/product/rate-worry-chart/
● https://www.bps.org.uk/sites/www.bps.org.uk/files/Policy/Policy%20-
%20Files/Talking%20to%20children%20about%20coronavirus.pdf
● https://www.youtube.com/watch?v=Xa_qNH8u3OM
● https://www.parentingacrossscotland.org/info-for-families/coronavirus/?fbclid=IwAR277z46IYCffWkMstkvhyU2SgYQknEx-
5ZC_RwsRGdcalbhJPS7Qg2GNhM
● https://depts.washington.edu/hcsats/PDF/TF-%20CBT/pages/combined/CBT-Strategies-for-Worry.pdf
● https://www.teacherspayteachers.com/Product/COVID-19-Coronavirus-Social-Story-for-SpEd-or-Early-Elem-5323750
● https://www.annafreud.org/on-my-mind/self-care/
● https://www.bps.org.uk/news-and-policy/bps-offers-advice-schools-parents-and-carers-help-children-through-uncertainty
● https://childmind.org/article/what-to-do-and-not-do-when-children-are-anxious/
● https://childmind.org/article/talking-to-kids-about-the-coronavirus/
● https://childmind.org/article/talking-to-kids-about-the-coronavirus/
● https://www.bild.org.uk/wp-content/uploads/2020/03/LD-Senate-Coronavirus-resources-for-use-by-families-27.3.2020.pdf
We look forward to you joining us again
soonFind out more about our upcoming webinars here:
https://www.eventbrite.co.uk/o/children-in-scotland-20206726841
Wednesday, 8 April 2020, 10.30am-12pm:ASN module 2: Creating positive routines & environments for children and teens
Wednesday, 15 April 2020, 10.30am-12pm:ASN module 3: Exploring strategies and resources for children and teens
Wednesday, 6 May 2020, 10.30am-12pm:
Discuss puberty & manage change with children with learning disabilities
11 82 56
11 82
56