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Stress from the COVID-19 pandemic can easily multiply problems for children who have experienced trauma in their young lives.
Known as an Adverse Childhood Experiences or ACEs, it can include all types of abuse, neglect and traumatic experiences. Upheavals in a family’s work, school, financial and social situations because of COVID-19 has created or intensified many adverse experiences for children.
Dr. Angelica Robles of Novant Health Developmental & Behavioral Pediatrics answered questions about ACEs, and how it affects children, parents and communities:
Are ACEs more prolific since the COVID-19 pandemic began in March? If so, why?
There are so many stressors. This is probably one of the biggest stress-provoking periods in our lifetime. I would definitely expect there to be more adversity that children are experiencing. We're not able to measure the exact numbers right now, but I know probably within the next year or so we'll be able to get more data to tell us that. We definitely theorize that there has to be an increase in these cases because of everything going on right now.
Which adverse childhood experiences (ACEs) are more likely to occur now, based on what kids are going through with parental job loss, work and school schedules, the compacting of families at home, etc.?
All of them have probably increased. A large study in the mid-1990s for Kaiser Permanente focused on certain ACEs including abuse, neglect, mental illness in the family, use of substances or alcohol in the family, domestic violence, having a parent in jail, current separation or divorce, or death of a parent or sibling.
We're most concerned about kids who don't have the outlet and the support of school. That's a big one, where you have teachers and school staff that can really look at them and see maybe there's something going on with the child at home. They are usually the mandated reporters that call Child Protective Services or DSS to share concerns. There's been a big decline in reports of child abuse. Some states are saying it's been half the normal rate. The big concern is that a lot of these are going unreported and kids are stuck in those situations at home.
What are some other concerns?
Other things that could be adversities include a lack of food, which is related to the economy being down and unemployment, along with being out of school where many children get meals for the day. I know some places have tried to help by providing meals, even through the schools themselves, but it's still a hardship.
Does ethnicity affect the prevalence of ACEs?
Absolutely. Before the pandemic, ACEs were noted more in minority children. Despite what socio-economic standing they had or anything else, minority backgrounds were definitely the highest at risk for having more ACEs compared to white children.
Another thing that COVID-19 has really shown is the disparities and highlighted a lot of the challenges we have in access to health care and need, in general. There has been a lot of data showing increases in COVID-19 cases among minority groups, kind of reflecting the disparities in health care access and poverty.
Has domestic violence risen during the pandemic, either against children or witnessed by them?
It is a little too early to tell, and there isn’t any data yet. But, any time there is a financial hardship or unemployment increases, you're going to see more domestic violence reported. This has been the biggest unemployment rate we've had in our lifetime, so I would definitely expect that to rise.
What can we do as a society and as adults, to help children dealing with additional stress these days?
We're all dealing with a lot of stress, and the children see that. As the parent or caregiver, try to ensure that you're taking care of yourself, your mental health as much as you can. Try to cope with your stress in a positive way, whether that’s by connecting with a friend or a counselor, someone in your church or community that you have relationships with where you can release some of that stress in a good way.
It's important to take care of your mental health because you'll be able to take better care of your child. The parent and caregiver is the person in the child's life who can be the biggest protective factor. Once you take care of yourself, check in with your child and see how they're doing, what their understanding of everything is, and just try to talk through it with them. The strongest protective factor for them is to have that strong positive relationship with you.
In the community, I hope that we would be able to offer supports to these families, by providing food or some respite to get them a break. We can't physically be close together, but we don't want to lose that social connection. That's so important within the community, trying to help each other out as much as we can.
How do you convey to children of different ages that the pandemic will end and many situations eventually will improve?
Some of the younger school-age children are stressed because of all the change in their routine and everything being thrown for a loop. Try to ask them what they think is going on, their understanding of everything.
Provide them information, not more than they need to know, but enough to let them know `OK, maybe we have to be healthy and keep each other safe by washing hands, wearing masks and school might look a little different for now.’
For teens, they're definitely having a lot of challenges because they're so social in nature. Talk to them and see where they're at, what they're most concerned about, and what they're able to understand. Try to be there for them.