Welcome to the December 5 Things Digest from the NTTAC Infant & Early Childhood Transformation Team, bringing you 5 Things to know right now about infant and early childhood mental health in the time of COVID-19.
Thing #1: Infants and young children are experiencing trauma during the COVID-19 pandemic. 
Young children, toddlers, and infants who have lived through frightening events and extreme stress may react in different ways. Understanding what trauma is and how to recognize the signs and symptoms in young children can ensure that appropriate steps towards safety and healing are taken. Young children can be supported after a traumatic event by providing security and comfort through trusted relationships, sticking to routines as much as possible, offering opportunities to talk about the event and acknowledging all feelings that may arise, teaching and practicing coping skills such as deep breathing or mindfulness, and allowing young children to play and find enjoyment in normalcy. 

When systems, professionals, and caregivers are aware of the impacts and can recognize the signs of trauma in infancy and early childhood, supports can be put into place quickly to help build resilience and begin the healing process. Check out the resources below for more information on trauma and young children.
One-hour webinar from the Office of Head Start
Tip sheet from the Child Mind Institute
Facts and figures about the traumatic stress in children with disabilities from the National Child Traumatic Stress Network
Tip sheet for supporting children after a traumatic event from the Child Mind Institute
One-hour webinar from Zero to Three

Thing #2: Nurturing and responsive relationships buffer the effects of stress and build resilience in young children.
Young children do not exist outside of the context of relationships. Infants, toddlers, and young children rely on adults to meet their basic needs; provide love, safety, comfort, and security; and have some consistency in these responses. When caregiving relationships are nurturing, responsive, and consistent, young children learn that adults can keep them safe. These high-quality responsive relationships have many benefits for young children, including buffering the impacts of stress; supporting social emotional health, development, learning; and building resiliency. Having one supportive adult relationship can make the difference for a young child in their ability to bounce back after a stressful or traumatic experience. 

COVID-19 has been stressful for adults down to infants and for everyone in-between. Having strong adult-child relationships can be a protective factor and support resiliency during this trying time. The resources below give further tips, strategies, and information on how to support relationships with young children.
Two-page tip sheet from Head Start
Three-page tip sheet on specific strategies for managing stress in young children from Harvard University’s Center on the Developing Child
Curated links to resources that help families build social supports during COVID-19

Thing #3: Adult wellbeing and stress management is essential to positive infant and early childhood mental health.
Infants and young children take cues about how they should respond to and feel experiences from the trusted adults around them. When caregiving adults are experiencing high levels of stress, young children notice and feel that too. COVID-19 has created new stressors for adults, including: worrying about health and safety during daily routines; financial hardships; loss of jobs or housing; caring for loved ones who are ill; and exhaustion from balancing childcare and work.

Adults who can recognize triggers and sources of stress in their day-to-day lives can use tools and coping skills such as mindfulness, relaxation, deep breathing, exercise, sleep, and boundaries to combat the negative effects of stress. Self-care is the act of taking care of or protecting one’s well-being, health, and happiness, especially during times of stress.  Adults who practice self-care regularly are less likely to experience the impacts of burnout and vicarious trauma. They are also better able to regulate their emotions and feelings during periods of stress. Caregivers with strong self-care habits are more available to build nurturing and responsive relationships with their children and respond to young children’s big feelings in a supportive way. 

Healthy adults lead to healthy relationships with young children, which is the key factor in building resiliency. The resources below offer more information on self-care, mindfulness, and stress management.
A curated list of resources including posters, relaxation exercises, and stress-reduction techniques from Head Start
Strategies for integrating mindfulness in early childhood workforce contexts from Zero to Three
Newsletter with summary and additional tips and resources to help identify and manage stress from the National Office of Head Start
One-hour webisode from the U.S, Department of Health and Human Services on how to support the early childhood workforce to manage stress
Brief tip sheet for parents with strategies for emotional regulation from Zero to Three

Playlist of calming music curated by NPR

Thing #4: Supporting young children with loss and grief is important.
Many families are experiencing losses in the wake of the COVID-19 pandemic. Grief and loss are difficult emotions for adults to process. It can feel overwhelming to think about how to support a young child with these concepts after a death or loss of a loved one. Young children may also be experiencing other losses such as moving homes, not being able to go to school or childcare, or not seeing grandparents or extended family members. 

When supporting young children with a loss, it is important to remember that there is no right way to show grief. Offering simple, straightforward, truthful explanations that are age appropriate about what has happened can support young children in the grieving process. Providing extra connection, predictable routines, and activities to young children who have experienced a loss is important. Listening, validating all feelings that may arise, and offering comfort within the caregiving relationship are also strategies that are supportive after a loss.

It is important that caregivers have time and space to process their own feeling after a loss. Practicing self-care during the grieving process can help to mitigate the stressful impacts of a loss. Adults may show a wide range of emotions after a loss such as spontaneous crying, laughing, anxiety, or depression. Labeling these feelings and explaining why they are happening can help young children have a better understanding of what is going on. Check out the resources below for more information on supporting young children with grief and loss.
Concrete strategies for talking with young children about grief and death from Zero to Three
A tip sheet from Stanford Children’s Health with strategies for talking to children and young adults (from infancy through teenage years) about grief and death
Brief overview of common reactions to death among children and conversation prompts for talking through the death of a loved one from the Child Mind Institute

Thing #5: Continue to talk and check in with young children about COVID-19.
As COVID-19 stretches on, young children may have new or continuing questions, worries, or fears related to the pandemic. Creating spaces to regularly check in and talk to young children about COVID-19 is important. Thinking about truthful, age-appropriate responses to questions young children may have is essential. Adults and caregivers may not have the answers to all of the question’s children have. It is okay to say, “I don’t know.” Validating these feelings and reassuring children that important adults in their lives are doing everything they can to keep them safe and healthy provides security and can support resiliency. 

Having these conversations on an ongoing basis can also provide opportunities to dispel misinformation children may have heard. Continuing to provide nurturing and responsive relationships, consistent routines, predictability, and joy through play can help to buffer the stresses young children may be feeling related to COVID-19. For additional resources to support conversations with young children about COVID-19, check out the links below.
Sample questions and answers for talking to young children during the time of COVID from Zero to Three 
A resource for the National Association of School Psychologists (NASP) for parents who need support for age-appropriate ways to talk to young children about the necessary changes under COVID 
A printable, illustrated storybook about living during the coronavirus that emphasizes resilience and coping skills, with accompanying companion answer resource and parent guide developed through the National Child Traumatic Stress Network
A coloring and activity book to help children understand the coronavirus and its repercussions from the Center for Child Stress and Health
Contact the National Training and Technical Assistance Center for
Child, Youth, and Family Mental Health
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Disclaimer: The views, opinions, and content expressed in this email do not necessarily reflect the views, opinions, or policies of the Center for Mental Health Services (CMHS), the Substance Abuse and Mental Health Services Administration (SAMHSA), or the U.S. Department of Health and Human Services (HHS).