This is the best health podcast brought to you by wake forest Baptist health in partnership with MedCost. Good afternoon everyone. Welcome to another edition of the best health podcast.
Um, we are, um, facilitating and several podcasts here, uh, using virtual technology and doing them from remote locations, uh, due to the Corona virus coven 19 situation that is altered, um, most of everyone's life here. And we are, I'm going to be talking, uh, related to coven 19 and Corona virus. Uh, again today. Um, what I wanted to do today was, um, facilitate, um, a second conversation creation with dr Nick Linda and Nick Alati. Excuse me, dr Nicole odea didn't mean to mess up your name. Uh, but that doctor Nikolai is joining us today and um, she did a best health podcast, um, a couple of weeks ago with us. Um, and really when so much has changed in the last two weeks, um, with, with most everyone's lives and in the United States and certainly North Carolina and the triad. And, um, we had a great conversation about having to facilitate, um, a conversation about coven 19 and Corona virus with your children.
Be a, they were younger children or older children. Um, and we've, we've fast forward to the couple few weeks and, um, wanted to touch base with her again and just, um, wanted to welcome you, doctor Nicola. Thanks for taking time out of your schedule to join us again. Yeah, thanks for having me back. Um, so, uh, I think we're going to have a really good conversation today about, um, you know, kind of what is, you know, several people are, are telecommuting or virtually working or have had their schedule altered for work in some way. And, uh, the children around our state, of course, I've had their schedule altered in a major way with doing virtual learning from, from their home or wherever they are with their guardian or their parents. So I'm just wanting to talk through some of that today. And, um, maybe you can help us and offer some words of wisdom and some tips and advice. Dr Nicola, you on, um, just the best way to kind of navigate through this what, you know, what I've, I've heard the new normal quote unquote, you know.
Um, so, um, before I do that, I do want to just let people know, um, we're, we're going to be talking about specifically helping kids, uh, manage this changing landscape due to coven 19, but for, um, all the coven 19 information that way, forest bath, Memphis health has, I want to encourage people they can visit wakehealth.edu/coronavirus that's wakehealth.edu/coronavirus. And that of course has much more comprehensive information about, um, you know, symptoms, what to do if you're sick, uh, visitor restrictions, clinic updates, all of that information. Uh, but all the coven 19 related podcasts were also be on that page as well, so that's good. Um, so, uh, dr Nick Galati, before I jump into the first question, if you wouldn't mind just, uh, talking with our listeners and telling them a little bit about yourself.
Sure. Yeah. I'm a licensed child psychologist and the director of pediatric psychology and behavioral health and the department of pediatrics at wake forest Baptist health.
Okay. Um, so how long have you been with Brenners and [inaudible] children's hospital and wake forest Baptist health?
Yeah. So I've been at working at Brenners and Wake Forest Baptist Health almost six years now.
Okay. That's cool.
Yeah, mainly with children and adolescents and families.
Okay. Uh, well we appreciate you being here and appreciate, um, all the specialists and experts we have at burner children's is definitely a huge asset that we have for this, for this area. Um, so a lot of this I can definitely personally relate to the last couple of weeks of adapting to this new normal and with kids being at home and, and trying to do schoolwork and maintain some sort of schedule. Um, you know, so the first question has to do with that. With the routine. They seem kids seemingly, you know, they, they seem to work with the best in, in a routine and structure. Um, and we've had a lot of our routines just flipped upside down. Um, so what should we expect, uh, from, from children? Uh, both young and older kids, uh, with the situation of, uh, you know, us, we're trying to find our new normal, but they're trying to find their new normal too, aren't they?
Yeah. I think right now everybody is struggling to find the new normal for possibly the next several months. Um, you know, Kendall lives have been turned upside down pretty much. Um, suddenly they're doing online school. Their activities have van cancels. Um, it's recommended they don't see their friends in person right now and they're pretty much home bound. Um, and similarly, parents are dealing with the same scenario. Many trying to work from home, trying to figure out how to be teachers from home and help their children with their schoolwork, um, keeping their families safe. Uh, so stress levels might be running high at home right now as families are getting adjusted to this new way of doing things, new way of life for now. And also maybe preparing for even greater movement restrictions. Um, and parents may notice some kids start having more behavioral issues. Uh, maybe you know, more irritability or moodiness or being withdrawn, kids might be experiencing more of these negative emotions. Um, and this may just mean that their kids are having a little bit of difficulty adjusting to the new normal. Um, but comparatively there's some other kids who may adjust pretty well. It's all these changes.
Gotcha. Well on speaking of adjusting, you know, what are some, as, as they kind of work through this, you know, kids, they, they share their emotions and different ways at different times. Um, just obviously number one at the developmental phase they're at based on their age. Um, but number two, just, you know, based on, you know, their, their surroundings and their structure. Um, so what, what are, what's some advice? What's some tips you can share with us on how we can encourage children to share their feelings in constructive ways where we can have constructive dialogue and conversation with, with the children?
Yeah. I mean, last time when we talked, it was, the question was more, should we be talking to our kids about Ron Avarez? It's not really bad anymore. It's, what should we be telling them? What conversation should we be having with them? So I think keeping lines of communication open with both younger and older kids, it's really important right now. So many changes even in the last couple of weeks, you know, we're looking at even our changes down the road. I think parents can be aware of giving kids permission to talk about their feelings, asking some questions, letting them okay to share their feelings and their experiences. There are helpful questions I think parents can ask to get that conversation started. Things like, you know, what worries do you have about run a virus? How are you doing with all the changes the hardest for you? Is there anything you actually like about the changes to your routine? You know, some kids sleeping in a little more about socializing and going to school or participating in activities. Yeah. So I know my kids are enjoying being able to sleep in a little more than they actually have to go to school.
Yeah, indeed. That's a good point. I'm um, one of my children, they had, he had a video chat today actually with his classmates and his teachers. Um, and it was the first time they'd able to do that and it was, it was great for them just to kind of touch base and see each other and talk in a, in a group setting. So, um, you know, where we're all kind of learning as we go of how to adapt. Um, so as kids are sharing their thoughts, their feelings, their emotions, you know, what is the quote unquote right way for us adults to respond to the children. Um, cause sometimes they might be sharing their feelings and what we perceive as a negative way. Um, you know, but we're all there still trying to figure out how to make sense of this. So, you know, what, how can we respond as adults to what they're sharing with us?
Hmm. That's a good question. Well, adults and parents can create an opening for children to be comfortable sharing and expressing feelings. Uh, it's important to listen to children validate their feelings and experiences. Sometimes parents have to be a detective, um, especially with kids maybe who aren't as good at sharing feelings, uh, verbally. Some kids share their parents' feelings more through behavior. And so, you know, parents may have to notice that change in behavior and bring up with their children whether or not they may be feeling an increased level of stress. Um, so acknowledging that adjusting to all of these changes can be difficult. I think it's important for kids and there might be an element of grief that children or teens are experiencing due to the loss of connection with their friends and family members, missing teachers and coaches not being able to participate in their extracurricular activities and really lost opportunities.
I know many families that have had to cancel family vacations and birthday parties, right, of passage experiences for older kids are getting canceled as well, such as senior year activities have been canceled. Um, college students are now home where they're used to having a lot of independence. So there's really a lot of adjustment that both older and younger children are experiencing. Parents can help by sharing their own challenges with the changes to routine and how they're managing these changes. They can let kids know that parents are adjusting to, and this can give kids permission to talk about these things, but parents should be mindful to do this in a helpful way, in order to demonstrate it's okay to have and talk about feelings and to model helpful ways of handling this. Just be sure not to overburden kids with adult problems or instill feelings of guilt.
Hmm. That's a good point. Um, that's, so let me follow up on that. You kind of based on, on, we want to have these conversations with our children and have open and honest conversations, but you know, what shirt are there? Are there landmines? We should stay clear over how much detail should we go into? You know, when the children are, start asking about the actual Corona virus cause the 19 how sick people are getting, you know, it's still, um, just, you know, all over our, our media cycle and in the news and you know, their friends might be talking about it. So, um, what's some guidance there?
For sure. Yeah, I think it's, it's in the news and media more than ever really. Um, I think parents can generally take their lead from kids. If a child or teen ask the question or ask for more information, then it's usually appropriate to answer the question and provide the information that they're asking for. Take into account the child's developmental level. I think that's important. You know, teens are likely to be more aware of the news. We're going to ask more informed options and want more detailed information. And the CDC has a lot of information out there and they've developed a video that would be good for teenagers that can be found on YouTube about coronavirus for younger kids. I think it's important to keep the information simple. There's a good book that I just came across for younger children that was recently put out by Dr. Christine Walsh. Forced calls. What is Corona virus. That'd be excellent for younger kids as young as preschool age, help them understand about coronavirus as well.
Okay, interesting. Well. Um, you know, so I think one other point that I've seen a float around a little bit on social media or a couple of articles is, you know, the, and this is no secret, we've known this for a long time. Children are very observant. Um, they, they kind of pick up more than maybe sometimes we give them credit for, um, in like how do they feed off of their environment? Um, the, you know, what's going on around them, the way adults are acting or what they're saying around the children, how can that affect them?
I think children are very aware of the stress level and their environment and they're very likely to pick up on that. So even if parents are being careful, you know, not to expose their kids. I think stress in general Titans right now and kids are probably picking up on some level of that only dealing with stress in our own home due to all the changes and health concerns. But there's also unity. Adults should be mindful of how their own conversations and behaviors might impact kids. Kids may be listening, even if parents think they're having conversations behind closed doors or their kids aren't paying attention and adults can also take steps to manage their own anxiety and stress, which will help reduce the overall stress level at home and provide a good role model for kids and managing our own stress and anxiety.
That's interesting. So you know, kind of man talking about managing stress with some good advice or good ways that's as you've come across in working with patients and clients in the past that you can pass along to us about, you know, there's, there's different stressors that come in and out of our lives at different times. This pain demic stress to this level is, is I think new to a lot of us. But um, what's some, what's some good ways or advice you can share for helping us, um, as families with kids manage stress?
Yeah, I think this is a really good time to brush up on stress management techniques. So, you know, first of all, I think it's always good to engage in self care, take care of yourself by keeping a routine at home. Making sure that you and your family are getting adequate exercise, spend time outdoors, especially now with the weather's nicer, get enough sleep and eat a healthy diet. Also, families can spend time together by playing games, going for walks or bike rides, preparing meals together. Families can be creative, they can ask everyone to contribute ideas about how to best enjoy their time together. And I think another good tip is keeping things in perspective. Um, all of our lives have been altered quite substantially. But keep in mind that this is a temporary situation and another sip is focusing on things you and your loved one can control and instead of was not in your control.
You know, that's always helpful. So the things that you can be doing or minimizing physical contact with other people, washing your hands appropriately, populating yourself if you're sick, those kind of things. Another thing that's really important during this time is, you know, physically distant from others but don't actually Justin's or isolate. And what I mean by that is stay connected with friends and loved ones. Even if you have to do that virtually, you know, some people are getting six feet apart, so you're able to do that. That's great too. And explore kids. The best way to stay connected with others that they care about. Another way to manage stress is to practice gratitude by thinking about what you're thinking. Or you can have family discussions about that with your children. Um, it's a great time to learn relaxation and stress management. Mindfulness. There's free apps for that are calm head space, breathe. Plus,
you know, as this is man, this is the net. Next question can help me out. And probably a lot of my, my, my friends who are also parents, you know, when we're trying to do, when we're trying to help them adjust to a new normal is help them stay focused. We still have, um, these tasks or these duties, uh, with school or work. Um, you know, what's some advice that you've learned with working with, with kids and adolescents over the years? Um, to help them to stay focus, uh, on being able to, in the midst of a, of a weird new schedule to still be able to focus on some of the items that they need to be getting done on a day to day basis.
Yeah. Um, well that, what is the challenge right now? I think everybody's in a state of transition. They can make a harder to focus. I think one, one important thing to keep in mind is the parents can help to create a routine for children and the family at home. And this can be really beneficial to help kids. So you can have a set wake up time and bedtime just as if your kids were actually going to school. Parents can keep every teen by keeping meal times consistent and then make sure to schedule time for schoolwork, chores, exercise, relaxation and family time as well. And parents can consider posting the schedule in a prominent place in the home so that everybody can see it. And this type of schedule can help kids adjust to their new normal for now. Um, older kids may enjoy helping to create their schedule and giving them a little choice in terms of when they're going to do certain things during the day. And of course parents might have to check a number of times on kids to make sure that they're sticking to the schedule.
Yeah, good advice. I, I love the idea of having that schedule and I in a real prominent place and reminding the kids that they can try and stick to that as, as closely as possible. Um, you know, I, I think generally, um, kids are pretty resilient and an amazing little beings, um, and they're able to adapt to a lot and kind of work with lots of different situations. So for some children, um, you know, they might have more trouble than others adjusting to this new normal, this their life kind of being flipped up upside down, that not being able to connect with their friends like they used to or, you know, go here or go there, interact with other family members, maybe grandparents. Um, you know, if kids are, if we notice, you know, a child in our life maybe having a little bit more difficult time, um, than, than we think or, or more difficult than normal. What, what some were just some ideas or some help that, that you can point us to for, for making sure that, um, we're taking care of all children, uh, as best we can.
Yeah, that's an important question. Um, you know, I think especially kids that have had anxiety prior to this pandemic might be more vulnerable to being even more anxious during this time, but, but of course anxiety's heightened for everybody. So if you notice anxiety in your child's or they're talking to you about it, take them seriously. Try not to minimize their feelings or symptoms that they're experiencing. And if you have a child or teen who's having any difficulty functioning today, they're noticing that they seem more tired and withdrawn if they can't control their worries or having trouble with these can all be signs that your child is having difficulty adjusting and might indicate that they would benefit from professional help, especially if it's ongoing. A lot of counselors now are offering virtual services by phone or video platforms that are set up. Yeah, I mean that's what, that's what I'm doing right now.
A lot of insurance companies now are relaxing some of their guidelines and um, criteria. So they're paying for a lot of the video services, um, counseling services. Um, and you know, parents that are concerned can always talk to their pediatrician, their school counselor, um, their insurance company to get a list of people and network. And there's also state licensure boards, um, such as the North Carolina psychology board where parents can get a list of licensed providers in their area. And then of course to help managing anxiety, limit news and media exposure, especially regarding the Cove in 19. This kind of repeated exposure can create more anxiety for kids.
Interesting. Well, um, that was really good information and we'll have, um, if, if people can also kind of checkouts, um, those services and those providers available on British children's website or the wake health EDU website as well. Um,
that's our plant website and source of inflammation. That's always updated.
Yeah. And I want to, um, switch gears a little bit, dr Nick [inaudible]. Um, as we're talking with, um, you about how to, um, process through this new normal, uh, with our children and just trying to maintain some semblance of, of structure and schedule. Um, one word that I've, I've heard more than once in my house is, is bored dad on board dad, you know, if they're done with their e-learning or you know, they're not, they don't want to follow the chore time, creative time on the schedule. Um, context of social distancing. And you know, we've heard more and more too about sheltering in place for a time. Um, what's some advice or some words of wisdom you can give us about, uh, helping combat the boredom, uh, situation with the kiddos?
Yeah, boredom will probably create then, especially as kids, we're spending more time ever. Um, again, I think having a schedule can be helpful to fight for them because it gives kids some structure, uh, but beyond that, um, you know, help them figure out any project to work on. You know, they can maybe build a Fort in the backyard or make a bird house or plants a garden. Uh, my kids have decided to make any cat stands in our house. Um, yeah. Also they can take the opportunity of having more time at home to complete some home projects. Uh, parents may appreciate this one, so maybe kids can clean out their rooms, identifying clothes that don't fit anymore. Toys that aren't going to be, are being used in donate those to people in need.
Yeah. And then, um, help kids figure out how they can consume to participate in all the activities that they enjoy. So, you know, for example, um, if they were on a basketball team, they can practice basketball skills in the driveway. Um, if they're involved in, you know, theater music, create a theater at home or concerts, take virtual music lessons. So I think there's lots that kids can do to stay busy. Um, I think it is important that kids and teens stay connected with their peers and their friends. Um, a lot of them will be doing this through social media, which I think is important. Parents just may want to limit the use of social media.
Yeah. Um, well, you know, speaking of still wanting to be connected, um, we might have a situation where we have a child or maybe a teenager who doesn't necessarily, um, grass or, or, or appreciate the social distancing, uh, recommendations and how serious they are. And they want to, you know, still connect with their friends, go over if they're younger for a play date or go hang out if they're older with some of their friends. Um, you know, what, how can we work through that situation if we're, if we're seeing that in, in our homes, um, with them wanting to not really be like, Oh, the social distancing doesn't really apply to me cause you know, I'm 15 and 16 years old. It's, it's not a big deal. How can we, how can we respond to that?
Yeah. I think that's a fairly common response. Um, so I mean, first of all, parents can be a good example to their children in this regard by, um, you know, not, not inviting people over and not, you know, staying within six feet of neighbors. And so on and so forth. Um, but also help them understand the real reason and purpose and rationale for these recommendations and why at this time especially, it's really important for us to adhere to them and parents can help their kids problem solve about how they can stay socially connected, but physically it hurts. And you know, for the very youngest of kids, they may have a difficult time understanding the rationale for some of these things. Um, for example, why they can't have their grandma. Um, and this might be saying, so, you know, parents can work on explaining that to young kids in an age appropriate way.
Yeah. That, that, um, is helpful. I appreciate that. So, dr Nikolai, as we wrap up, um, I just want to let people know that they can visit, um, our website. Again, it's, uh, the way calc.edu. Um, there's information, uh, about, um, uh, children's services and if, if someone needs to contact a professional, um, also if people are just looking for, um, coven 19 updates, they can go to wake health.edu/corona. Um, and, uh, we have a plethora of information. Um, on that site, including, uh, this podcast and other coven 19 related podcast we've done. So, um, dr Nick Galatia. I know you're busy. I appreciate you taking the time and chatting with us today. This has been so helpful. So, um, I really appreciate it. It's really nice talking with you again. Um, well, uh, thanks everyone for listening to, to this best health podcast and, um, feel free to go to wake health EDU slash podcasts and, um, look at the full range of podcasts that we have. If,
if you're, if you have additional time on your hands, you can, we can listen to some of our other podcasts. Um, and until we talk next time, I encourage everyone to please the, well, thanks for listening to this episode of the best health podcast brought to you by wake forest Baptist health. For more wellness info, check out wake help.edu and follow us on social media, wake forest Baptist health, the gold standard of health care.
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