With the publication of this column, hopefully the world emerges from the quarantine
of the COVID-19 pandemic. In March of 2020 with the onslaught of the virus, the lives
of working adults changed exponentially, and so did the lives of children. COVID-19
disrupted life as we know it, the effects of which we may be only beginning to realize.
It would not be unusual if adults and children felt an impact on their sense of wellbeing
throughout this time. Lack of support, trauma, unhelpful thinking styles, chronic
illness/disability, and substance use compromises wellbeing in adults (Roddick, 2016).
Caregivers' wellbeing can have a direct effect on children's wellbeing. Behavioral
health experts recommend building five dimensions of wellbeing in children: social,
physical, emotional, intellectual, and spiritual (Roddick, 2016).
Throughout the COVID-19 pandemic, there was a growing reliance on the use of technology
to learn, live, and stay connected. This column will explore how technology became
essential during a time of isolation and social distancing and was used to leverage
and maintain wellbeing for children.
Play is an essential part of children's physical and social development. Closures
of parks and playgrounds were not uncommon throughout the COVID-19 pandemic. The world
became more restricted each day. The monkey bars and swings in my neighborhood usually
are buzzing with children laughing and playing; now, they have yellow caution tape
wrapped around them and signs posted “playground closed.” It just seems unconscionable
to see an ordinary, innocent playground condemn as if it were a safety hazard.
During the COVID-19 pandemic, the (Center for Disease Control and Prevention [CDC],
2020a) recommended that caregivers avoid setting up playdates for children to practice
social distancing from other children. Instead, caregivers were encouraged to set
up supervised phone calls and video chats for their child and their friends. The American
Academy of Pediatrics [AAP] (2020a) suggested that children play outside while maintaining
social distancing so that they had time to move and explore nature. Children who play
outdoors experience better motor development and focus, lower obesity rates, reduced
attention deficit hyperactivity disorder, less anger, aggression, stress, and depression
On the positive side, families seem to be spending more time together, walking, biking,
and completing school work. Where time is available, caregivers were encouraged to
socialize with children through playing games, arts and crafts, and listening to music.
Caregivers could also share time with children by co-viewing television programs or
using educational apps. “Co-engagement with media and ‘co-viewing’ is optimal for
learning and spurring conversations (and thereby helping to develop vocabulary and
more in-depth understanding) around new content” (Takeuchi & Stevens, 2011, p. 10).
Positive interaction that occurs between caregivers and children is healthy. The fast-paced
lifestyle that two working caregiver families are accustomed to seems to have slowed
down if only for a short while.
To date, children are not in the high-risk group of COVID-19 for severe illness or
hospitalization (CDC, 2020b). Children are, however, susceptible to illness from the
virus with lesser degrees of severity, and are known carriers. Several countries are
working on a vaccine; however, it will be months before one is available for use.
The AAP (2020b) published guidelines for primary care providers to access during the
COVID-19 outbreak. Posted on the AAP website are up to date guidelines and available
research. Unlike most adult primary care offices, the AAP (2020b) recommends that
newborns, infants, and young children continue to be seen in person by a primary care
provider for their routine vaccinations and well visits. Pediatricians are encouraged
to monitor community spread of COVID-19 and, if necessary, administer older children's
routine vaccinations at a later date. Pediatricians can determine whether or not to
separate well and sick visits by rooms and times of appointments.
The AAP (2020c) launched a telementoring COVID-19 emergency readiness and response
program in March. COVID-19 Project ECHO (Extension for Community Health Care Outcomes)
modelTM “is a tele-mentoring platform that uses video conference technology to connect
a multidisciplinary team of specialists with primary care providers in local communities”
(para. 2). By participating in the program, pediatric primary care providers can stay
abreast of policies, procedures, and recommendations for treating children throughout
the COVID-19 pandemic and participate in education, case study presentations, and
Pediatric health care providers are unable to provide telehealth for all children
due to differences in licensing laws by state and gaps in insurance policy coverage
(AAP, 2020c). Throughout the COVID-19 pandemic, physician groups have lobbied Federal
and State Governments to relax the rules on telehealth to provide care to more children
across state lines and in rural areas of the country. The AAP (2020c) is working at
the Federal level with the Medicaid/Children's Health Insurance Programs (CHIP) and
with other third-party insurers to reduce barriers and increase access to telehealth
care. Still, amid the COVID-19 crisis, there is a long way to go to overcome obstacles
to telehealth provisions for all children. The AAP (2020d) is keeping a current list
of states which are allowing telehealth, the rules, and regulations and publicizes
this list for pediatric care providers. The COVID-19 pandemic may cause a paradigm
shift that relaxes restrictions imposed by the Health Insurance Portability and Accountability
Act (HIPAA), state laws, and insurance reimbursement for telehealth.
Caregivers are essential for helping children maintain emotional wellbeing. Throughout
the pandemic, caregivers were encouraged to reassure children that adults that they
trust (e.g., doctors, nurses, police, teachers) are doing everything they can to learn
about the disease to help keep them safe (AAP, 2020e). Also, caregivers can give children
a sense of control by letting them know what they can do to help limit the spread
of the virus (e.g., washing their hands and coughing and sneezing into their sleeve
or a tissue).
The CDC (2020b) recommends that caregivers watch children for signs of stress. Children
can exhibit stress and anxiety with excessive worry, sleeplessness, inability to concentrate,
and unhealthy eating habits. Caregivers can help alleviate stress by remaining calm,
creating a daily routine, and talking to children about COVID-19. Reducing children's
exposure to COVID-19 television and social media coverage can also help to provide
a relaxed and reassuring environment (AAP, 2020e; CDC, 2020b).
Families may be more stressed than ever. Today most adult jobs that have survived
the pandemic are those that can use computerized technology, are in healthcare, education,
or those in food distribution (Carruthers, 2020). To date, over 17 million Americans
filed for unemployment benefits, and the unemployment rate is 13% in the US (Long
& VanDam, 2020).
School lunch programs are funded by the federal government and subsidized at the state
level for children whose caregivers meet a certain income level. Schools are required
to stay open and provide meals (breakfast and lunch) at a free or reduced rate to
those children who qualify. Schools have had to be creative with how they distribute
the food, and although the funding for no cost lunches will not increase this school
year, the number of students that will qualify for free lunch will rise. Some schools
send out a weekly survey to capture all students who will need a free or reduced lunch
The Tsunami of online learning has occurred. Many schools are offering online (virtual)
learning for students (CDC, 2020a) as a means by which to continue education for the
remainder of the academic year. Those teachers and administrators who were reluctant
to teach online, have had little choice but to embrace this decade-old technology.
Some teachers may have experienced fear and trepidation with transferring their classrooms
online, but the majority have done so at a rapid pace and in a short period; in the
long run, everyone seems to be adapting well. The digital divide is more apparent
than ever (Guernsey, Ishmael, & Prescott, 2020). Children who are proficient with
using computers are ready for it. Instructors and teaching methods are a bit behind;
however, there is hope that new models of education emerge. Change can be useful.
We live in a world where Internet access is a now necessity, not a commodity. Access
to a computer is as essential for learning in school as is owning paper, pencils,
and books. Unfortunately, we still have a disproportionate amount of children in parts
of the country that are unable to access the Internet. Some families may share one
computer; others may not own a computer at all. We need to find ways through partnerships
with government, business, and educational systems to provide computers and Internet
access for all learners. During this pandemic, some Internet companies have graciously
offered their services for free (e.g., Comcast and Charter Spectrum) for a limited
time to low income families (Guernsey et al., 2020). Caregivers may need to work with
younger children to show them how to work a computer. School administrators may need
to help families to troubleshoot computer and Internet connection issues (CDC, 2020a).
Services for children with disabilities
In the US, there are over seven million children with disabilities (mental, emotional-
behavioral, physical, and more) that require special services in school (Silva, 2020).
School districts are required to identify children with special needs and to develop
Individual Education Plans [IEPs] (Silva, 2020). Schools are required by law to provide
special needs children with free and adequate public education and special services
(US Department of Education, 2020). During the COVID-19 pandemic, school districts
were continuing to provide special needs children with therapeutic services online.
Delivery of specialized therapy online opens the possibilities for services to children
with special needs in remote areas who may not have previously had access. IEPs are
traditionally complete on reams of paper; because of COVID-19 and school closures,
now experts can meet online in synchronous or asynchronous forums with some completing
the IEPs in an electronic format (Silva, 2020).
Families struggled with being physically separated from their faith communities during
the COVID-19 pandemic, especially during the holy season. Places of worship recognized
the spiritual needs of the faithful, and many created access to their communities
through social media. Some faith communities made themselves available through Livestream
worship on Facebook, communicated with followers on Twitter, and accepted prayer requests
on Websites. The Pope had several Livestream services from the Vatican in Rome that
were translated, recorded, and posted on YouTube for followers to watch on-demand.
Several faith-based educational learning platforms offered subscriptions free of charge
for families so that they could continue religious education with their children at
Technology became essential during the COVID-19 pandemic. During a time of isolation
and social distancing, the world relied on technology to learn, live, and stay connected.
Technology is best used to leverage and maintain social, physical, emotional, intellectual,
and spiritual wellbeing for children, in an environment where children are co-engaged
with an adult.
The impact of the COVID-19 pandemic will be long-lasting. Hopefully, this time of
disruption and loss of lives are not wasted and propels us toward a new way a life
improved with technology in a way that enhances wellbeing for all.
American Academy of Pediatrics [AAP], 2020f