Parents with young children and children with special needs are struggling with maintaining routines and social distancing during COVID-19. Michele Kong, MD, and Lindsay A. Thompson, MD, MS, put forth tips for preventing anxiety, frustration, and negative behaviors as children experience pandemic-related stress. This guidance is centered on establishing an at-home routine and was published in JAMA Pediatrics.

Parents should use direct and clear language when discussing COVID-19 with their children, the authors said. Figures of speech and euphemisms can confuse young children, who may become frustrated if they do not understand why their typical routine has been disrupted.

The authors note that visual aids may be helpful for parents to explain the events of the pandemic as well as establish a new routine. Through storyboards, parents can use narratives to explain new situations with pictures and simple language. Visual timers may be effective to mitigate difficulties transitioning between activities as the child can see how much time is remaining for a particular activity before transitioning to the next.

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Children may experience a sense of lost control due to stay-at-home orders. The authors recommend establishing a daily schedule to help familiarize the child with their routine; this schedule should include the same wake and sleep times each day as well as set meal, schoolwork, and play times. Further emphasizing the importance of visuals, the authors suggested having a child mark a physical calendar to help them feel in control of their day at home.

Drs Kong and Thompson note that expressing emotions through traditional communication may be difficult for young children and children with special needs such as autism spectrum disorder. To provide them with an outlet for alternative expression, the authors suggest engaging kids in art and music activities or using technology such as a tablet to communicate.

The final point made by the authors is to incorporate regular check-ins with the child’s family members, teachers, therapists, and friends to keep them connected to their social support system.


Kong M, Thompson LA. Considerations for young children and those with special needs as COVID-19 continues. JAMA Pediatr. Published online August 31, 2020. doi:10.1001/jamapediatrics.2020.2478.