Parenting Strategies in the Time of COVID-19 with Dr. Kate Eshleman

Podcast Transcript

Nada Youssef:  Hi, thank you for joining us. I'm your host Nada Youssef, and you are listening to the Health Essentials Podcast brought to you by Cleveland Clinic. In the midst of this Coronavirus pandemic, we find ourselves challenged as our everyday lives change. One of those challenges are raising and taking care of children. Many parents have questions and concerns about this current situation. So we have virtually with us today, Dr. Kate Eshleman. Thank you so much for your time.

Dr. Kate Eshleman:  Thank you for having me.

Nada Youssef:  Dr. Eshleman is a psychologist in the Center for Pediatric Behavioral Health at Cleveland Clinic Children's, and she's here with us today to address parents' concerns during these challenging times. Please remember, this is for informational purposes only and is not intended to replace your own physician's advice. So, between keeping our entire family quarantined right now, homeschooling our children for the very first time, fulfilling our household duties and work duties, working from home, all while staying indoors, we're challenging many, many things in our lives right now. First thing is finding balance. How do we create a balance for our families right now?

Dr. Kate Eshleman:  Sure. I think one thing that's important to remember is that balance implies equality and recognizing that that's probably not going to be the case. That if we are continuing to work, we still have to work. The hours or when that gets done may change a little bit, but I think the goal really is to try and make the most of each time. So, when you're focused on work, to try and make the most of that time. And when you're spending time with the kids or the family, trying to make the most of that time.

Nada Youssef:  Great. So, many of us are homeschooling and using our e-learning skills for the first time with our kids that we've never used before. I had to go pick up a laptop from our school. Can you talk about these challenges that we're having now, they are brand new challenges in this new era and how we can combat?

Dr. Kate Eshleman:  Sure. I think part of the challenge is just familiarizing ourselves with a lot of new technology. So, whether that's using Zoom meetings for work or becoming familiar with the Google Classroom for the school, the first thing you have to do is, is familiarize yourself with the technology. So I think kind of being patient and kind, seeking help, whether that's speaking to the technology officers at this school or looking up videos on YouTube about how to do it. And then finding a system that works for your family. Even with technology, I am still kind of old fashioned pencil and paper. So it's helpful for me to go to each of the Google Classrooms, figure out what needs to be done and then be able to write it down on a checklist. That's what works for me. So I think it's about finding what works best for you and for your family.

Nada Youssef:  So, do you have any tips for parents that are working from home right now and how to separate work and personal life, physically and mentally?

Dr. Kate Eshleman:  Sure. And I think one thing that's important to keep in mind too is that these are all kind of aspirational goals and recognizing that every family and every household has different capabilities. So, keeping that in mind, to the extent possible, trying to physically separate. So, if you spend your time together as a family in the living room, then trying to do your work elsewhere. If you have a dining room table that you could set up or a kitchen table or a spare bedroom that you can make a makeshift desk. So, working with the resources that you have in your home, but to try and physically create that separation, which will help mentally create that separation.

Nada Youssef:  Great. So, with all these changes, kids may be having very high levels of anxiety and struggle with change right now. What can parents do to alleviate these issues for the kids?

Dr. Kate Eshleman:  Sure. And I think again, setting realistic goals. I don't know if it's a realistic goal to say that we will alleviate these issues. Right? This is a very uncertain time where a lot of the adults don't actually know what's going on. So I think really the goal is to try and engage your kids in conversation. Ask them what are they thinking? What are they feeling? Observing any changes in their behavior and trying to talk with them about that. Really trying to limit what comes into the home, and that goes for adults and children. That if you want to know what's going on, having the news on for a limited amount of time or reading it on your phone for a limited amount of time, but not overdoing it. Because anything that we're exposed to, the kids are likely exposed to also.

Nada Youssef:  Right. And speaking of that, can you talk a little bit about children that may have developmental disabilities or issues and the best ways to talk to them about change or anxiety they might be feeling right now?

Dr. Kate Eshleman:  Sure. And I think what's really important too is these parents, all parents know their children the best, right? So certainly parents of kids with developmental disabilities know the ways to get to their kids. But always keeping in mind the child's developmental level. So even in spite of the chaos of what's going on, making sure that we're talking to them and engaging with them at their developmental level. What's oftentimes helpful for kids with developmental disabilities is the use of what we call social stories. So, if it's kind of difficult to explain with words, trying to find pictures. Downloading pictures on the internet, so that we can walk them through what's going on and what changes may occur and what their day may look like.

Nada Youssef:  So, communicate with them through pictures or voices, rather than just the normal everyday talk.

Dr. Kate Eshleman:  Absolutely. Another thing I would keep in mind too, is feel free to reach out to your child's resources. Especially children that have special needs that are engaged with many resources at the school, most of those resources are still available, even if to a different degree. So speaking with the child's intervention specialists, their teacher, OT, PT. Reaching out to those resources and finding out how they can help you, even when you can't see them in person.

Nada Youssef:  Great. So, switching gears a little bit to snacking. "Can I have a snack?", has been told to me about 11 times a day. It's the most popular question in my household right now. How do I make sure my kids are still eating healthy food, still getting some snacks and not just out of boredom like I am?

Dr. Kate Eshleman:  Sure. I think there's a couple of ways to approach this. And these are healthy rules of thumb for anytime, not just during a pandemic. But being mindful of what we bring into the home. Now, again, aspirational goals, but if there's something that we don't want the kids to eat, then we shouldn't have it around, that would be the best. Or at least not easy access for them. Now, that being said, it may be harder to buy your regular groceries right now. So if that's true, we have to kind of be kind to ourselves and maybe allow a little bit for that flexibility.

Dr. Kate Eshleman:  Another great strategy I saw on Facebook was a parent set out a basket of the child's snacks for the day. And they could have them at any time throughout the day, but once they're gone, they're gone. So again, I think finding what works best for your family. But really trying to provide those healthy snacks, encouraging them to go play. If they want some of that leftover Easter candy that might be in the home, they can have it after they've played outside for a half an hour.

Nada Youssef:  That's a really good point, Dr. Eshleman, because I actually, what I try to do, is I put a really big basket of tangerines and apples right in front of the TV. And I'm so surprised at how much more they're eating it in the morning and after their food. And if they ask for a snack, I'll tell them to eat an Apple first. So, it's been working, we're out of apples.

Dr. Kate Eshleman:  Great.

Nada Youssef:  With this quarantine, many parents are faced with the challenges of screen time. The World Health Organization guidelines recommend that children between the ages of two and four spend no more than one hour in front of the screens. And less than that, nothing, there's no recommendations for it, for babies or toddlers. And many parents are feeling guilty going way over these recommendations. What do you say to them?

Dr. Kate Eshleman:  Again, I think right now the goal is to be kind to yourself. This is not business as usual and we certainly still can strive to abide by those guidelines, but things are going to be a little bit different. And if you're working from home and you have an important meeting where you really need silence, you may use strategies that you don't typically use. So, one, I think just being kind and patient to yourself. But I think also trying to find other activities and ways that kids can be active.

Dr. Kate Eshleman:  So, whether it's having your child read a book or listening to audio books, cleaning out a closet, which I know nobody really wants to do. But you may come across some materials that you don't need anymore, and allowing the kids to kind of be creative with those things. Digging out toys that they haven't played with for a while, or just sending them outside, weather and neighborhood permitting. But to use their imagination and use their bodies. So again, I think the goal would be, to try and be creative, but also recognizing that some of those limits that we typically strive for may not be achievable during this time.

Nada Youssef:  Yeah, there's a lot happening and we are home all the time, so we're messing up the home all the time. So I feel like chores have to almost be a part of the daily list now. But I mean, with our kid’s home all day long, it may be tempting to let certain behavior, rules and boundaries slide. Keeping clear rules and consistent consequences during this time can be very challenging for us as parents. What can we do to maintain that peace at home?

Dr. Kate Eshleman:  So, I think it's important to remember that that structure and routine is helpful for everyone. Kids really thrive when they know what to expect, what's expected of them, so trying to maintain that as best as possible. Including going to bed at the same time as they usually would, getting up at the same time. So, it's really important to maintain those expectations and/or to maintain expectations that may look a little bit different. So, to your point, the expectation is typically that you unload the dishwasher each time it's clean. Well, now if you're running the dishwasher twice a day, maybe you're not having the child do it twice a day, but the child is still expected to do it. So, maintaining those expectations, even if they look a little bit different, is really going to be helpful for everyone.

Nada Youssef:  And to the point that you made earlier, I love that. And the kids are kind of reflecting what the parents are doing or feeling or seeing. So, as parents, we should be leading by example. That means taking care of ourselves first sometimes. Right? But how do we do that right now?

Dr. Kate Eshleman:  Sure, that's a great question. Because what we know and what I've talked with children and families about a lot in practice, is that right now we don't have access to our typical coping strategies. So, going shopping or going out with friends, going to the gym. We don't have access to those things right now. So, the goal would be, just as you said, to try and model good self-care to the best of our ability. So maybe that's getting a little bit more sleep or getting up earlier and going for a run or doing a YouTube workout, still trying to eat healthy. And maybe finding other ways, things that you don't typically have time for, maybe sitting and reading a little bit or engaging in art activities yourself as a parent. Doing things that maybe you enjoy that you don't typically have time for. So, modeling those good self-care behaviors.

Nada Youssef:  And what do you say if, you know, my child came up to me yesterday and said, "Why is this happening to us?" Something like that with ... I don't watch a lot of news when they're around. I do watch it once a day to see what's going on. But how do we explain this pandemic to our kids? How do we tell them what's going on and how serious it has been not to be doing this?

Dr. Kate Eshleman:  Sure. I think that the thing to keep in mind is always to tell the truth in a developmentally appropriate way. So, we do want to be honest with the kids. Because if they don't hear it from us, they're probably going to hear it from someone else: on the TV, through a Zoom meeting with school. And we want to maintain their trust. I think simplifying things depending on the child's age will depend on what you say or how you describe it. But giving them information that we know and talking about the ways that we're being safe. So, things like the physical distancing that we're doing, working from home, closing schools. All these things that we're doing to keep them safe, to provide some of that reassurance. And it's okay to sometimes say, "I don't know." That this is something that we've not encountered before and everybody's working very hard to do their best to keep people safe and healthy, but we don't know what's going to happen next or we don't know when we're going to go back to school. And it's okay to say that.

Nada Youssef:  So, it is spring break time right now. Many kids are very disappointed with dealing with canceled spring breaks. My kids were supposed to be in Disney, Disney is closed. How do we deal with these frustrations and disappointments in our children right now, that don't understand why this is happening?

Dr. Kate Eshleman:  Sure. I think just to your point, there's a lot typically going on in the spring, and all of those things have to be canceled. And what I think is really important is to hear what your kids are saying, acknowledge those feelings and validate them. I think oftentimes, people when they're trying to be helpful, offer a little bit of perspective. "It could always be worse." And it could always be worse, but it's not helpful to hear that when you're feeling upset about something. So just to acknowledge that, "Yes, I'm upset too. I'm disappointed that we're not at the beach right now and hopefully we can plan one for the future." But just to acknowledge and validate those feelings.

Nada Youssef:  And that this is hopefully just a temporary thing and everything will go back to normal. Another question I wanted to ask you is many parents right now are dealing with kids that I have built up anger. They're disappointed and angry just with the whole spring break and anything else, to just being cooped up in the home. How do we deal with the anger in these kids and maybe even some teenagers that have to deal with staying home with mom and dad every day?

Dr. Kate Eshleman:  Sure. I think that's a really important point. Because again, no matter who it is or what, everyone is experiencing some loss right now. So, whether that's having your birthday party canceled or your senior spring break or the NCAA tournament as a senior year basketball player, everyone is experiencing some loss right now. And what I think is happening, is kids are having feelings that they can't necessarily easily identify or describe. So then they end up coming out and behaviors. The way that we respond is going to probably vary by age. And also recognizing the behavior won't always come out looking like anger. So, for little kids you might see increased crying or clingy-ness or disruption to sleep patterns. Previously stabilized routines, you may see some loss of that. With older kids you might see more irritability or anger or withdrawal. So when you see these changes, really again, trying to engage the child. Ask him or her what's going on, what are they thinking, what are they feeling? "Are there things that I can do to help?" And see what the child says.

Nada Youssef:  And Dr. Eshleman, do you think this is a sign of grief? Are we going through grief right now?

Dr. Kate Eshleman:  Sure. There's been a lot of discussion about this is grief. That again, we have lost things and then we tend to grieve those losses. And we know that one of the stages of grief is anger. So, there is a lot of grief and grieving of the things that we're missing right now.

Nada Youssef:  And finally, how do we stay mindful and mentally healthy together as a family?

Dr. Kate Eshleman:  Sure. And again, I think this is going to look a little bit different for each family. So, ideally, having meals together, whether that's breakfast together before you start the day, whether that's dinner at the end of the day. Going for a walk after dinner, reading stories or engaging in discussion before bedtime. So, it's going to look a little bit different for every family. But just, I think as you said, being mindful and being intentional in our effort to do that, to spend our time together.

Nada Youssef:  Thank you, Dr. Eshleman. Is there anything else you want to tell our audience or viewers, any parents that may have any concerns right now?

Dr. Kate Eshleman:  I think, again, just to kind of reiterate, to be kind to yourself, that this is a very unusual time. There is no playbook about how we should handle this. So, again, the things that we talk about are kind of good goals or guidelines, but they may not work or they may not work every day. So, looking to yourself and your family and those that are important in your life. Not turning to social media or Pinterest to figure out what you should be doing and how you should be handling it. This is a lot. And it's okay to kind of experience your feelings and acknowledge those feelings and seek help as appropriate.

Nada Youssef:  Sure. Great.

Dr. Kate Eshleman:  That is one other thing too, that help is still available. So reaching out to your own physician or your child's physician. Resources are still available if families feel like they need extra help.

Nada Youssef:  Yes. And the community is really helping each other, it's really good to see.

Dr. Kate Eshleman:  It is.

Nada Youssef:  Thank you so much for your time. And thank you to our listeners and viewers for tuning in. If you find this information helpful and we'd like to listen to more of our Cleveland Clinic Health Essentials Podcast, please go to ClevelandClinic.org/HEPodcast. Thank you again for tuning in.