COVID 19 AND CHILDREN

COVID 19 AND CHILDREN –
MISSION ‘SCHOOL AGAIN’ July 2021
IMPACT OF PANDEMIC ON MENTAL AND EMOTIONAL HEALTH IN CHILDREN
and
STRATEGY FOR REOPENING SCHOOLS
The Indian Psychiatric Society

Preface
It is a momentous occasion for me to be part of a revolutionary mission to save our future generation and our country. We have been devastated by the physical, social, financial and above all the emotional impact of the Covid 19 pandemic in the last 20 months. As the society battled arm in arm to save lives, procure oxygen cylinders , provide food and basic amenities to the neighbours in need, a whole generation of innocent faces silently witnessed these unprecedented changes engulfing their lives without any forewarnings.
Yes friends, I am referring to the thousands of school children and young adults who were growing up in their most formative years, oblivious to the concept of pandemics and any universal upheavals, when the pandemic struck with its rigmarole of lockdown restrictions and school closures.
Over the months whilst we proceeded to normalize other situations to the extent that is safe and balanced, we are yet to turn our full attention to the generation of school children and college students.
This has upset me for a number of months and now I am somewhat relieved that our team from Indian Psychiatric Society has joined hands with NIMHANS and Indian Association For Child And Adolescent Mental Health to publish a document highlighting the emotional, social and physical health impact of the school closures on children and possible ways forward of phased school re-opening.
As we know learning is not just academic knowledge which the online media may help to facilitate, but It is much more and beyond. The document outlines the adverse effects of prolonged and exclusive online learning, impact of children not growing up in a physical school environment and the future implications on their lives and our society.
This generation is our future. They will be responsible for our well being in the next few decades. So we owe it to them, and indirectly to us, to make their learning and development more meaningful.
I agree that the concept of ropening schools carries with it some risks. However recent studies published in International journals have outlined reduced adverse outcomes of Covid infection in children. Thus with majority of teachers being vaccinated we should start planning school reopening. Let us now seriously weigh the risks and benefits of opening schools and take a proactive approach for our future generation.
Dr. Gautam Saha
President, Indian Psychiatric Society

Contents
Section A: Impact of Pandemic on Mental and
Emotional Health in Children ………………………………………………… 5
Section B: Strategy for reopening schools………………………………………………10

COVID 19 AND CHILDREN – MISSION
‘SCHOOL AGAIN’ JULY 2021
[A] IMPACT OF PANDEMIC ON MENTAL AND EMOTIONAL HEALTH IN CHILDREN [B] STRATEGY FOR REOPENING SCHOOLS
— A Joint Initiative By —
The Indian Psychiatric Society
National Institute Of Mental Health And Neurosciences And
Indian Association For Child And Adolescent Mental Health
Dr Prerna Khar1, Dr Debadatta Mohapatra2, Dr Sreyoshi Ghosh3, Dr Rajendra Kiragasur Madegowda4, Dr Chhitij Srivastava5, Dr John Vijay Sagar Kommu6, Dr Alka Subramanyam7,
Dr Abir Mukherjee8, Dr Kishor Gujar9

  1. Sr. Child Fellow, Department of Psychiatry, TNMC & BYL Nair Ch. Hospital, Mumbai
  2. Assistant Professor, Department of Psychiatry, AIIMS, Bhubaneswar
  3. Assistant Professor, Department of Child and Adolescent Psychiatry, NIMHANS, Bangalore
  4. Assistant Professor, Department of Child and Adolescent Psychiatry, NIMHANS, Bangalore
  5. Associate Professor, Department of Psychiatry, MLN Medical College, Allahabad and Research Affiliate
    at Institute of Psychiatry, King’s College London
  6. Professor and Head, Department of Child and Adolescent Psychiatry, NIMHANS
  7. Associate Professor, Department of Psychiatry, TNMC & BYL Nair Ch. Hospital, Mumbai
  8. Senior Consultant Psychiatrist, Medica and AMRI group of hospitals, Kolkata and Advisor, Trainer,
    Board Member and Consultant for Iswar Sankalpa, Caring for the Homeless Mentally Ill 9. Consultant Adult & Child Psychiatrist, Pune

Impact of Pandemic on Mental and Emotional Health in Children
IMPACT OF PANDEMIC ON MENTAL AND EMOTIONAL HEALTH IN CHILDREN
Introduction
The COVID-19 pandemic has affected humanity worldwide, causing a disruption in work, economy, social life and has brought with it a plethora of mental health issues. Children constitute roughly 28% of the world’s population and have been dealing with the pandemic in their own way. It has been estimated that the pandemic is going to have long term consequences on their emotional well-being and mental health. [1] Hence it becomes imperative to study the effects of the pandemic and the lockdown on children and adolescents, so that appropriate measures can be taken to safe-guard their interests.
Normal Vs New Normal
During the first wave of the lockdown, it was estimated by the United Nations Educational, Scientific and Cultural Organization (UNESCO) that 90% (1.5 Billion) of enrolled children were out of the educational system all over the world. This disruption was said to be “unparalleled”, as per UNESCO director general Audrey Azoulay. [2]
For children with pre-existing mental health issues, the school routine served as a coping mechanism and as an anchor. In India, many schools supply mid-day meals and hence school closure impacts the nutritional status of children as well. Many schools run programs and counselling sessions for children with emotional issues or academic difficulties. Thus, school closures have taken away the resources children relied on, to a greater extent. [3]
With the closure of schools, we have been forced to shift to e-learning. However due to lack of access to the internet as well as a digital device, approximately 70% of children have not attended school since March 2020.[4] Excessive screen time impacts physical health to a large extent. It reduces the time spent in physical activities, can cause eye problems (dry eyes, blurring of vision, increased risk of myopia), headache and vitamin D deficiency (due to decreased sun exposure). It negatively impacts the circadian rhythm by affecting melatonin production, especially if screens are viewed at night. One must also not forget the various behavioural addictions which are rampant in the digital era and have risen during the pandemic-internet addiction, gaming disorders and porn addiction. [5] Having said that, it is thanks to the digital platform that a large part of learning could however continue.
Impact on sleep
Lack of structure due to school closure has impacted the sleep cycle of all children, more so the adolescents. They can watch pre-recorded lectures as per their convenience and hence prefer staying up late at night, being active on various social media platforms and attending zoom parties/ gatherings with friends. Due to excessive screen time, they are unable to sleep early at night, as a result of which the sleep cycle has reversed in many children. Lack of physical activity and sports does not tire the body as much and this in turn causes less sleep and disruption in the sleep pattern. Additionally, an increase in body weight might lead to the development of premature obstructive sleep apnoea and result in excessive daytime sleepiness, diminished attention and therefore cognitive skills.
Impact on group activities
Prior to the pandemic, children would engage in social play, sports, games and projects at school. With the advent of online education and the lockdown, physical group activities have now come to a standstill. Children and adolescents are now engaging in online group activities such as watching movies together on online platforms, watching episodes and online games, as this is the only means to socialize at present.
Family structure and parenting during the Lockdown: Work from home and at home!
In the midst of schools being shut down, parents have the added responsibility of looking into online schooling; apart from working from home and doing household chores. This has led to further stress in parents as external support and help from extended family members has been withdrawn due to physical distancing. [6] The economic impact of the lockdown has also increased parental stress levels, thereby increasing the risk of verbal and emotional abuse in children. [3] Moreover, children see adults as their safety blanket and model the behaviour of adults around them. They are highly sensitive to the emotional state of their caregivers. If parents are themselves dealing with anxiety, it can negatively impact children. [7] Families are also finding the need to have bigger houses and more individual
5

Impact of Pandemic on Mental and Emotional Health in Children
space, to cater to online school and work from home needs. This may add additional financial burden and stress on the family.
Impact on specific age groups
A) Preschool
Children, with their limited understanding of the pandemic and its implications and due to limited coping capacities, are more prone to develop mental health issues in the present scenario. [7] Play forms an essential aspect of a child’s development and an integral part of their routine. With a closure of playgrounds, parks, sports complexes, the social interaction of children has been limited to close family members, their immediate bubble, and indoor games. [6] This can negatively impact their social and language development, which can have long lasting consequences.
At home, language development can be optimized through story-telling and social-emotional development through joint play activities. Play could also be a way to understand the worries, fears and emotions of young children. Parents can try to set up a play space for their young child where they can feel free to express themselves, without judgement or criticism. Children should be allowed to ‘lead’ the play. Parents can try to identify any emotions that the child may be expressing and point them out, for example- ‘You seem angry when you punched that bear’. This will increase the bonding between the parent and the child, help him/her feel understood and assist them in developing a vocabulary for emotions. Activities like “circle time” where children typically sit together and discuss non-academic issues that are of relevance to them can be conducted online, to enhance their social development.
Once schools and Anganwadis reopen it will be essential to identify those preschoolers who have fallen behind in terms of their language development and social skills, organize specialist referrals and set up corrective measures including resource rooms and social skills training programs (individual and group). Kindergarten teachers can be sensitized regarding normal developmental milestones in young children, in order to enable them to identify vulnerable children, so that subsequent aid can be provided.
B) Primary and middle school
Young children may start showing regressive behaviours such as asking to be bottle-fed, thumb sucking, enuresis, wanting to be dressed and may become clingy.[7] Many children are experiencing emotional trauma due to various psychosocial stressors such as prolonged confinement in a hostile home environment, poor communication and lack of in-person interaction with friends and teachers. Added to this is the study-related pressure, worries about attending online classes and lack of appropriate facilities to attend the same due to financial crisis in the family.[8] Irritability and defiance has been seen among this age group as a result of physical isolation and lack of routine and structure. More frequent meltdowns may be experienced in this group, as well as the use of a comfort object.
In order to help youngsters cope with the forced isolation effected by the pandemic, the daily structure of a child’s typical day should largely be maintained. Online meetups and virtual parties with friends can be planned in place of face-to-face interactions.
Schools can help promote the social development of children even while operating online. Life skills that focus on social skills like interpersonal effectiveness and effective communication can be held through online discussions, role plays, debates and skits. Group activities and assignments can be conducted over video conferencing as well.
School going children love to challenge themselves, master new skills to show their friends and family and feel ‘recognized’. Giving them an opportunity to practice their hobbies and perform in front of the camera (which can then be shared), with compliments and encouragement when they succeed will go a long way in increasing their self- esteem and coping abilities.
C) Secondary school
Young adolescents can experience irritation being confined to their homes under parental supervision round the clock as this is something they are not used to. They crave for the company of their friends and find it hard to follow social distancing due to high levels of curiosity, enthusiasm and motivation. Adolescents normally deal with “Identity crises” which can be amplified due to the effects of the pandemic.[7] Being exposed to regular updates about the pandemic can also cause a lot of emotional turmoil in this age group as they tend to experience emotions more intensely vis a vis the adult population. [9] Due to exams being cancelled/ postponed, many of them are facing high levels of anxiety about college admissions. During the first wave of the pandemic, online surveys done in China showed a rise in depressive and anxiety in adolescents in 54% of the participants. [6]
With board exams getting cancelled, many students have had a sense of relief while others have felt cheated as 6

Impact of Pandemic on Mental and Emotional Health in Children
their year- long efforts seem to have gone in vain. The possibility of delay in further education has also increased, as it is dependent on a Common Entrance Test (CET). The uncertainty of this has been a cause of anxiety for many adolescents, who sense a loss of control due to an unknown entity.
Adolescents can be given opportunities to feel useful and productive by engaging them in community efforts to tackle the pandemic such as awareness drives, helping individuals in quarantine and setting up preventive measures and safety protocols in their neighbourhoods and apartment complexes. This will give them a sense of purpose, confidence and identity, irrespective of the socio-economic strata.
D) Higher secondary and college
During adolescence, there is a mismatch between the development of the subcortical regions (mature faster) and that of the prefrontal cortical regions (last to mature). Thus, reward seeking takes precedence over appropriate decision making. This makes adolescents vulnerable to risk taking and emotional dysregulation. [10] The pandemic has precipitated this, due to the uncertainty of the situation and many children being away from home due to travel restrictions and at the same time not being able to avail college facilities in person. Due to schools being shut, many adolescents have resorted to online mediums to explore their sexuality and can come across misinformation while doing so, which can have a lasting impact on their tender minds. Many of them also grapple with gender identity issues and are finding it difficult to come out to their parents, in the absence of support from school counsellors/ support groups at colleges. Also, there is an increased exposure to porn, which can potentially develop into a behavioural addiction and distorted views on sexual practices.
Studies done during the initial stages of the pandemic have shown that more than one-third of adolescents reported high levels of loneliness. [11] The suicide rate among the young have also seen an alarming rise during the lockdown. Kerala saw 173 deaths due to suicide in children between the ages of 10-17 years during March 2020 to October 2020. Other parts of the world have also shown a rise in self-harm rates among children and adolescents by 9-33%. [8]
Many university and college students were forced to leave their campus at once and were expected to continue education from a remote location. This has created a sense of uncertainty and fear among them, as well as apprehensions about their course completion, exams and subsequent job prospects. A study done in China by Cao et al demonstrated anxiety in approximately 25% of college students, during the initial stages of the pandemic. [10]
Online education and screen time
The entire nation has now moved to online education in the form of live online lectures, pre-recorded videos, online assignments and examinations. This has added more responsibilities on the shoulders of the parents. They have had to arrange for devices (laptops/desktops/ mobile phones/tablets) for their children as well as internet connectivity and space for the children to view the lectures at home. In households with space constraints, this has become an added stressor for parents.
The World Health Organisation (WHO) recommends no screen time for children less than 2 years of age and limits screen time to maximum one hour for children in the age group of 2 to 5 years.[5] Unfortunately, there are no cut-offs for older children. As per the Ministry of Human Resource Development, Government of India guidelines for digital education -“PRAGYATA”, daily screen time for online lectures has been limited to one session of 30 min for pre- primary, two sessions of up to 45 min each for 1st to 8th standard (1.5 h), and four sessions of 30–45 min duration for 9th to 12th standard (3 hours). [12] This will help limit the harmful effects of excessive screen time in children and at the same time ensure that they don’t miss out on academics. Parents should try and set up a routine for their children and encourage them to pick up hobbies which do not involve use of screens, such as art, reading, crafts and play board games with them. The 20-20-20 rule can help minimize eye strain- after every 20 mins of screen time, look at an object at 20 feet distance for 20 seconds. [5]
It is crucial to completely disconnect from screen time at the end of the day. This will prevent burnout and stress, improve the sleep and eating pattern and help prevent excessive cortisol secretion which disrupts our immune regulation and paves the way for infectious diseases. Outdoor activities like walking, running, cycling, and individual sports for at least an hour a day should help in this, if engaged while maintaining the COVID protocol. Children living in congested localities where pandemic protocol is difficult to follow can use any kind of outdoor space like rooftops, backyards etc. This not only ensures a break from monotony but also helps to substitute the physical activity at schools, thereby aiding in weight reduction at the same time, which is crucial, given the rising epidemic of obesity in children.
Online schooling may have come as a relief to children who are bullied at school or have social anxiety. [6] At the same time, their avoidance behaviours are positively reinforced. Social anxiety was somewhat buffered through 7

Impact of Pandemic on Mental and Emotional Health in Children
contact with teachers in school. Now, a few children have exhibited increasing avoidance and anxiety, particularly in relation to social situations, which are so few and far between. Post lockdown, once schools reopen, decompensation can be expected in such scenarios.[13] There has been a flood of COVID-19 related posts on social media which can heighten anxiety in children. COVID related memes can take away the seriousness of the issues and cause children to become lax in their social distancing practices, as they are very readily influenced by social media. [14] Lack of interaction, sudden disruption in routine and the quarantine has also unmasked psychosis in a few children, more so in those with pre-existing vulnerabilities and family history of psychosis.
Parents should be provided accurate information about the relative risks and benefits of social
media as they often overestimate the dangers of allowing their children too much screen time. [11] Co-viewing online content with their children can help in strengthening the parent-child bond, and can also improve digital hygiene in children.[5]
On the other hand, online education has some advantages as well, which are enumerated as follows:
• The overall travel time of going to school is definitely cut down due to online classes.
• Online education has enabled small children to acquire some knowledge about computers, which will definitely
help them progress in this digital world.
• Kids can interact with each other on a virtual platform and have fun while they are at home.
• Parents can supervise their child’s activity and can be involved with their education.
• Most of the schools are incorporating recreational activities like yoga, dance, music, art which can make the
child more enthusiastic to learn.
• Online platforms can also provide the required audio-visual modes of learning which can help children grasp
concepts better and make education a fulfilling experience.
Advent of Telemedicine
The pandemic has seen a tremendous rise in telemedicine, which is the need of the hour. Many institutes have been able to utilise this platform to provide the necessary services to children in need. But at the same time, it is important to keep in mind that all children do not have access to this and some may not even have the privacy to make use of teleconsultations due to being confined to a small space at home. [6] It may be wise to anticipate an exacerbation of emotional and behavioural issues amongst this population once in-person consultations resume.
As a part of a planned community intervention to connect people, the Government of Kerala, has started a teleconsultation service for children undergoing stress–“Ottakkalla Oppamundu”—“you are not alone, we are with you.” [8] Such initiatives can be taken in other parts of the country as well to extend support to the youth in such trying times.
Post-lockdown challenges
Not all children and adolescents have had access to online education during the lockdown. It is estimated that only 24% of Indian households have internet access, making online schooling difficult for the rest. [15] Unfortunately, many students, possibly more so in the rural areas, may have dropped out from school and started vocational pursuits. An attempt should be made to reach out to them, and try and reintegrate them into mainstream education.
Once schools reopen, they may face the added pressure of having missed out on academics which could negatively impact their self -esteem. [6] Also, given the importance that social interaction plays in a child’s life, it may be difficult to practice social distancing norms. Children and adolescents are inherently curious, full of energy and enthusiasm and may find it difficult to curtail themselves once they see their peers in person.
Child abuse
Child abuse is defined as any intentional harm or mistreatment to a child under the age of 18 years. Child abuse manifests in several forms that include physical abuse, emotional abuse, verbal abuse and sexual abuse. These forms often coexist in children exposed to vulnerable situations such as low-income families, children with pre- existing developmental conditions or mental illness, those living on the streets, children whose parents have physical/ psychiatric illnesses and those forced into child labour/ child marriage, but can happen in just about any family.
Children living in an abusive home environment have had to bear the brunt of the lockdown, with no escape from their perpetrators. The lockdown and school closure also unfortunately imply that children do not have the safe haven of their schools anymore, to escape from difficult homes. Childline reported a 50% increase in children reaching out to them for protection from abuse and violence, during the lockdown. Approximately 92,000 calls related to child
8

Impact of Pandemic on Mental and Emotional Health in Children
abuse were received within the first two weeks of the onset of pandemic itself. [15] Adverse childhood events have been shown to affect their survivors across their lifespan. The long- term effects range from having an increased risk of mental and physical disorders, reduced quality of life, developmental and cognitive impairments, social problems to even a reduction in life expectancy by upto 20 years. [6]
Out of 385 million children in South Asia living in extreme poverty, 30% are in India. The migration of labourers
may unfortunately see a rise in child labour. An alarming 40% of the sex workers in India are children. Due to the
economic crises as well as parental loss due to COVID, there might be an increase in child trafficking and flesh trade. [3]
We suggest the following measures to ensure prevention, early identification and specific interventions in the case of child abuse:
1) Setting up of COVID-19 helplines for children and families.
2) Enhancing the awareness about child abuse through electronic media, social media, FM radio etc.
3) Online training for children, parents, teachers, ICPS staff, counsellors, staff of child care institutions etc.
4) Training school counsellors to work with children to develop personal safety plans.
5) Support families in distress by providing financial support, access to health care etc.
6) Designation of child protective services as essential services and enabling adequate support.
7) Ensuring the continuity of child and family court services.
8) Creating community awareness and participation in child protection issues through ANMs, Anganwadi and Asha workers.
9) Enhancing the capacity of child care institutions by improving their facilities and infrastructure.
10) SupportingtheDistrictMentalHealthProgramme(DMHP)andotherdistrictlevelprotectionandhealthservices, with requisite training and treatment protocols for the implementation of child mental health interventions at the field level.
9

The way forward
Strategy for reopening schools
STRATEGY FOR REOPENING SCHOOLS
Having looked at the impact of the pandemic on the education system, it is imperative for schools and colleges to reopen, and this expert consensus group strongly recommends the same. Promoting vaccine trials in the 2–18-year- olds needs to be emphasized on so that offline educational facilities can be availed.
For preparing children, we recommend that parents and schools act in a partnership.
a) Role of parents- Preparing children in advance
COVID-19 has introduced a lot of uncertainties in our lives. For a lot of children, the biggest uncertainty is perhaps their return to school. It is extremely important for parents to prepare their children and support their return back to school when that happens. While parents do this, they also have to deal with the fact that it is not certain when that would happen. Besides, even when it happens, there would always be a possibility that schools will close again at short notice. Parents too have to deal with this uncertainty in order for them to prepare their children. Using analogies often helps with children. Parents can talk about this uncertainty being the essence of life and use examples to show how life will be “so boring” if we knew for sure everything that will happen in the next few days, weeks or months. However, while some uncertainty makes life interesting and exciting, too much of it makes us anxious. While we cannot control and predict the COVID situation, we can certainly prepare ourselves so that whenever the school reopens, things don’t come off as a surprise.
In order to prepare kids for school, it is very important that parents don’t get into an “expert” mode where they just tell the child what to do. Instead, parents have to encourage their kids to talk and express themselves. It is important for parents to understand the following about their child:
a) What do they know about COVID?
b) What myths do they have about COVID?
c) What are their worries about COVID?
d) What are their worries about school reopening?
Only once parents understand these things, will they be able to help their child. Parents will need to build on their child’s understanding about COVID and also bust some myths they might have. It is important that parents provide information in an age- appropriate manner. For younger children, educating about COVID may have to be done in a playful manner. It may have to take the form of a family quiz where everyone participates and the child also gets to become the quiz master. We recommend that schools develop educational material about COVID, which could be shared with parents beforehand. Schools may also opt to conduct some online quiz/classes to educate their students.
When dealing with children’s anxieties, parents need to start from a position of acceptance. Children need to hear that it’s ok to be a little anxious in these times and that they should feel comfortable in expressing their worries. Parents can tell their children that they themselves have some apprehensions about going back to their workplace and how things might have changed there, hence can understand their worries as well. A lot of worries about COVID can be handled by providing accurate information about how one contracts the infection, how it can be prevented and treated. A lot of children would also be anxious about other aspects of going back to school after more than a year. These have to be understood and adequately handled. Possible reasons could be pre-existing anxiety traits, academic issues and previous bad experiences at school such as bullying. Some, especially older children may have actually developed a liking for online schooling and may want to persist with that. Schools will have to factor this aspect as online schooling brings in a lot of other benefits like less travel time, and the overall convenience of studying in their home environment. Parents will also need to prepare their children with respect to practical issues like changing their sleep and meal times and restructuring other activities according to school hours.
B) Role of schools
Staggered reopening of schools and colleges should be attempted to curtail the spread of COVID-19, which can be done in the following manner: –
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Strategy for reopening schools
[i] COVID compliant measures for school staff and students
● The teaching staff and ancillary staff will be required to get vaccination, to begin with.
● Schools and colleges can act as vaccination centres for their students, once the vaccines are approved in this age group.
● Year-wise orientation programmes will be required for children and parents, prior to re-opening.
● Practice/mock drills can be carried out to ensure that the covid protocols are running in place.
[ii] Proposed Action plan to restart classes
● A soft launch with 3-4 classes can be carried out on a trial basis.
● 50 % of the class strength (odd/ even roll numbers) can attend the class in person and the remaining can attend from home via online streaming of lectures/ pre-recorded lectures.
● Pre-primary classes can be functional for 2 days a week, primary and middle school (1st- 8th standard) classes can be operational 3 days a week and secondary classes (9th and 10th) can be operational on all 5 days (Monday- Friday).
● Regular temperature checks should be carried out in the school for the children and staff.
● Rapid antigen test (RAT) kits should be available in the schools, in case any child/ staff is detected with symptoms, while on campus.
● The staff should be trained to identify symptoms and control outbreaks.
● The doors and windows of the classrooms should be open and the use of air-conditioners should be avoided. Sanitization of all surfaces should be carried out at regular intervals.
● Online classes need to be carried out on all days for the students who will not be attending educational institutes in person.
[iii] Adherence to Mask Protocols
WHO’s mask use guidelines state that children under the age of 5 years should not be wearing masks for source control. Those between the age of 6 to 11 years of age should wear masks, under adult supervision. For children older than 12 years, mask use is the same as in adults. [16]
[iv] Bridging the academic loss
The focus of school re-opening should be on extra-curricular activities, life skills and re-attaining social skills and not on catching up with the anticipated ‘learning loss’. These activities will have to be taken out in smaller groups and ensuring safety protocols. Curricular work can continue online at least till vaccination is approved and completed in children. However, this does not apply for schools which had completely stopped online activities and need to restart academics from scratch, and schools which have been shut down since March 2020. In those cases, staggered physical re-opening is truly recommended.
Given the multitude of effects of COVID, lockdown and prolonged school absence, there is likely to be an increase in mental health problems. Schools should be well prepared to be able to develop a method that helps them screen for mental health concerns. This should be done through both the school counsellor and class teachers. Apart from observations of their behaviour, students should also be encouraged to talk about any mental health concerns they might have.
During these trying times, schools can also develop a peer support system (Buddy system) wherein children can network and help each other deal with emotional issues and academic difficulties, which can be supervised by a counsellor/school psychologist. [14] Regular sessions in class can be organised to help children deal with their anxieties, especially pertaining to COVID. These could include simple relaxation techniques.
Children can be encouraged to come forward and share their experiences during the past 1 yr. Some of the questions which can be asked to children are:
● How was home?
● How was online school?
● What was your best moment?
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Strategy for reopening schools
● What was your worst moment?
● Did you cry? When and why?
● Did you laugh? When and why?
Some of the questions which can be asked to the adolescent age group are:
● Did you meet your friends?
● Did you experience any change in your sleep pattern?
● Did you consume any substance?
The responses provided by children and adolescents can be used to plan further interventions.
For students who don’t want to openly discuss things, every class can have a “worry box” in which students could drop in brief notes describing their concerns while maintaining anonymity. Common themes can be picked up from these notes and addressed generally for the entire group. Schools should have a clear guideline on talking to parents and advising them to seek a specialist opinion should there be concerns regarding a particular student.
On similar lines, the mental health of the teaching and ancillary staff also should be addressed. Debriefing sessions can be undertaken at regular intervals to allay their anxieties, counselling sessions can be arranged to promote mental hygiene and senior teachers can play the role of a buddy for the junior teachers.
[v] Achieving Curricular Equivalence
Educational institutes should not be over-ambitious of the same. For children appearing for Board exams, curricular leniency should be considered. For other classes, an approximate time of 2 years should be expected before curricular equivalence can be achieved to a pre-pandemic level. The thrust has to be on mental and emotional health and well -being, as a cohesive school unit.
A silver lining
Having looked at the negative side of the pandemic, one must not forget that this period has allowed children to develop resilience and contributed tremendously to their personal growth. Successful management of the current stressors will instil confidence in them to face their future challenges in the real world. [6]
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