Monthly Archives: September 2020

Teachers and the Pandemic

by Andrew Skoirchet, M.D. with Alexandra Harrison

This image is picture of children in a school in South India.
A Harrison: The colleagues I rely on most in my therapeutic work with young children are teachers. I know that teachers write about teaching and what it is like to be a teacher much better than I ever could, but as an outsider, I would like to offer some observations from my long collaboration with teachers.  In addition, the current health crisis brings us time to reflect as well as bringing us new challenges. I would like to take advantage of both of those opportunities.
Preschool teachers, and perhaps teachers of older children also, have been taught Child Development more thoroughly than I ever was in Child Psychiatry training. Teachers see so many children. They see many children of the same age together and gather information from their own experience about norms of behavior for their particular cultural or socio-economic population. They observe peer interactions and find ways of supporting them and managing the behaviors that emerge. They learn to say hello and goodbye. That is what they do every year. They say hello and make an attachment to a group of children, whom they see every day and help with their struggles—academic and socio-emotional—and then they say goodbye to them. In addition, teachers attempt to meet the needs of children with special learning challenges. Finally, they have to plan a curriculum and implement it, despite the individual needs and preferences of their many students.
 
All this, and then the pandemic struck. My colleague, Andrew Skoirchet, and I gave a talk to some Indian teachers about the transition to remote teaching, and that gave us a chance to talk to some U.S. teachers about their experiences.  Here are some thoughts that Andrew put together from our conversations with teachers.
 
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A Skoirchet: One of the most frequent comments we’ve heard was about how suddenly teachers had to transition to online learning. Many teachers doubled their work hours in order to prepare for class, often working through the weekend with no days off. They wondered how to create an engaging and effective remote learning environment, including what schedule to follow, how to promote active learning, and how to ensure that every student, with their own unique strengths and challenges, can stay involved in the lesson. Teachers worried about their younger students sitting in front of a screen for so many consecutive hours each day. Not surprisingly, teachers also found that their youngest students were often the most challenging to teach. Even after all the extra preparation, teachers would sometimes catch their students distracted by video games, cell phones, and other side activities. Or they had no idea about their students’ distractions, which can be just as disruptive to the learning process. Some children cannot effectively learn in a remote environment, whether because of some learning disability, issue with attention, or another cause, however teachers continually tried to “make it work” for these students.
 
Another major issue was the technical challenges in transitioning to the use of remote video platforms, which caused much confusion, anxiety, and quite a few mistakes. How do you manage when a screen freezes or the internet fails? Do you wait for students to rejoin a class, or keep the class going? Do you pause and recap when each student returns from a disruption? Are students even able to process the lesson through a video format? Nobody had the answer to these questions when COVID started. Just like teachers, school administrators were overwhelmed and uncertain about how to proceed, so teachers most often had to make their own individual decision for how to run their classes, while still being held to the standards of “evidence based” and “results driven” education. 
 
In order to accommodate all of these new demands, teachers often made great sacrifices in their personal lives. They struggled to balance these new work demands against taking care of their own families and other household responsibilities. They lost the satisfaction of in-person connection with students and the sense of community with fellow teachers: the simple “hellos” and brief chats in the hallways that are incredibly important for teachers’ morale. And teachers also faced new emotional burdens. One of the more common complaints we have heard was self-doubt about the quality of their instruction and not having any point of reference to judge one’s own work. This self-doubt often consumes the little remaining “free time” a teacher has, and might leave them with a feeling of inadequacy and failure. Teachers often worried about losing their jobs and, in fact, many teachers have lost their jobs or have been placed on temporary leave. For many teachers, it has been a huge contradiction to work twice as hard as before COVID, making so many personal sacrifices, and then to feel so undervalued. Loneliness and a feeling of isolation have emerged as two common experiences during COVID, which can be especially difficult if a teacher does not live with family or a roommate. Teachers, like many, are reporting higher levels of anxiety and depression.
 
Other common worries that we have heard include witnessing the backsliding of their students’ progress. There is the concern that younger children are not having the necessary socialization experience, and it is not yet clear how this generation’s development will be affected. While some students’ families have the means to pay for additional resources and learning supports during COVID, other families do not. This has highlighted the inequities that exist in our society, as many teachers and students do not have the resources to overcome the challenges imposed by COVID. Teachers are saddened to see their most vulnerable students fall further behind because they cannot afford extra tutors, high-speed internet access, or computers. Even if both parents work extra hours, this means they have less time to help their children at home, and teachers are realizing just how crucial it is for parents to be available to support remote learning. 
 
As for what teachers can do to take care of themselves, here is some of the most helpful advice we have learned: it is critical to schedule time for yourself, even if only 15 or 20 minutes per day. This could involve physical activity, writing in a journal, meditating, or doing a hobby. Some teachers have formed support groups, which has helped to replace those hallway conversations that can be so sustaining. It is also helpful to set boundaries on a number of different levels. For example, having a dedicated work space at home, ideally outside of the bedroom, can be especially helpful. If a teacher is being asked to return to in-person teaching, they should feel permitted to make their own decisions for how to keep themself and their loved ones safe. On a personal level, it is important to acknowledge when you need alone time, time for self-care, or time to be spent with loved ones. Professionally, teachers should also expect for their productivity to decrease and to understand that this is okay. It is important to draw boundaries around the total amount of time spent on work, as well as how much access students and families have of teachers outside the classroom. Finally, it is important to have boundaries in one’s own frame of mind. Teachers should not have to apologize for having limits, and they should feel justified in sharing these limits with administrators, students, and their students’ families.

Returning to Preschool During COVID-19

Panel on school reopening

I participated in a great panel at the Cambridge Ellis School last night. It was a remote meeting for parents and teachers in preparation for the opening of school during the COVID-19 crisis. The panelists included Dr. Michael Yogman, the school pediatric consultant, Tal Baz, an occupational therapist and specialist in sensory processing, Dr. John Mazzotta, and me, the school child psychiatric consultant. 

Most of the questions the parents sent to the coordinator before the meeting concerned safety. That is what would be my primary concern if I were sending children back to school during the pandemic.  Some of us feel relatively protected, working from home, somewhat insulated from the illness and financial insecurity others are suffering. Many parents of preschool children are more aware of the burden of caring for children while attempting to work from home than they are of the threat of physical illness. But when they prepare to send the children to school, that is when they are confronted with the dangerous reality of life outside the home.

Early on, the panel talked about the need to balance the threat of illness against the preschool children’s need for socio-emotional growth. Both are extremely important. How can we balance the two? The question of how to balance the need for protection and the need to support socio-emotional development is stressful to parents. Yet, parents are the foundation of their children’s sense of security. How can parents manage their own nervousness and be calm for their children in the transition back to school? Many studies have documented the “contagion” of anxiety in the parent-child relationship (Murray, Cooper et al, 2007; Nicol-Harper et al, 2007). How can we protect our children from parental anxiety that is based in legitimate fear?

One way of managing parental anxiety is to identify concrete measures to protect their children. We talked about the use of masks, hand washing, and constraints on behaviors that could potentially increase contagion– physical closeness and singing. 

Masks are challenging for very young children, but there are ways of helping children feel comfortable wearing masks. Games can be played wearing masks-peekaboo games, games about guessing the emotion being displayed by the person wearing the mask. Children can decorate their masks, enhancing their sense of control and agency when unusual demands are being placed on them. Especially masks representing superheroes can allow the child to—in their imagination—inhabit that superpower and feel safer and more in control. It is important to emphasize the individual differences among children in terms of the tolerance for wearing masks; some children with tactile sensitivity, for example, may need extra support. In terms of the emotional distance conferred by masks, since emotion is communicated more by the top of the face than by the lower part of the face, this should not be such an issue. In fact, authentic smiling is communicated by the orbicularis oculi muscle of the eyes more than by the facial muscles around the mouth. While it is true that children who are learning to talk may find the muffling effect of the mask problematic, this may be an opportunity to learn to enhance communication through gestures. 

We talked a lot about hugging and other physical contact and the constraints imposed by concerns about contagion, especially in the case of the youngest children. Can the toddlers not sit in their teachers’ laps? What about teachers attempting to calm a dysregulated kindergartner? What about the children who have a hard time “keeping their hands to themselves” while waiting in line? This again seemed to be an issue of balance that will depend in part on the comfort of the individual teacher and in part on the comfort of the parents of that particular child. 

An important emphasis of our discussion was on self-regulation. I have already talked about how to manage parents’ anxiety through concrete steps of protection. Another way is to work on self-regulation. The first step is to slow down. Meditate if that is a method you can practice. Slowing down and behaving in a calm, well-regulated manner will be very helpful to your child. Mental health in the pandemic has been strained both for children and parents (Gassman-Pines et al, 2020). 

The issue of self-regulation brings up another salient theme of the panel—the stimulus to innovate, create. For a long time I have thought that self-regulation should be an even more important focus in preschool education than it is at this excellent preschool. I have written about my visits to a school in South India in which each school day is begun with chanting prayers, a highly regulating activity, followed by dancing for the young children.  These repetitive rhythmic motor activities, as Bruce Perry explains, engage the “bottom-up” stress regulating system. They create an organizing force in the nervous system–and like all activities–if they are repeated, they reinforce the neural circuits that govern them (Perry, 2006, CTA). Similar self-regulation activities include marching, drumming, clapping and other organized hand games. We talked about games that build regulation of the motor system—games that involve stopping and starting like red light, green light, like “Simon Says”. The more outside time the better during the pandemic. One of the most enjoyable and organizing activities of the school day in preschool is singing. An alternative to this potentially virus-spreading practice is humming, which—through the exercise of breath control—is also self-regulating! Perhaps the urgency generated by COVID-19 can spur us to create new practices that build self-regulation into the curriculum.

We talked about a new emphasis on imagination. Remember that preschool children are in the “magic years” (Fraiberg, 1959). Their most effective way of making meaning of their world is through pretend. Pretend play offers the preschool child a means of representing the insecurities, the anxiety, the desires, and ambitions in their inner world and to master them. The frustration and sadness associated with the constraints of freedom, the limitations of socialization, and the demands to take precautions—these can be represented and mastered in pretend play. Preschool teachers are experts at scaffolding this developmentally enhancing play, and parents can also facilitate it at home—by encouraging it, providing the space and props for it. Although parents can contribute to the effectiveness and enjoyment of children’s play by helping them elaborate the themes that the children introduce and by helping the child maintain regulation when stirred up, parents do not have to actively engage in pretend play with their children all the time. Parents’ affirmation and appreciation of pretend play in itself is helpful.

Finally, we talked about community building—for the children, of course, but also for the parents. Remember the question about how to manage the anxiety generated by the real threat to our safety? We can do that through the support of the school community. We encourage regular meetings—to share information about medical advances, to share ideas about how to help parents, children, and teachers cope with the ongoing challenges, and to share emotional experience—because no matter how hard the journey, it is easier when you have traveling companions.

References:

Gassman-Pines A, Oltmans Anant E, Fitz-Henley J (2020). COVID-19 and Parent-Child Wellbeing, Pediatrics, e2020007294; DOI: https://doi.org/10.1542/peds.2020-007294

Fraiberg S (1959). The Magic Years: Understanding and Managing the Problems of Early Childhood, NY: Simon & Shuster.

Murray L, Cooper P, Creswell C, Schofield E, Sack C, The effects of maternal social phobia on mother-infant interactions and infant social responsiveness, J Child Psychol Psychiatry(2007). 48(1):45-52. 

Nicol-Harper R, Harvey A, Stein A (2007). Interactions between mothers and infants: Impact of maternal anxiety, J Infant Behavior & Devel, 30(1):161-167.

Perry B (2006). The neurosequential model of therapeutics: Applying principles of neuroscience to cinical work with traumatized and maltreatment children In Working with Traumatized Youth in Child Welfare(Nancy Boyd Webb, Ed.) The Guilford Press, N.Y., pp. 27-52.

Training Series 2: Six Core Strengths for Healthy Child Development, Overview, The Child Trauma Academy, www.ChildTrauma.org.