Hidden pandemic trauma harming children

GPs have been advised to remain aware of ‘the silent patient in the room’ when treating patients with young families.
 
Speaking at last week’s Federal Department of Health COVID-19 response update for general practitioners, Chair of the RACGP Specific Interests Disaster Medicine network, Dr Penny Burns, said children are ‘probably one of the most vulnerable groups’ in disaster events and as a result require special care.
 
‘Children’s brains are still developing and we know that the effects of trauma on this younger group can actually be quite significant,’ she said.
 
‘There can be neurological developmental changes that then affect their increased risk for mental health and physical health in adulthood … [while Australian research has] shown the deterioration in ability to learn and an effect on academic performance.
 
‘Probably 100% of Australian children have been affected by this big bug that’s arrived and that has absolutely changed the way we live … [so] it’s really important basically to remember the children when we’re going through all of this, because we have an opportunity to really change the outcomes.’
 
Aside from mental health concerns, Dr Burns’ warning preceded new research conducted by the Royal Children’s Hospital (RCH) in Melbourne, which found children are having their healthcare impacted due to parental concerns related to contracting the virus.
 
One in three unwell or injured children captured by the survey has had their treatment delayed due to COVID-19, while one in five children under the age of five has had a routine vaccination delayed during the pandemic.
 
The RCH Immunisation Service has also seen a decrease in presentations with almost two-thirds of families delaying or cancelling their appointment during the pandemic, prompting the hospital to launch a new drive-through immunisation clinic.
 
‘The main reason parents gave for delaying care was fear or concern about their child or themselves catching COVID-19 in a healthcare facility or service,’ Poll director and paediatrician, Dr Anthea Rhodes said.
 
‘Some families are of the misunderstanding that because their children are not exposed to other kids, perhaps they are not at risk of catching preventable diseases, so perhaps they are putting off having the children vaccinated.’
 
According to Dr Burns, one of the best ways to help children during the pandemic is to help the parents.
 
‘Whenever we see a parent come in who’s distressed, not coping, struggling with what’s going on, we need to remember that that parent has a strong effect on that child, any child they have,’ she said.
 
‘That child may not be presenting, but we can think of them as a silent patient in the room.
 
‘It’s very important that we realise that in helping the parents and helping them cope and develop agency – work out what to do, support their health, help them to get better, help them to adapt to the changes – we’re actually also helping the children.’
 
It’s also important, Dr Burns said, to ‘look at the world from a child’s eyes’.
 
‘Children are not little adults. They’re different,’ she said. ‘They’re very reliant on adults for their care, but they’re very much affected by their age and stage of development, by any pre-existing conditions or health, and by their cultural and family context, and also their experience of the event they’re going through.
 
‘What I’ve been trying to do is just stop with every child that comes in and … just take a moment to see how they’re coping and what they’re doing.
 
‘It’s really important basically to remember the children when we’re going through all of this, because we have an opportunity to really change the outcomes.’
 
Dr Burns suggested a number of resources to help GPs connect with younger patients and help them cope with the pandemic, including a book called My Hero is You: How kids can fight COVID-19, which she described as a ‘beautiful story of agency for children’ and has been translated into a number of different languages.
 
‘There’s another YouTube video which I really like called “The Great Revelation”, and it’s a father in the future talking about what happened back in the great revelation when COVID the virus came, and how it changed our lives for the better,’ she said.
 
‘There’s a lot of positive ways of looking at this, and you can give these to children and you can give them ideas on how they can contribute to this fight.’
 
Log in below to join the conversation.

children coronavirus COVID-19 mental health vaccination