COVID-19 and Educational Activities for Children

August 19, 2020

As the new school year approaches, many families have questions and concerns about their children returning to an in-person learning environment. The concerns may be heightened if you have a child with a medical condition.

Please note: Lurie Children’s will not judge whether specific schools or school districts are right or wrong in their decisions to return to in-person learning versus holding classes online. Instead, Lurie Children’s goal is to provide information to help parents, schools and communities make evidence-based, child-centered decisions. The decision about going back to school is often a personal decision for families, as they consider multiple factors.

Taking Precautions and Assessing the Risks

"We have to remember the scientific evidence about what steps we can take together to stop the spread of COVID-19 in our communities," says Matthew Davis, MD, MAPP, Chair of the Department of Pediatrics, Northwestern University Feinberg School of Medicine; Head of the Division of Advanced General Pediatrics and Primary Care; Executive Vice President and Chief Community Health Transformation Officer, Lurie Children's. "In all public spaces including schools, it's important to stay home if you are sick, wear masks, keep hands clean, maintain physical distance, and clean common surfaces on a regular basis."

If your school district is opting for in-person return to school, families should consider these factors as important infection prevention measures when returning to school:

  • Screening for symptoms: Schools need to ask parents and staff about symptoms of COVID-19 on a daily basis, and if students or staff have symptoms they should not go to school.
  • Physical distancing: Maintain a safe distance (ideally 6 feet) in-between individuals (students and staff).
  • Masking: If physical distancing is not possible and contact with other students and staff will be prolonged, a face covering should be worn.
  • Hand Hygiene: Hand hygiene should be encouraged for all students including (but not limited to) upon classroom entry, before and after eating and use of bathrooms, and before and after touching shared objects.
  • Cleaning and Disinfection: Schools should ensure that cleaning and disinfection practices adhere to local health department recommendations.
  • Sick Day Policies: It is important that students and staff who are sick, as well as those who have been exposed to a known COVID-19 case, stay home. Schools should also have policies about what steps will be taken if a student or staff member gets sick while at school.

In addition, it is a good idea to “cohort” (assign) students in small groups over several days in order to reduce the risk of spread among broad groups of children.

It is important to remember that, because COVID-19 can spread easily in the community, any return to school comes with some risk of COVID-19 transmission. The common-sense, evidence-based steps to prevent transmission (see above) will help reduce risks for your child.

Some items to consider when assessing risk to return to school include:

  • Underlying Conditions: Patients who have received a transplant and have other underlying conditions, including asthma and other lung conditions and diabetes, may have increased risk of more severe disease from COVID-19.
    • Level of Immunosuppression: If your child is on high levels of immunosuppression (for instance, they are within their first three months of transplant, or recently treated for rejection) they may have a greater risk of transmission and we would recommend that they participate in school on an e-learning platform. Pediatric transplant recipients at the lowest risk are usually on one or no immunosuppressants, and probably have a risk similar to children in the general community.
  • Prevalence of COVID in your community: An area is considered a “COVID-19 hot spot” if greater than 10% of the COVID-19 tests performed are positive, and/or the number of COVID-19 cases is increasing rapidly. In Illinois, you can find this information on the Illinois Department of Public Health website: https://www.dph.illinois.gov/countymetrics.
  • Specific Educational Needs: Your child’s specific educational needs, such as an individualized education program (IEP), need to be considered when making the decision for remote or in-person learning.
  • Emotional Well-Being: Some children thrive in the e-learning environment, while others struggle with the isolation it can cause.
  • Family Needs: It is important that families can work and provide for their families. If you are required to work outside of the home, this makes e-learning more difficult. In addition, working from home with children who are also learning at home may present many challenges for families. If your child is not on high levels of immunosuppression, in-person schooling may help reduce family strain provided that steps to prevent COVID-19 transmission (above) are being taken by schools and by families.

“If schools decide not to hold in-person learning, it is essential to keep in mind that there are particular groups of children whose needs may shift in e-learning or home-learning environments and require special attention,” says Dr. Davis.  “Children with special healthcare needs who have 504 plans, children who have individualized educational plans, children who depend on schools as vital sources of nutrition, and children who receive counseling services on-site at school are at risk for worsening of their health, well-being and learning if on-site educational services are not available. Lurie Children’s encourages schools to take steps to make accommodations to ensure that children with these specific needs are supported in alternative ways outside of the in-person learning environment.”

Supporting Your Child’s Mental Health - Is My Child Ready To Go Back To School?

Starting a new school year always comes with a little bit of nerves but starting a new school year in a middle of a pandemic brings on a new level of stress, anxiety and unknowns. The last several months have caused many disruptions and changes to families’ day-to-day routines. Most notably, many children and adolescents in the U.S. finished the school year remotely.

As the new school year approaches, Tali Raviv, PhD, Pediatric Psychologist, The Pritzker Department of Psychiatry and Behavioral Health, offers tips to help support your child and his/her/their return to school:

  • Take time to talk to your child or teen about COVID-19 and their concerns about returning to school so that you can understand and address their specific concerns and questions.  Keep in mind that their concerns might not be what you expect.
  • Share the facts. Answer questions with age appropriate information that as best your child can understand. Don’t overshare. You know your child best.
  • Discuss the ways that you and other adults are working together to keep them safe.
  • Encourage them to share what they are feeling so you can help them sort through difficult feelings. Look for opportunities to correct any false information, magical thinking or self-blame.
  • Work with your child to identify coping and problem-solving strategies that they can use if faced with situations that make them feel nervous or upset
  • Help your child identify things they are excited about or looking forward to once school resumes
  • Engage your child in planning for the school year ahead—this could include setting up their workspace and school supplies or creating a daily schedule.
  • Limit the amount of news coverage they see including time spent on social media and ask them what they are seeing/hearing and if they have questions.
  • Be mindful of your conversations with other adults about COVID-19 -look for private space away from curious ears.
  • Be sure you are managing your own stress and anxiety (“Put on your own oxygen mask first so you can continue to help others!”).

It’s important to recognize the signs that your child is anxious about returning to school so you can help them accordingly.

“It's a very different situation if a child is worried, ‘I'm not going to have my best friend with me in my little pod’ than if they're saying ‘I'm worried I'm going to get sick and die’ or ‘you're going to get sick and die,’” says Dr. Raviv.

Dr. Raviv says signs that your student is anxious about returning to school include:

  • Any significant changes in sleep, falling asleep, staying asleep, not wanting to sleep alone or having nightmares
  • Changes in appetite or a lack of appetite
  • Headaches or stomach aches
  • Being more irritable, frequent meltdowns
  • Withdrawal from friends, family, other activities

If your child is experiencing anxiety that is prolonged, resulting in significant impacts on their functioning, or causing a good deal of distress, please seek help from a professional healthcare provider.

For more resources related to COVID-19, please visit our COVID-19 page for families