How to help children who need behavioral interventions while they're home during coronavirus closures

Jason Khan

The COVID-19 pandemic has changed everyday life in countless ways. As a parent, the one that still seems surreal to me is the closure of our schools. And while many are focused on how these closures will impact learning and academic achievement, we must also remember that

schools are an enormous mental health provider. How will the children who need mental health services get care if their school is closed?

It’s a bigger problem than you may realize. In 2019, the Commonwealth allocated just over $13 billion for special education, and much of that is spent on behavioral interventions. But now that schools have closed, these services have vanished. Making matters worse, many clinics have also decided to close their doors. That means kids aren’t getting the services they need, and there could be some serious social emotional fall out down the road.

Children receive behavioral interventions because those interventions help them to succeed in a myriad of ways. In the mental health world, we know there is often a price to pay for inaction, as disorders can progress. We also know that social isolation is never recommended. Under the stay-at-home advisories that governors have issued in response to the ongoing coronavirus crisis, I fear that children who need behavioral interventions are falling further behind.

What can we do to intervene and stop this negative feedback loop? For kids at risk, we must:

·      Start rapid deployment of telehealth services and digital interventions and work to connect specialists with kids. This is not necessarily easy, and there are few good models available. Remember, kid therapies aren’t structured like adult therapies, and talking is only part of the puzzle. In instance, we will need to - learn as we go. We need to immediately identify, deploy and engage with at-risk children to provide practical strategies they can use now. 

·      Recognize play as serious business. Whether as part of telehealth services or within the family, play can provide valuable opportunities for socialization. Board games can work remotely when both parties have the game; some card games, such as deck building games (think Pokémon) work especially well. Video games can play a role too. Multiplayer games require social interaction, but safe internet practices are a must. Ideally, a child plays with others they already know, who are their own age, and with age-appropriate content. In other words, a race against a neighbor in Mario Kart with a video chat running concurrently has a useful place in a COVID-19 world. Violent video games played with strangers still requires all the caution that would be used, no matter what.

·      Work closely with families to think and plan about how best to meet the needs of their children. It is a chaotic and constantly changing time, so flexibility and adaptability are key. What’s working today may not be as effective in another week. We don’t have a playbook for managing this, so parents and mental health professionals need to communicate about their experience, so everyone can continue to learn and improve.

·      Plan for longer-term strategies. It is critical to protect and preserve the gains these children make while they are at home. That will mean innovating toward new models of mental health care and delivery that address the challenges emerging ahead of us.

We must not lose sight that we will come out on the other side of this temporary pandemic, and that it is our duty to ensure that the children we serve remain primed for success for the rest of their lives. 

Jason Kahn is a researcher at Boston Children's Hospital who focuses on using technology to aid in mental health care. He's also the Chief Scientific Officer and co-founder of Mightier