Author: Kerry Jamieson

Many parents are breathing a sigh of relief this month as their children return to in-person learning at school. While it’s a welcome break from juggling the competing needs of home schooling and work for some parents, others have mixed feelings about schools re-opening. Parents’ responses range from mild concern to extreme reservation. The COVID-19 pandemic may have caused intense feelings of stress, fear, and apprehension but the return to school brings its own set of uncertainties. Are our schools safe? Are we, as a society, prepared to tackle future outbreaks? Is our children’s mental health being considered?

While the return to school may seem like a return to normal, it’s anything but. Schools will be tasked with managing the results of the past year when homes have been thrown into turmoil, financial strain has been extreme, and children’s minds have been confused and overwhelmed by the constant barrage of (often mixed) pandemic messages. Prior to the pandemic, children were already experiencing more mental health concerns, including escalating rates of anxiety, depression, and suicide rates tripling from 2007-2017 for those ages 10-14 years old. Researchers expect the post-pandemic mental health crisis to cause these numbers to rise even more.

ACEs and Children’s Environments

Pandemic pandemonium aside, every day thousands of children arrive at school deeply affected by the circumstances in their homes and communities. ACEs describe specific adverse experiences that occur before the age of 18, but childhood trauma can be caused by circumstances that exist outside the home, too. The latest understanding of ACEs acknowledges that in the absence of buffering relationships, intangible situations like racism, fear of neighborhood gangs, bullying, and countless other unmitigated societal ills can cause the toxic stress that hampers brain development and delays children’s normal, healthy growth.

Currently, children have the added burden of an international health disaster. We cannot underestimate the profound impact this global crisis has had on our children. We also cannot fully predict the extent and exact nature of the mental health fallout, or ‘echo pandemic’ we are likely to experience as children come to terms with the isolation, changed family circumstances, fear, and anxiety of spending months and months at home, many of them in abusive or neglectful environments.

The following graphic, courtesy of ACEs Connection, shows how adversity affects children at home, in the community, and in the overall atmosphere or environment in which they live. Children bring adversity from all three of these realms with them to school.

Service at Schools Make Sense

So why does it make sense to focus a large portion of our childhood mental health efforts on schools? Quite simply because that’s where children are for a good portion of most days. Bringing services to where children are makes sense, but it also makes for stronger, better schools and improved educational outcomes. According to the National Association of School Psychologists, mental health plays a crucial part in a child’s academic success as well as their future success in life. Students who have access to social–emotional and mental health support at school do better in their studies and are generally better adjusted to face life’s ups and downs. These children enjoy stronger relationships and are more likely to participate in a wide range of sports and extracurricular activities. A school that works on its mental health climate and encourages both student connectedness and teacher wellbeing is a school that is going to be a healthy place where students feel free to express themselves and where behavior in the classroom is well managed.

Despite the fact that schools which embrace metal health services have been shown to thrive, there is a growing unmet need for mental health services for children and youth. According the U.S. Department of Health and Human Services, one in five children and adolescents experience a mental health problem during their school years. Unfortunately, an estimated 60% of students do not receive treatment due either to stigma or simply the lack of access to services. Of those who do get help, however, nearly two thirds do so only in school. Issues can include anything from depression, to stress and anxiety, bullying, family problems at home, learning difficulties, and alcohol and substance abuse. Serious mental health problems, such as self-harming and suicidal ideation, are on the rise, too.

The Right Intervention At the Right Age

Since we work with children from birth to 18, Center for Child Counseling has formed a close partnership with the Palm Beach County School District in order to bring our unique blend of trauma-informed resiliency building to as many children as possible. Our approach has always focused on prevention and early intervention services, as well as targeted clinical care for those children who need it most. The skills our therapists teach can benefit a child throughout their lifetime, such as self-regulation, executive functioning skills, and healthy relationship building. Our approach is science- and research-based and is founded on the latest understanding of children’s developing brains.

As a general rule, the earlier we can connect with children, the better the outcome is likely to be. This is especially true for children impacted by trauma and abuse, those who are dealing with ACEs. So many of the behaviors exhibited in classrooms (and which are so disruptive to all students) are really just symptoms of an underlying problem a child is finding it difficult to express. Before the necessary language skills develop, these experiences may be expressed by fighting, biting, hitting, and unruly outbursts. Our skilled therapists look for what is happening in a young child’s life that is prompting these behaviors.

But it’s not just children who are struggling who benefit from our in-school support. All children need to develop resiliency or the ability to bounce back from life’s setbacks. Children who do well in the face of hardship usually have a biological resistance to adversity and strong relationships with the important adults in their family and community. Often, teachers can play this role along with parents and caregivers. You can learn more about teachers as buffers in one of our prior blog posts.

Having a mental health professional on-site and available to respond can make all the difference in the environment every student and teacher experiences on a daily basis in their school. Center for Child Counseling operates three programs within the school system:

CCSEW (Childcare and Community Social-Emotional Wellness) 

Our CCSEW Program brings on-site prevention, early intervention, and counseling services into childcare centers, schools, and shelters in Palm Beach County. Developing the capacity of adults, through workshops and consultation, in our community to meet the social-emotional needs of young children is an essential part of this program. Our team of CCSEW therapists are co-located in select Palm Beach County Schools as well as childcare centers and shelters throughout Palm Beach County.

Our therapists provide prevention, early intervention, and teacher support services. These services are co-located, with our therapists and interns working as a part of the fabric of the school and community to meet the therapeutic needs of children and their families.

School-Based Mental Health Program

Our School-Based Mental Health Program is conducted by a team of skilled therapists co-located in select Palm Beach County schools who work on-site with more than 1,200 students from pre-Kindergarten to 5th grade. We provide services including classroom support, contact with teachers and caregivers, crisis intervention, and one-on-one therapy support within the school setting, at home, and out in the community.

The goal of this program is to meet the needs the highest-risk students, some of whom may not be identified otherwise and may never be linked to the mental health services that will undoubtedly help them.

Created as part of the Marjory Stoneman Douglas (MSD) Public Safety Act for school safety, this program aims to provide students and their families with evidence-based mental health treatment that includes assessment, diagnosis, intervention, treatment, and recovery.

SNAP® – Stop Now and Plan

Funded by the Florida Network of Youth and Family Services, the Stop Now And Plan (SNAP®) Program serves as a “front-end” resource to the Department of Juvenile Justice, Office of Prevention, for at-risk youth aged 6-11 and their families.

Each SNAP® program provides high-risk youth and their families’ strategies to increase pro-social skills that will help the youth stay in school and out of trouble by making better choices throughout the 13-week program. Youth and their families participate in engaging activities such as group discussions, role-playing, interactive games and self-reflection to address topics including dealing with anger, learning how to cope and practice self-control, engaging in problem solving and learning not to bully and how to prevent bullying. SNAP® is an evidence-based behavioral model that provides a framework for teaching children struggling with behavior issues, and their parents, effective emotional regulation, self-control and problem-solving skills. The primary goal of SNAP is to keep children in school and out of trouble by helping them make better choices “in the moment.”

So, as your children head back to school to differing degrees, advocate for their mental health and ask if essential services are available to them. If your school has an on-site therapist, get to know him/her and reach out to them with your questions. The Center for Child Counseling team is equipped to help you with COVID-19-related issues and any of the normal anxieties of life your child might be facing. ACEs at home, in the community, or in the overall environment don’t necessarily have to result in trauma for your child or lifelong negative consequences. Your response to these experiences can make all the difference in the world to your child and their future happiness at school and in life.

By now, we know that Adverse Childhood Experiences (ACEs) are as pervasive as they are dangerous. No community, race, or socio-economic group is immune to their insidious effects. We know that toxic stress caused by sustained childhood trauma can impact children’s growing brains, resulting in potentially devastating mental and physical health outcomes throughout the lifespan. Scientific studies bear out the fact that childhood adversity can result in countless social ills from alcoholism to suicide to diabetes, but it is comforting to realize that the opposite is equally true. Positive Childhood Experiences (PCEs) are the kinds of activities and experiences that enhance a child’s life, resulting in successful mental and physical health outcomes. According to a recent study cited by Contemporary Pediatrics, “positive childhood experiences [may even] counter the damaging effects of adverse experiences.” PCEs are what make childhood such a joy, a time of growth, change, exploration, and undiluted happiness. So what interactions make the most effective PCEs and how can we focus on filling our homes (and the lives of all the children in our community) with these kinds of uplifting, fortifying experiences?

The Power of Positive Experiences

Whether we are parents, caregivers, or someone who spends a significant amount of time with children, as adults we play the most crucial role in childhood happiness. PCEs include identifiable situations in a child’s life that set them up for success such as feeling safe at home, having adults who support them, and being able to talk to the adults in their lives during difficult times. It seems clear that children thrive when they are provided with clear structure, age-appropriate games and entertainment, security, a kind yet authoritative parenting style, and oodles of love and acceptance. This is the kind of atmosphere in which children thrive, learning the skills they will need to be happy, healthy adults and productive contributors to society.

Of course, this is the “dream childhood” that many (if not most) of the world’s children will never experience. But families don’t have to be perfect for children’s lives to be full of positive childhood experiences. As long as there are buffers against the negative or traumatic experiences, children can learn to be resilient and rise to meet the challenges in their homes and communities. In fact, studies show that the presence of just one positive adult influence can make all the difference in a child’s life. No matter what a child’s circumstances are, each of us can be the adult who brings positivity, solid life lessons, stimulating experiences, and fun and laughter into a little one’s life.

Play is a Child’s Language

One thing most of us associate with childhood is play. Playfulness is the defining attribute of most children. It’s a quality that many of us miss as adults. A lot of the activities we engage in as adults like sports, games, practical jokes, or general silliness are an attempt to reconnect with the freedoms and exhilaration of childhood. But does it seem like the type of play children engage in has changed? It certainly has. You’ve probably noticed that the children in your life don’t play in the same way you did as a child. Were you outdoors more? Did you have to rely on your imagination to entertain yourself and your friends? Do you look at the amount of time your children spend on screens with concern? You should. As human beings, we may be adaptable, but recent studies confirm what scientists, child development experts, and pediatricians have been saying for some time: too much screen time can be detrimental to your child’s physical and mental health. It’s not necessarily that simply looking at a screen for a few hours a day is inherently harmful, but it takes away time from other activities your children definitely should be doing like being outside, exercising, and getting enough quality sleep. There are lots of ways to help manage the time your children spend on screens, if you feel it’s getting out of control.

Screen Time vs. Real Play

Since the onset of the COVID-19 pandemic, children’s screen time has rocketed. Where it might’ve been a vague concern before, it is now a genuine threat to mental health. Many children are now home schooled remotely using screens for a good portion of the day and then rely on screens for entertainment in the form of television viewing and gaming at night. “Children’s brains are not designed to grow and develop from screens,” explains Alice Ann Holland, Ph.D., ABPP, Research Director of the Neuropsychology Service at Children’s Health and Assistant Professor at UT Southwestern. “The brain is designed to develop from human interaction and exploration of the natural environment.” So what is the antidote to screen time and how can we replace the opportunities children have lost as social distancing prevents them from playing naturally with other children as they once did?

As the old adage goes: The more things change, the more they stay the same. Even though play seems to have changed over generations, young children still love the same things we loved when we were young — activities like drawing, coloring, playing with toys, acting out adventures with figurines, dressing up, conducting puppet shows, and reading books (especially with mom and dad when they are still very young). Examining a few of these few evergreen activities clearly illustrates their benefits and why we should never discourage time spent doing them.

The Purpose of Play

Firstly, we should can ask ourselves why children play? Play is a crucial developmental activity that teaches children countless lessons and prepares them for many adult roles. For example, coloring books teach physical dexterity. You will notice that as a child grows, their ability to control their crayons and pens increases. They are able to stay within the lines, eventually becoming very adept at coloring in perfectly. At this point, they may become bored with this activity and move onto another type of play that will challenge them to develop in different ways. When children play with the figurines or toys, they often use them to understand the world they live in, working out relationships, re-creating situations they have seen or experienced, or simply expanding their imaginations to create a whole new world. By watching children play, we can gain insight into what they are trying to work out in their minds, if something is bothering or upsetting them, or if there are issues that they seem to have trouble resolving.

We Can Learn from Children’s Play

Play also offers adults an opportunity to identify skill sets in a child that are unique to them and which are going to be part of who they are as they grow up. Some children demonstrate very clear talents or abilities in very specific areas at a young age such as art, music, creative writing, building, fixing, curiosity with nature, etc. It is our job as adults to nurture these interests and skills, to tell the child that they are talented in this area, and to encourage their interest. This builds self-esteem and allows the child to excel and thrive as they learn to be proud of their uniqueness.

Play is very revealing in other ways too. Children are individuals and develop at different rates, but there are certain developmental milestones that healthcare professionals look for to determine whether a child is reaching growth goals within an appropriate time-frame. These milestones are identified by the degree of skill with which a very young child can complete simple tasks. For example, by the age of 18 months, a child should be able to play act an everyday task like pretending to feed a doll. By the age of five, a child should enjoy singing and dancing and be able to complete a somersault. Pediatricians, teachers, and other experts may be able to determine if children are falling behind developmentally based on their dexterity and physicality but also by watching their social interactions with other children during play. Are they able to share? Can they manage their feelings (or self-regulate) when small disputes arise on the playground? A thoughtful, observant adult can intervene as a buffer when they witness a child struggling in any of these areas. You do not need to be a childcare expert to step in and help children learn vital skills like problem-solving, mediation, cooperation, and general kindness and sharing.

Play as an Antidote to Stress

Undoubtedly, the COVID-19 pandemic has thrown many people’s lives into turmoil. Fear and anxiety are at an all-time high among adults and children. Financial difficulties caused by the economic shutdown, uncertainty about the future, and all the unknowns caused by these unexpected events have many families facing a year of intense challenges. Children are very astute when it comes to picking up the atmosphere in a home; they are undoubtedly hearing news, whether you intend them to or not. At a time like this, play becomes more essential than ever before to relieve stress and provide joy. We need to give our children as many opportunities as possible to simply be children. It seems that “play more, worry less” should be the mantra of the day, even though it may be easier said than done.

While screen time and video games seem like quick fix solutions to keep children entertained, even a small amount of effort in the direction of real-life play will pay off in terms of your child’s happiness. At Center for Child Counseling, our work revolves around the therapeutic nature of play. Our mission is building the foundation for playful, healthful, and hopeful living for children, families, and communities in Palm Beach County and beyond. Play therapy is at the core of our work but the overwhelming benefits of play can be duplicated in every home in the country with a little bit of effort. Remember, your children love you, look up to you, and are hungry for time with you. This may be very difficult for parents and caregivers who are working from home and homeschooling their children, but even a half hour at bedtime sharing a book together will create a sense of security and memories of love and togetherness that will draw your child closer to you.

Providing Play Kits 

Sadly, for some families, simply providing their children with the physical tools to facilitate play is a financial burden. For this reason, we have developed age-appropriate play kits which contain items like books, games, toys, crayons, coloring books, figurines, playdough, tip sheets, and other items that are at the heart of healthy, real-world play. Through generous grants from the Town of Palm Beach United Way, the United Way of Palm Beach County, Children’s Services Council of Palm Beach County, and individual supporters like Ruth Hartman and Kathy Leone, these kits will be used to guide Telehealth sessions, with our therapists working closely with caregivers to promote healthy parent-child attachment, expression of feelings, and processing of traumatic experiences.

While Center for Child Counseling provides professional therapeutic services for children and families who have experienced trauma or who need mental health assistance, many of the benefits we provide as professionals can be duplicated on a much simpler level in your home. Make it a priority to carve out some time every day to play a little with your children, save them from an hour of screen time, and experience some of the joy, fun, and laughter of being a child again. This is a time when we could all benefit from a little more childish silliness and laughter.