Journal Identification = NRP Article Identification = 0596 Date: June 21, 2021 Time: 5:5 pm
doi:10.1684/nrp.2020.0596
REVUE DE NEUROPSYCHOLOGIE
NEUROSCIENCES COGNITIVES ET CLINIQUES
32
Point of view
Rev Neuropsychol
2020 ; 12 (S1) : 32-3
Children facing precarity due
to the crisis *
Les enfants précarisés par la crise
Lise Eilin Stene
MD, PhD, Norwegian Centre for Violence and Traumatic Stress Studies, NKVTS 1-3, Pb 181 Nydalen, NO-0409 Oslo, Norvège
To cite this article: Stene LE. Chil- dren facing precarity due to the crisis.
Rev Neuropsychol 2020;12(S1):32-3 doi:10.1684/nrp.2020.0596
T
he pandemic and the restrictions implemented to counter it have troubled our daily lives with threats toward our health, economy and social relations. The uncertainties regarding COVID-19 trigger heated debates on the measures to be taken to slow its spread, yet pre- venting that the precautions become more harmful than the epidemic itself. Children have no voice in the pub- lic debates. After almost two months of confinement, the reopening of schools and nurseries arouses fear in many parents. How are children experiencing the ongoing crisis, and how does it impact them?Knowledge is still scarce, but the available data suggest that the COVID-19 infection is benign in the vast majority of affected children[1]. Even though children seem less vulner- able to the virus than adults, many bear heavy consequences of the current crisis. During the confinement, there has been a considerable increase in calls to telephone lines for chil- dren in danger[2]. Furthermore, many children, especially the youngest, had no possibility to disclose that they were living in danger or distress. When children are enclosed at home, it becomes difficult to identify their suffering.
After 55 days confined in unequal conditions, children return to school or nursery with contrasting experiences.
Some have tolerated this interruption well; others have gone through burdensome trials: the illness or death of relatives, loss of job and income among their parents, separation from loved ones, the appearance or aggravation of intra-familial conflicts, abuse of alcohol or drugs in parents, neglect or violence.
We still know little about the impact of the pandemic and the confinement on children’s mental health. A study conducted in 398 parents living in the regions of the United States, Mexico and Canada that were the most severely affected by the H1N1 and SARS epidemics, found that children who had been in quarantine or in isolation had
∗This article is an English language translation of the following article:
Stene LE. Les enfants précarisés par la crise.Rev Neuropsychol2020 ; 12 (2) : 148-9. doi:10.1684/nrp.2020.0554
Correspondence:
L.E. Stene
on average four times higher levels of posttraumatic stress symptoms than children who had not been in quarantine or isolation[3]. Among the parents, 28% of those who had been in quarantine or isolation disclosed symptoms con- sistent with a diagnosis of post-traumatic stress disorder (PTSD), compared to less than 6% in other parents. More- over, among parents with symptom levels corresponding to a diagnosis of PTSD, 86 % reported symptoms consistent with a PTSD diagnosis in their children, compared to 14 % in other parents.
A generalized confinement may have a different impact than a targeted quarantine. Yet, this potential amplifica- tion of stress symptoms between children and parents is a phenomenon we find also in other circumstances[4]. In the closed chamber of confinement, such reciprocal stress exacerbation can persevere and create a painful circle.
In a limited period, stress is not harmful. However, it is paramount to prevent prolonged stress, to which children are particularly vulnerable, as they are in a phase of psy- chosocial development. At the end of confinement, it will be essential to identify children and parents in psycholog- ical distress and provide the necessary support to relieve their suffering.
In France, theOfficial Bulletin of the National Education of May 7, 2020, states that the reopening of schools should enable to listen to children’s experiences during the confi- nement, in order to identify possible traumatic events and report these to competent personnel[5]. These are large and important objectives. Still, the children’s return to school depends on the decision of their parents. It is vital to also lis- ten to children who do not come back to school and ensure their well-being.
The reopening of nurseries and schools has sparked concern about a potential resurgence of the epidemic. In Norway, nurseries reopened on April 20. Next, schools admitted children up to the age of 10 years from April 27.
Finally, on May 11 the schools reopened for all the pupils. So far, we have not observed a rise in the epidemic. It is uncer- tain whether the same will occur in France. Across national borders, we do not know if there will be a second wave of the epidemic leading to a reintroduction of restrictions.
Nonetheless, even a temporary opening of schools and
Journal Identification = NRP Article Identification = 0596 Date: June 21, 2021 Time: 5:5 pm
REVUE DE NEUROPSYCHOLOGIE
NEUROSCIENCES COGNITIVES ET CLINIQUES
33
Point of view
nurseries could help to identify children and families who need support. To achieve this, it is essential that teachers, school psychologists, child protection services and other personnel working with children receive sufficient support and resources. Their working conditions are currently highly challenging. They must attend children who may need more attention and support than usual and at the same time adapt to the new strict sanitary measures. Additionally, they may have colleagues who cannot come back to work at school due to having particular health risks toward COVID- 19. At the pinnacle of the epidemic, we were worried about the intensive care services being overloaded. In its aftermath, school psychologists, child protection, and child
& adolescent psychiatric services risk being overloaded.
Facing the uncertainty of the epidemic’s evolution, one might feel powerless. The flood of contradictory information can rapidly nourish anxiety and conflicts. Initially, govern- ments called on us to respect social distancing to slow
the spread of the coronavirus. The term “social distancing”
has been used frequently in English-speaking and Scandi- navian countries, albeit it is not favorable. In the coming months, a major challenge will be to promote physical distancing while preventing that we become socially dis- tanced. Prior research indicates that social support plays a key role in preventing and alleviating psychological dis- tress, which may arise in the wake of the epidemic [6].
Children have sacrificed a lot to fight a virus that primar- ily threatens the health of adults – now we should strive to identify and support children facing precarity due to the crisis.
Conflicts of interest
None. The author’s work was financed by the Research Council of Norway as Principal Investigator of project num- ber 288321.
References
1.Sinha IP, Harwood R, Semple MG,et al. COVID-19 infection in children. Lancet Respir Med2020 ; 8(5) : 446-7.
2.Ministère des Solidarités et de la Santé. Enfance en danger : le gouvernement mobilisé 2020. [Updated 15.05.2020. Available from: https://solidarites-sante.gouv.fr/actualites/presse/communiques- de-presse/article/enfance-en-danger-le-gouvernement-mobilise.
3.Sprang G, Silman M. Posttraumatic stress disorder in parents and youth after health-related disasters. Disaster medicine and public health preparedness2013 ; 7(1) : 105-10.
4.Morris A, Gabert-Quillen C, Delahanty D. The association between parent PTSD/depression symptoms and child PTSD symptoms: a meta- analysis. J Pediatr Psychol2012 ; 37(10) : 1076-88.
5.Le Bulletin officiel de l’éducation nationale numéro 19 du 7 mai 2020. [Available from: https://www.education.gouv.fr/bo/20/
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6.Ozer EJ, Best SR, Lipsey TL, Weiss DS. Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol Bull 2003 ; 129(1) : 52-73.
