Talking to Children about Ebola

The following is a message from Dr. Tim Kearney, Chief Behavioral Health Officer here at CHC about how to talk with children about Ebola, adapted to the blog.

All of us as parents and those who work with children wish that we could protect them from the knowledge of the tragedies that occur in the world around them and from the impact that this knowledge has on them. Unfortunately we cannot; especially in this age of constant news feeds and social media.  We must therefore help them to develop the skills to cope with what happened and structure their world to make their response as manageable as possible.  As with the many shootings and terrorist activities that have flooded the media and  invaded our lives in the past years, so too the recent horror of the deaths from Ebola and the various risks and fears the disease raises must be addressed with our children.

Like adults, children need accurate information about what happened.  Give them the facts as they are known, and correct details as more information becomes available.   Be on the lookout for misinformation or fears they may have that are based on incorrect understandings. A child who is afraid to go to school for fear of contracting the disease from others there may be reassured to hear that there are only a few cases in the United States, which are far away, and that basic hygiene practices such as hand washing may help to keep one safe.    Deliver this information in age appropriate ways.  Young children just need the basics – “There is a disease that started in Africa call Ebola. Ebola makes people very sick and some die.  It is spread by the bodily fluids of someone with the disease – by touching their blood or poop or pee.  Only a few people have had it so far in America.”  Be guided by your child’s response as to how much information to give them.  As children ask questions, give them accurate information to the best of your ability or let them know you do not know the answer and will check into their concerns and get back to them when you do know.  Older children are more likely to be curious and ask more questions/ Let their interest be your guide as to how much to go into it.  Too much information can be as bad as too little.  Manage your own fears and anxieties.  Children will take their cue from how you act as much or more than from what you say.

Common concerns children will raise include:

1. Wanting to know where people are sick.  Younger children will assume that whatever they see on the media is right around the corner, and may think that a police car or ambulance going by their window is responding.  Give them an accurate sense of the distance and if possible tie it into a reference that will make sense to them.  “Africa is a long plane ride from here.  The people who brought it to the United States have been in Georgia, Maryland, Texas and Ohio, not near here.”
2. Wanting to know how widespread the disease is.  Seeing the news over and over children they may think that each report is about a new occurrence and that the disease is everywhere. Reassure them with accurate information.  “There are just a few people sick in the US right now, but the TV keeps talking about it and it seems like there are many different ones.  In other parts of the world like Africa, there are a lot more.”  Turn off the TV and do not subject your children to more information that they need about this.
3. Wanting to know if anyone they know was hurt.  Younger children in particular may ask about specific people they know.  If news reports mention a location they may think that hearing “Dallas” or “Ohio” means that their grandparents or whoever they know in that state or city is already sick or in danger.  Older children are more likely to have a compassionate response for those stricken.  Acknowledge and support their emotions and take whatever action is appropriate within the context of your family’s believes (praying for the families involved, participating in giving to send help to victims, participating in community activities, and so on.)
4. Wanting to know that they are safe.  This can be both an immediate concern – does anyone in my family have the disease right now, or a longer term worry that they or those they love may not be safe in the future.  Do not offer meaningless reassurance – any one is potentially in danger.  But talk about how the disease works, what precautions can help people not get it, and give a realistic picture of what the risk is to your child and/or those he or she loves. “Although thousands of people in the world have gotten Ebola and become sick and died, and even a few in this country, there are many who have gotten it and gotten better, and even more who never caught it in the first place.   Most people are OK.”   Let your children know that you and their loved ones will be there to help them through any problems.  Give them concrete practices, such as telling them to sing “Happy Birthday” while they wash their hands to ensure that they give them a thorough scrubbing.
5. Needing some way to express their feelings of anger, fear, concern, or relief.  In age appropriate ways engage your child in drawing, play, or verbal discussions.
6. Wanting to know why this happened.  The direct response is the best.  Explanations of how the disease is spread help. Depending on the age of the child, they may ask more specific questions.   Older children may ask the more difficult question of why someone would knowingly take the risk of giving it to others. Be guided by your own belief systems and explain to your child as you would any other area of life.
7. Wanting to know what they can do to help.  This tragedy can be an opportunity to model and to teach compassion.  Pray together or attend a religious service dedicated to those who are suffering or dying with the disease if that is a part of your family’s practice.  Donate money or give time to those organizations working to fight the disease or help those impacted.

There are some actions parents can take as well:

1. Reassure children about their safety and the safety of those they love. If you have family or friends who in involved in the treatment of those with the diseases, help you children understand Personal Protective Equipment (PPE) and other means that those caring for the sick take precautions to stay safe.  If your child is fearful of catching the disease themselves review how the disease is caught and universal precaution steps that can be taken by everyone.
2. Limit children’s exposure to TV and other media.  Turn of the stream of information and redirect your child’s attention to other matters unrelated Ebola.
3. Talk to adults about your own reactions – do not use your children to think though your own fears and worries about their safety.  Turn to your own supports – family and friends.  You must take care of yourself so that you can care for your children.
4. Reach out to professionals such as your child’s primary care provider, school staff, school based health center staff, therapists, clergy, or others who know children and can guide you in how best to help your child.

Most children will be fine with support.  Those with previous trauma or who are already anxious may need additional help from parents and family or professionals.

The following links also provide good resources:

http://www.washingtonpost.com/news/parenting/wp/2014/10/07/5-tips-for-talking-to-your-kids-about-ebola/   A review of facts to present to children, this post also include additional resources for parents and older children

http://kidshealth.org/kid/health_problems/infection/ebola.html  A short article with specific information about the origin of the disease, symptoms, and spread written in language that can be understood by older children or easily translated into simpler words for younger ones.

http://kidshealth.org/kid/health_problems/infection/ebola.html  Another short article with specific facts and guidelines for good health practices that can be read by other children or explained to younger ones.

http://www.cdc.gov/vhf/ebola/pdf/ebola-factsheet.pdf  Link to the Center for Disease Control’s Ebola information fact sheet.