About IBD Podcast Episode 77 - Back to School In the Pandemic With Dr Brad Jerson

About IBD Podcast Episode 77 – Back to School in a Pandemic With Dr Brad Jerson

Back to school will be quite different for families across the United States and the world this year. There aren’t many answers to be had to our questions, yet we must make decisions with the best information that we have at this time. I speak with Dr Brad Jerson, a Pediatric Psychologist in the Division of Digestive Diseases, Hepatology, and Nutrition at Connecticut Children’s and an Assistant Professor of Pediatrics at the University of Connecticut School of Medicine about how we can prepare our kids, and ourselves, for the school year. We discuss the behaviors we can model for our children, how we can talk to young kids about mask wearing, and how to engage kids of all ages in conversation about their fears and anxieties during this time. 


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Concepts discussed in this episode:

Find Dr Brad Jerson on Twitter and at Connecticut Children’s.

Find Amber J Tresca at AboutIBD.comVerywellFacebookTwitterPinterest, and Instagram.

Credits: Mix and sound design is by Mac Cooney. Theme music, “IBD Dance Party,” is from ©Cooney Studio.

Transcript

[Music: IBD Dance Party]

I’m Amber Tresca and this is About IBD. It’s my mission to educate people living with Crohn’s disease or ulcerative colitis about their disease and to bring awareness to the patient journey.

How do we wrap our heads and our hands around going back to school during a pandemic? Like many parents, I have questions about how I can help my kids through this unusual back to school transition, not to mention how to manage my own feelings and expectations. So, I decided to ask an expert. My guest for the next two episodes is Dr Brad Jerson who is a Pediatric Psychologist in the Division of Digestive Diseases, Hepatology, and Nutrition at Connecticut Children’s and an Assistant Professor of Pediatrics at the University of Connecticut School of Medicine. He is also a member of the Crohn’s and Colitis Foundation Connecticut Chapter Medical Advisory Committee.

Dr Jerson and I are local to one another in Connecticut, which at the time of this recording, is doing well in terms of cases of COVID-19. Some schools are offering both in-person and distance learning, and parents have the ability to choose between those options. Some areas in the United States and the world have decided to make school available as distance only, in-person only, or with a hybrid model. What’s true for all of us, though, is that school is going to be different this year. As parents, we have work to do in order to help our kids, and ourselves, manage this next chapter as best as we are able. The good news is, we have tools and resources that we can use, as Dr Jerson will explain. 

Amber Tresca
Dr. Gerson, thank you so much for coming on about IBD

Dr Jerson  
I’m very excited to be here. Amber, thank you for asking me.

Amber Tresca  
We’re all being faced with the impending school year. And as parents we have a lot of questions. But I think the first thing that we have to to sort of think about is how we talk to kids about the choices that we’re going to make for the school year coming up, what should we do to start the conversation about how the school year might look for them and how it might be different than the school year that they left last year?

Dr Jerson
So it’s a really good observation and point because I think we are all incredibly overwhelmed by the uncertainty that still lies ahead. Okay, I think we can say that there is somewhat more certainty than there was, but there’s still a lot of unknown. And this is a really unique situation and that all of us kind of collectively, as a society are interacting with something that is constantly changing. So we can have a really solid plan right now. And three weeks from now, that might be different. So it’s very hard to talk to kids who crave structure and predictability and routine about the fact that something that we’re going to start with may not be the same thing that’s there in October or might not be the same thing that’s there in November. And that’s that’s disarming and confusing for a lot of kids. And then when kids get unraveled by that, then their parents unfortunately kind of get unraveled by that as well

So I think the first thing to acknowledge is that we all have concerns, because this is a really confusing and uncomfortable situation. And there’s not a perfect answer. There’s not a concrete solution that fits for every family. And it also depends on the age of the child, because we’re recognizing that children and teenagers, older teenagers are affected by COVID transmission differently as are young adults and college students, and this depends on so many factors that depends on the number of students who are going to be in the school building. It depends on how many teachers are going to be in the school building. And different districts even within the same state can have a vastly different experience of What that’s going to be. So the short and long answer to your question is we don’t know. And there’s so much unknown that goes along with this. And that’s, that’s confusing.

Amber Tresca
And what do you think about acknowledging all of these unknowns? Is that scary for kids? Like, should we go ahead and do that with them? What do you think?

Dr Jerson
We have to acknowledge the unknown. And I think there’s a really unique opportunity that we’re in right now. And we don’t get in our lifetimes, too many, like really developing on the spot, predictably good learning opportunities. And this is a this is a chaotic time. There’s, it’s an active experience of trauma that we’re all going through. Because of all of these changes and these unpredictable routines.

It’s absolutely essential that we verbalize to our kids that we don’t know some things because we operate as parents a lot of the times as if, if we let down our guard and if we let down the disguise that we’re not actually superhuman and have all the answers to everything that our kids are going to think that we’re frauds or that we’re not good enough parents. And in fact, I would argue quite the contrary, that if we allow our children to see that we’re also dealing with a lot of different factors and variables that are informing these decisions, it allows the children to gain a little bit more of a perspective and see like, Oh, Mom and Dad are nervous too. And if we create a narrative to that by saying, I’m very excited that your school is reopening, but I have to tell you, I’m also a little bit nervous and worried about some things. That’s not going to inflict fear in children.

In fact, it’s actually going to acknowledge that we all have mixed emotions. And if we don’t verbalize them, your kids won’t verbalize them. So we need to be able to model to them and say, this is how I’m feeling. I wonder if you’re feeling the same kinds of things. And then in fact, that actually gives them permission to be able to share some of the thoughts some of the worries some of those confusing blurry thoughts that have not connected in their own mind just from their own development, and let them say them out loud in the safe space of your home to you as their parents.

Amber Tresca
I think some of the times for me in in my household, is that my concerns and the kids concerns are very different.

Dr Jerson
Yeah.

Amber Tresca
And so I obviously know what what my issues are. But sometimes it’s really challenging, I think, to sort of get from them what their real worries are, because I think their real worries are often something that hasn’t even occurred to me. And it’s totally different than what my worries are. So how can we sort of pull that out of them?

Dr Jerson
Yeah, kids and adults always have have different concerns, and rarely will they just magically align that they happen to be seeing along the same frame, especially teenagers. And it depends on the age of the child, of course. So a lot of the parents that I’ve spoken to throughout this pandemic especially in recent weeks, are concerned about so many different things, first and foremost, the safety of their kids. When we talk about returning to school unconditionally, the single first thing is are my kids going to be safe? Then after that comes the very important and we can’t ignore reality of other family members in the home. So adults, caregivers, and other relatives or older siblings, or other relatives who are not in the home, who you have interaction with quite often, there’s still a lot that we don’t know about how this is transmitted within a childhood population.

We don’t have concrete evidence that kids do not transmit this to others. We’re still learning that data, we’re still trying to figure that out. We know fortunately, that most of our data thus far points to kids predominantly doing better and not as likely to get the diagnosis or to get the virus and when they do thankfully, they mostly do very well with  it, but that isn’t children can isolate in the vacuum with that, and that’s I think a very narrow minded approach to take is to ignore the reality that children do, in fact, exist within greater systems around other people who might be quite vulnerable to this. So those are the things that kids and families and teenagers may not be as attuned to, but of course, are on the parents minds.

Parents are also concerned about quality of education and child care. Work routines, like this was a huge change for a lot of parents whose jobs were significantly affected by this and those who weren’t able to have accommodations to their job. Their family members were significantly altered and affected by having to change their routines or not have adequate supervision in the home or more, be more vulnerable to challenges that they weren’t able to deal with themselves. So these are the concerns that adults are more likely to have the flexibility Be able to continue what they were doing beforehand is getting harder to justify right? You know, there was a communal understanding from March through like, late April, early May. Of course, parents for the most part, if you can do whatever you need to do. We weren’t primed for needing to do that some more in September and October and November. So these are things that are requiring a lot more considerations from the parents.

Kids I talked to, really, for the most part want to be back to school. And it was actually surprising to me like I anticipated a lot of the kids and children that I see saying, like, “Oh, this was sweet, I got to stay home all the time, this was really wonderful.” They really, really miss the routine of being in the building. They miss seeing their friends actually miss being in a classroom and having those touch point relationships with the teachers. And I think that’s what’s important for them.

I’ve had a lot of patients and children say to me, “I don’t care what my mom and dad say, when school’s back, I’m going back, doesn’t matter. I don’t care what they’re saying, I’m there. So you can say whatever you want Mom or Dad, I’m gonna be there.” And of course, this is them saying, ‘this has been really overwhelming to me. And being in the same place and not being able to see my friends and not being able to do the same things that I used to do that made me feel like me. Even if I am playing video games and watching YouTube all day. Now, I would actually prefer the other stuff that involves schoolwork, because that makes me feel a confidence that makes me feel competent. And that’s the type of kid I want to be right now.’ So teens, teens, and kids are focused on those things.

Amber Tresca
Yeah, that’s been my experience, too. I’ve been surprised at how many kids just you know, the kids that I know from my children’s friends and kids in the neighborhood that they say that they want to go back to school.

Dr Jerson
Yeah.

Amber Tresca
But that’s interesting. What you say is you almost kind of like translated something for me there that when the kids say that they want to go back to school, that that’s saying that they They sort of want to get back to normal it almost sounds like.

Dr Jerson
Yeah.

Amber Tresca
And that’s something that they’re using to sort of tell us that they’re having anxiety without actually using the words, that they’re having concerns and anxiety about the situation.

Dr Jerson
Yeah. And then the tricky part comes in as, as, as adults, you’re able to realize right now that the normal isn’t there anymore. You know, the the school year that they left in March, as you mentioned, is not going to be the school that they returned to in September, they’re going to return to buildings that have probably lost about 50% of their furniture to make room for desks being further apart from each other, and a sense of excessive sterility and taking away the ability to see people’s facial expressions at times and having an over abundance of caution and anxiety that people are having about being in that space. No, there may not be the same choral opportunities, theater productions may not be happening for people who were involved with that sports are different across all the districts. So the normal will be different. I still think kids who realize that are still craving the opportunity to experience that jointly with their peers. So they can go through this together as opposed to as isolating as it has been.

Amber Tresca
To send them back no matter what that looks like to a very different situation than any of us have ever had to deal with before. Especially because as you say, there was sort of this this communal understanding previously, in regards to parents’ work life balance.

Dr Jerson
Yeah.

Amber Tresca
And that is probably not going to be the same. So we’re going to have to help our kids work through this. I think as parents most of us put our children first. So is there a way for us to sort of model behavior that will be helpful to them? We talked about acknowledging worries or fears. Are there other things that we can be doing that can sort of set them up for more success as they go back to our new normal?

Dr Jerson
Yeah. So I think in terms of accepting and recognizing the anxieties and fears that are there, the very first thing that I recommend parents do is acknowledging that kids do indeed have thoughts and feelings of their own. And it may not be as obvious as saying, “Hey, this is what I’m feeling really nervous about. Or I’m anxious and I’m nervous. So this is what I want to do.” Parents have a really good opportunity here to connect during this uncertainty by saying it’s okay to feel whatever you’re feeling and I may not feel this same thing as you’re feeling, but I recognize that you’re experiencing different things than I am. Let me know if you ever want to talk about it.

Some teenagers, more so teenagers than the younger kids will be able to then find the vocabulary and the words to express their emotions and express their thoughts, their feelings, their concerns, but oftentimes, we need to give them the outlet. And by demonstrating to kids that we also are feeling this uncertainty and by actually modeling that socio emotional language to say, you know, “I’m feeling excited that you get to go back to see your friends, but I’m also feeling worried that all of the students being in the same place again, are gonna mean that COVID is gonna increase again in our district, and I’m really concerned about that.” That doesn’t make panic happen that acknowledges that you are a human who has feelings and emotions, and instead you’re actually showing to your kids, that it’s okay to have feelings and emotions.

And I think one of the things that I’ve been impressed with in some of the dishes district proposals that I’ve read so far across the area, at least where we are, is that there’s a very strong recognition that socio emotional education and learning and trauma informed work need to sort of lead the ship here, that we’re not going back to, how much can we pound through this intense curriculum to make sure that all of these standards have been met. And I hope that once school does go back in whatever form it’s looking like that the district actually maintain that commitment to that plan, because really, that is what is at stake here. It is not a matter of facts and concepts and educational standards. This is a matter of helping kids maximize their resilience and learn these new skills during this time. That is a very formative time in their life.
So that’s one thing that you can model for younger kids and just any kids in general, there’s the actual literal modeling of like, “I’m going to wear my mask and therefore you can wear your mask too,” because for certain families, too. have not gone out in public often, or have not been in situations where they have gone back into stores yet regular mask wearing may not be something that kids are actually used to. So this is a time during the summer as we’re getting ready to actually help kids get used to literally wearing a mask, because with all the uncertainty that is the one degree of confidence that I can say is going to be there in any plan in a building is that kids or teenagers are going to have to wear masks in some part of their day.

So that’s something we can do by starting to model that we want to model the right way to wear it. We want to say “Look how I’m wearing my mask covering my nose and my mouth, both places.” I’m not a fan of mask shaming people out in public who do not have it over their nose but you can like quietly point out and say like, I noticed that person didn’t have their mask covering their nose, you do a great job. This is involving them in the process and also just making it fun, right we know it is not new data that simply telling kids to do something is going to result in that behavior.

So we have to build up a habit and we still have time to do that we can still make that happen. So making it fun making it a routine building into parts of the day where it’s actually not physically strange for them to have that tactile stimulation around their nose and mouth is an important thing for them to do. Then, of course, modeling hand hygiene. If kids have not known that they have to sing Happy Birthday two times by now, in the last four months, then now’s the time to start doing that for 20 seconds when they’re washing their hands. Because it actually what we started to see at least in in my own home and in other surroundings, like the the hygiene like kicked into full gear during that March and April and then like it sort of petered off a little bit and I think people are starting to forget that that is actually a really essential part of this, especially as they go back to school. So reminding and re practicing that as part of the daily household routines and family ritual. There’s something so good to do.

Amber Tresca
How about things like not sharing your crayons or not touching your face? I mean, can we overwhelm them with with too many of these sort of rules? I know the teachers will probably enforce them too. But, you know, is there is there a limit?

Dr Jerson
The the general philosophy, I think, from the positive parenting angle of things is whenever you find yourself saying, don’t do this, don’t do this, don’t do this. It always usually goes in the opposite direction. So instead, we want to give kids the opportunity to start practicing the things that we do want them to do. So like, Look, even for adults, if you tell adults not to touch their face, they’re going to touch their face. So instead, you need to tell them what they should be doing instead. And that’s like a super fine minutia like behavioral dissection of like one or the times that your kids are more likely to touch their noses. Is it like an itch, or can they do something else with their hands instead? Or is it just like an anxious reaction, what can they be doing instead with their hands. So like giving them other strategies or teaching them stretches, or having them use their minds to imagine that they’re squeezing different things with their different parts of their body, like that’s something where they can actually do with their hands. This is gonna be really hard.

So I would focus more so on, this is how you wash your hands. This is how you sneeze into your elbow. This is how you wear your mask, and then comment on the things that they’re doing really well in terms of working to practicing by themselves and just letting them know, “Hey, there may be some new rules that teachers are going to say, you’re gonna have to keep your things to yourself because we’re trying to just make your supplies your own to keep the germs from spreading.” And I think it’s that’s not a scary thing to say. It’s a fact and we want kids to understand why teachers are going to be saying some things that last year would have been absolutely asinine to not share a pencil with someone, but now they’re going to be hyper vigilant to that. So we want them to understand why that’s happening.

Amber Tresca
Right? You talked about touching your face and then immediately I started touching my face!

Dr Jerson  
Now I have a conscious effort to not do so. So you didn’t see me touching my face and call me out on it. So we’re on the same page.

Amber Tresca  
I know. Well, masking is also good for that that because you know, then you remember not to touch your face because there’s something about your face.

Dr Jerson  
Yeah.

Amber Tresca  
My family is one of those ones that we have not been out a lot.

Dr Jerson  
Yeah.

Amber Tresca  
So we definitely do wear masks when we go someplace. But there’s really not too many places that we have to go, right, where the kids have to go. If an errand needs to be run, I will do it or my husband will do it. So they know to wear it, they will wear it, but it’s not something that they’re in the habit of wearing for several hours at a time.

Dr Jerson  
Yeah, as most most kids aren’t, because honestly, in a lot of situations, if kids are like, I don’t want to wear my masks today, then you say okay, then you’re not coming out of the house with me right now and you stay here or you stay in the car and I’ll go in like and you can’t come with me, then that’s fine. We’re not going to have that choice in school. So we can’t be in the mask avoidance stage anymore. And I would just say that this is part of the new routine within school. These are some of the new daily routines that we’re getting used to. Just like we used to get her get dressed and choose your clothes and brush your teeth. Now you decide which mask you’d like to wear today.
And then I think another thing also when you haven’t been out that much is modeling and actually practicing with the distance elements of it because if kids have not been around other people for the last four months, the idea of six feet apart can feel a little bit strange. So actually starting to practice that as this build up to school by going out and you know, getting a little bit closer to neighbors than maybe they had been in the past or going on physically distant playdates and yards with other kids just to get into that rhythm of what it’s like to be excited to be around your friends while not being able to go up and be right up in their faces.

Amber Tresca  
Yeah, it’s hard enough as adults, I’ve had just, you know, remind myself like almost out loud to myself. No, you cannot hug your friends, right now. A couple of times where I’ve like immediately just gone into sort of this is how we normally behave. And because we’re social creatures.

Dr Jerson  
Yeah.

[Music: About IBD Transition]
Amber Tresca  
Somehow in the middle of all these adjustments, we need to be making sure that as parents, our own needs are being met. To me, it’s kind of challenging to admit that I need to take time for myself. What should parents be thinking about in terms of managing our own self care at this time.

Dr Jerson  
We need to actually model self care. It’s it’s so easy for us to preach it and say everyone needs to be taking care of themselves. But as parents, the old important adage of putting on your own oxygen mask first is super important during this time, and kids are actually taking note of that. So by being able to actually say, I’m taking care of myself because I want to be able to get through this day. It’s teaching kids that It’s okay to pause, it’s okay to breathe. And it’s okay to also have a little bit of self compassion, because we are all working really hard to get through this. And perfection never existed. And it certainly does not exist now.

So I think we have to be able to say, as our kids are going back to school, my most important goal for you returning to school is to feel like you can connect to your peers connect to your environment and feel good about the things that you’re doing, and focusing a lot less on the outcomes and the standards that have been existing and running things in the past.

And ultimately, we can control the things that we can control. And there’s a whole lot that we can’t and we need to be able to accept the things that are in our control. And that’s what we lead with. If we lead with our values, the things that are important to our families, we will never be led astray. If we are consistently focusing and making choices that are informed by the things that feel right to us in our family.

Amber Tresca  
Dr. Gerson I love to be able to give listeners some tools as a takeaway. Does Connecticut Children’s have any resources available for parents that can help with some of the things that we’ve talked about?

Dr Jerson  
The blog on the Connecticut Children’s dot org website is, is consistently updating a lot of really wonderful resources as things are unfolding and evolving with great content pulled together from pediatricians, psychologists, educators, nurses, child life specialists, everyone is using all of their their backgrounds to try to help kids and families feel a little bit more comfortable.

[Music: IBD Dance Party]

Amber
Hey, super listener. 

Thank you to Dr Jerson for taking the time to answer my questions about how we can better manage back to school this year. On the next episode, which will be part 2, we will talk more specifically about kids who live with chronic illness and especially with IBD, and what parents should be thinking about before sending their kids to school. You can find Dr Jerson on Twitter as @DrBradJerson. I will put that information in the show notes, as well as links to more resources for parents on the topics we discussed. 

Thank you also to all of Dr Jerson’s patients who listen and I am especially remembering the families I met in March for College Night at Connecticut Children’s. Dr Jerson asked me to be a part of the program at his hospital which is a workshop for kids with IBD who are entering college. It is a fabulous project and I wish every teen with IBD and their parents had access to a similar program, because I know it is helpful in making a smooth transition to college. I think of the kids I met during the workshop, as well as those across the country that I’ve never met, and how the pandemic changed their senior year of high school. I know that the first year of college will also be different than expected but I am confident that kids with IBD will adjust well because they are exceptionally resilient. 

Thanks for listening and don’t forget that you can find me, Amber Tresca, all over the interwebs as @AboutIBD, on Facebook, Twitter, and Instagram. I will put all this information in the show notes. or you can find it on the Episode 76 page on my web site, aboutIBD.com

About IBD is a production of Mal and Tal Enterprises.

It is written, produced, and directed by me, Amber Tresca.

Mix and sound design is by Mac Cooney. Theme music is from Cooney Studio

Amber:
I’m in control of everything so I don’t even know what you’re talking about right now. I have complete control.

Dr Jerson  
I know. Yes, clearly. Tell me your secret and I will buy it from you.

Amber Tresca  
Denial, denial denial.

Dr Jerson  
That’s fair enough.

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