Protecting the psychological health of children through effective communication about COVID-19

Louise Dalton, Elizabeth Rapa, Alan Stein

Published: March 31, 2020


…media and social conversations are entirely dominated by the outbreak, and children are exposed to large amounts of information and high levels of stress and anxiety in the adults around them. Simultaneously, children are experiencing substantial changes to their daily routine and social infrastructure, which ordinarily foster resilience to challenging events.

Children need honest information about changes within their family; when this information is absent, children attempt to make sense of the situation on their own. Consideration of the child’s developmental stage is crucial to ensure that communication is effective and neither underestimates or overestimates their understanding. Communicating with younger children should not solely rely on simplification of the language or concepts used, but must also take into account children’s comprehension of illness and causality. Between the ages of approximately 4 and 7 years, understanding is substantially influenced by magical thinking, a concept that describes a child’s belief that thoughts, wishes, or unrelated actions can cause external events—eg, an illness can be caused by a particular thought or behaviour. The emergence of magical thinking occurs around the same time children are developing a sense of conscience, while still having a poor understanding of how illness is spread. Adults need to be vigilant that children are not inappropriately blaming themselves or feeling that the illness is a punishment for previous bad behaviour. Therefore, listening to what children believe about COVID-19 transmission is essential; providing children with an accurate explanation that is meaningful to them will ensure that they do not feel unnecessarily frightened or guilty.

Adults need to be authentic about some of the uncertainty and psychological challenges of the pandemic, without overwhelming children with their own fears. This honesty not only offers a coherent explanation for what children are observing, but also grants permission for children to safely talk about their own feelings. Normalising their emotional reactions and reassuring children about how the family will look after each other helps to contain anxiety and provides a shared focus.


The Lancet – DOI: