How to Practice Gratitude & Improve Your Family’s Mental Health

As the COVID-19 pandemic drags on, its effects on our everyday lives feel never-ending. As parents, we want to provide our children with a sense of consistency and normalcy in the middle of a time filled with uncertainty, fear, and change—not an easy task to accomplish.

We are all grappling with the ever-changing rules and demands placed on us by our “new normal” life at home, school, and work. It is mentally and physically exhausting work that often has no tangible reward. We may not be able to change this reality at the moment. However, we can focus our energies on “controlling what we can control” and practicing gratitude for the events—no matter how small—that enrich our days.

The habit of gratitude can help us get off the treadmill of everyday life and acknowledge the small victories that we all have every single day.

Reasons to be thankful: the health benefits

A growing number of studies have looked at the impact of gratitude on our overall health. The results show benefits to both our physical and emotional health. A recent study highlights the direct relationship between gratitude and happiness among young children.

Luckily, gratitude can be added to our daily routines without increasing our “to-do” and “to-learn” lists.

Beyond thanks: 5 ways to nurture gratitude in children

Teaching polite manners, such as saying “thank you,” isn’t the only way to promote gratitude in children. Here are some tips to help build a habit of gratitude in your children.

  1. Focus on what went “right” each day. Take a couple of minutes at bedtime to write down or talk about at least one thing, no matter how small, or one part of the day that you and your family are grateful for. Studies have shown that gratitude improves sleep quality and decreases symptoms like unexplained aches and pains. By focusing on the positive parts of the day, gratitude helps set us up for a positive outlook for the day to come.
  2. Don’t save conversations about gratitude for Thanksgiving. Whether driving back home or enjoying a family game night, talking about the people you are grateful for in your life—and why—can go a long way. Think about positive traits in others that make us feel grounded, loved, and give us a sense of security. Reminding ourselves of those high-quality relationships can help us manage anxious and sad thoughts more effectively.
  3. Promote sincere verbal or written expressions of thankfulness. Creating a habit of thankful expression helps to increase self-esteem, mental strength, and positive social behaviors—such as helping, sharing, and volunteering. All of these are vital to strengthening our resiliency, a trait that we all need right now.
  4. Find ways to help others in need. It’s important to encourage children and teens to take active steps in providing service to their communities. Help them find causes that they are interested in, such as volunteering for a nursing home or raising money for charity. By participating in such giving activities, they will gain a sense of purpose and develop skills that will help them succeed in life.
  5. Be a role model. One way to teach your children to be more grateful is by actually being more grateful yourself. Show them your appreciation on a regular basis and they will learn to follow in your footsteps. You can start by modeling good behavior and practicing positive discipline techniques.


Spending just a few minutes a day to practice gratitude with our families can have a positive impact on how we address stressful situations life unexpectedly throws our way. It is especially effective as part of an overall family wellness plan that focuses on healthy eating, sleeping, screen time habits, and daily physical activity. Regular check-ups with your pediatrician are also a wonderful opportunity to further discuss gratitude and other ways to improve your family’s physical and emotional resilience.

Be sure to talk with your pediatrician if you have any concerns about your child’s health and wellbeing.

Source: Datta Munshi MD, FAAP, American Academy of Pediatrics (Copyright © 2020). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Cleaners, Sanitizers & Disinfectants

Housecleaning may not be the most enjoyable activity in your day, but a few minutes killing germs can go a long way toward keeping your family healthy.

  • Routine cleaning with detergent or soap and water removes dirt and grime from surfaces (ex: floors, walls, carpet, windows).
  • Sanitizing removes dirt and small amounts of germs. Some items and surfaces are cleaned to remove dirt then sanitized (ex: bathrooms, counters, toys, dishes, silverware).
  • Some items and surfaces require the added step of disinfecting after cleaning to kill germs on a surface (ex: changing tables, sinks, counters, toys).

Use caution around cleaners, disinfectants & sanitizers

Although chemical disinfectants and sanitizers are essential to control communicable diseases, they are potentially hazardous to children, particularly if the products are in concentrated form.

  • Products must be stored in their original labeled containers and in places inaccessible to children.
  • Diluted disinfectants and sanitizers in spray bottles must be labeled and stored out of the reach of children.
  • Solutions should not be sprayed when children are nearby to avoid inhalation and exposing skin and eyes.
  • Before using any chemical, read the product label and manufacturer’s material safety data sheet.

Questions to consider when selecting a disinfectant

  • Is it inactivated by organic matter?
  • Is it affected by hard water?
  • Does it leave a residue?
  • Is it corrosive?
  • Is it a skin, eye, or respiratory irritant?
  • Is it toxic (by skin absorption, ingestion, or inhalation)?
  • What is its effective shelf life after dilution?

About bleach

Household bleach (chlorine as sodium hypochlorite) is active against most microorganisms, including bacterial spores and can be used as a disinfectant or sanitizer, depending on its concentration.

Bleach is available at various strengths:

  • Household or laundry bleach is a solution of 5.25%, or 52 500 parts per million (ppm), of sodium hypochlorite.
  • The “ultra” form is only slightly more concentrated and should be diluted and used in the same fashion as ordinary strength household bleach.
  • Higher-strength industrial bleach solutions are not appropriate to use in child care settings.

Household bleach is effective, economical, convenient, and available at grocery stores. It can be corrosive to some metal, rubber, and plastic materials. Bleach solutions gradually lose their strength, so fresh solutions must be prepared daily, and stock solutions must be replaced every few months. Bleach solution should be left on for at least 2 minutes before being wiped off. It can be allowed to dry, because it leaves no residue. Household bleach can be used to sanitize dishes and eating utensils. The concentration of chlorine used in the process is much less than that used for disinfecting other objects.

Cleaners containing disinfectants:

By separating out the cleaning and disinfecting processes, you will reduce the amount of disinfectant chemicals used.

  • Soiled objects or surfaces will block the effects of a disinfectant or sanitizer. Therefore, proper disinfection or sanitizing of a surface requires that the surface be cleaned (using soap or detergent and a water rinse) before disinfecting or sanitizing.
  • Bleach (the sanitizer/disinfectant) and ammonia (the cleaner) should never be mixed, because the mixture produces a poisonous gas.
  • Not all items and surfaces require sanitizing or disinfecting. See the Cleaning, Sanitizing, and Disinfecting Frequency Table from the National Association for the Education of Young Children (NAEYC) for more information.

Alternative/less toxic homemade cleaning products

Alternative or less toxic cleaners are made from ingredients such as baking soda, liquid soap, and vinegar. Many of the ingredients are inexpensive, so you may save money over time. However they may require more “elbow grease,” which means you may have to scrub harder.

Although the ingredients in homemade cleaners (e.g., baking soda for scrubbing, vinegar for cutting grease) are safer, not all are nontoxic. Treat them as you would any other cleaner, with caution.

Talk with your pediatrician

If you’re concerned about cleaning product safety, talk with your pediatrician. Your regional Pediatric Environmental Health Specialty Unit (PEHSU) have staff who can also talk with parents about concerns over toxins in cleaning products.

Source: Adapted from Pediatric Environmental Health, 3rd Edition (Copyright © American Academy of Pediatrics 2011). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Fire Safety: Planning Saves Lives

Protecting your home against fire involves planning. Here are some precautions you can take to help you protect you and your family.

  • Never leave small children alone in the home, even for a minute.
  • Install smoke alarms in furnace and sleeping areas. Check batteries once a month. It is best to use alarms with long-life batteries, but if these are not available, change the batteries at least yearly.
  • Plan several escape routes from each room in the house. Plan a place to meet right after leaving the house.
  • Conduct home fire drills so everyone knows how to get out in an emergency.
  • Do not smoke in bed.
  • Dispose of cigarette butts, matches, and ashes with care.
  • Keep matches and lighters away from children.
  • Be sure your gas water heater is off the ground. Spilled flammable liquids will be ignited by the pilot light.
  • When using candles, place them on a sturdy surface out of reach of children. Never leave a candle burning unattended.
  • Place a barrier around open flames.
  • Do not wear loose-fitting clothing near a stove, fireplace, or open space heater.
  • Have your heating system checked and cleaned yearly.
  • Check electric appliances and cords regularly for wear or loose connections.
  • Use only 15-ampere fuses for lighting circuits. Never use a substitute for a fuse.
  • Place fire extinguishers around the home where the risk of fire is greatest—in the kitchen and furnace room and near the fireplace.

In Case of Fire…

  • Get everyone outside right away. Go to your planned meeting place.
  • Do not stop to dress or put out the fire. (Most deaths occur from suffocation due to hot fumes and smoke, not from direct burning.)
  • Call the fire department from a neighbor’s house or mobile phone.

Source: TIPP-Protect Your Home Against Fire…Planning Saves Lives (American Academy of Pediatrics Copyright © 2020). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Avoid a Food Allergy Scare on Halloween

​​Halloween can be one of the trickiest days of the year for children with food allergies. Kids often haul home pounds of treats, and even small amounts of an ingredient they are allergic to can cause a potentially life-threatening reaction.

Here are some tips from the American Academy of Pediatrics (AAP) to help ensure Halloween’s frights stay festive and don’t involve a medical emergency.

Reading before eating

  • Always read the ingredient label on any treat your child receives. Many popular Halloween candies contain some of the most common allergens, such as peanuts or tree nuts, milk, egg, soy or wheat.
  • If the ingredients aren’t listed, arrange for a treat “exchange” with classmates or friends. Or, bag up the goodies your child can’t eat because of an allergy and leave them with a note asking the “Treat Fairy” to swap them for a prize.
  • Be aware that even if they are not listed on the ingredient label, candies (both chocolate and non-chocolate) are at high risk of containing trace amounts of common allergy triggers, because factories often produce many different products. Also, “fun size” or miniature candies may have different ingredients or be made on different equipment than the regular size candies, meaning that brands your child previously ate without problems could cause a reaction.
  • Teach your child to politely turn down home-baked items such as cupcakes and brownies, and never to taste or share another child’s food.

Food-free fun

  • Offer non-edible goodies to trick-or-treaters and classmates. Food Allergy Research & Education’s Teal Pumpkin Project, which promotes safe trick-or-treating options for food-allergic children, suggests items such as glow sticks, spider rings, vampire fangs, pencils, bubbles, bouncy balls, finger puppets, whistles, bookmarks, stickers and stencils. Consider supplying some to neighbors whose homes your child will visit.
  • Plan alternatives to trick-or-treating, such as watching an age-appropriate creepy movie together.
  • Center parties around festive activities such as costume parades, pumpkin decorating contests, Halloween themed games, crafts and scavenger hunts or spooky storybooks. (During the COVID-19 pandemic, especially if your child is not yet eligible to be vaccinated, keep safety steps in mind.)

Don’t keep others in the dark

  • Inform teachers and other adults with your child about the food allergy and how to react to an emergency.

Source: American Academy of Pediatrics (Copyright © 2015). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Are Your Children Getting Enough Physical Activity?

The American Academy of Pediatrics recommends that kids 6 years and older get 60 minutes of moderate to vigorous physical activity​ on most days of the week. This can come from walking to and from school, for example, or a sports practice.

After many schools closed and sports seasons stalled because of COVID-19​, it became more challenging for children to stay active. But even as children stay home more, active play such as hopscotch, jumping rope or a game of tag can help keep kids healthy and fit. Active play comes naturally to kids and has many proven health benefits: better sleep​, improved mood, increased focus, healthy muscles and bones, fundamental strength and coordination development, relaxation and resilience, building social skills. Are your children getting enough physical activity each day?

Check out this Physical Activity Checker on the website. Start by entering your child’s name. Type in the name of the activity, how long your child does the activity, and the intensity. Enter as many activities as you wish. The stopwatch will calculate the minutes for each activity and let you know when you hit 60 minutes. Add more family members and check their activities, too!

Some kids may be reluctant to spend more time being physically active because it has not been part of their routine. We encourage you to focus on the play element of activity, to make it part of your family’s daily routine, and to make physical activity an enjoyable experience that your family does together.​

Your Child’s First Crush


Do you remember the first time you looked at a classmate and your heart pounded just a little bit harder? Many kids go through this in their teen years, but some children can feel romantic interest well before puberty.

Learning how to be in a healthy one-on-one relationship is a normal part of learning how to be an adult. Talking with your child about relationships with their peers at every age sets the foundation for healthy personal connections as they grow. This learning process does not begin with the teen years, but as soon as a child begins noticing other people and how they relate!

Learning about relationships

Children first learn about loving and caring relationships from their families. But they also get messages about relationships from friends, television, and social media. Some of what they learn may not be healthy, so talking with your child about relationships is important. You may find teachable moments in scenes from movies or in song lyrics – carefully selected, of course!

Primary school relationships

Young kids often say they are dating. Some may try to sneak kisses from classmates, but often they do not go anywhere or even hold hands. This is typical, and it is important not to tease children or to dismiss their feelings.

  • Special friends. Help your child understand that having feelings for someone else is normal, but that dating is not appropriate until well into adolescence. Explain that just as adults sometimes have people they feel closer to and want to spend more time with, they may also feel more strongly about one friend that another. But this does not mean that they are necessarily in a dating-type relationship. Seeing friendship as a normal interaction between people of any sex is an important lesson.

Adolescent & teen relationships

Adolescent dating may involve physical affection such as kissing, cuddling, and holding hands. There is not a specific age at which dating is best. Every adolescent matures at a different rate and may be ready for a romantic relationship at a different age.

  • Remember how real it can feel. Some adults may be cynical about or dismiss teenage relationships. They realize that friendships and love at this age can be short-lived. However, this does not mean a teen relationship is less important or less strong than an adult relationship. Friendships and even romantic relationships in the teenage years are just as real, and perhaps as painful, as relationships at any other point in life.
  • Be ready to talk. Don’t be surprised if your child, who always told you everything, starts to clam up and go silent. It is a natural process for adolescents to put family relationships in the back seat, socially, as they learn to develop their friendships. Your role has changed from main character to supporting cast. But your teen needs your support and advice as they navigate the ups and downs of their relationships.

How to start talking about romantic relationships

Talking about relationships with teens can be a minefield! Your teen may feel bad about not having dated or may even have felt rejected by someone. So, bringing up the topic may have the opposite effect you intend.

  • Tread lightly & listen. Instead, to open the topic, you might begin by asking, “Are any of your friends dating?” After that, it is less important what you say, than that you listen carefully. If your teen says absolutely nothing, then it might be best to wait and ask again a few weeks later. Pushing for information can be a mistake.

Here are some other ways to encourage positive communication with teens:

  • Try not to react. If your teen shares a bit of information, try to listen without judgement or reaction. Simply hear what they are saying and then ask a question about it without offering your opinion.
  • Don’t participate in the drama. If your teen shares a concern, create a safe space with a positive, problem-solving attitude. This helps avoid making your teen feel it is an overwhelming problem. Be a calm voice of reason.
  • Don’t overly empathize. Maintain a reasonable distance from the ups and downs of teenage life. This means if your daughter has a fight with her boyfriend, you sympathize with her feelings, but take the long view.

Not Alone

  • Dating. Keep in mind that most adolescents (even older adolescents) have never had a dating relationship. Among 15- to 17-year-olds, most (66%) are not and never have been in a romantic relationship.
  • Sex. Despite a lot of peer pressure, more than 50% of teens wait until after high school to have sex. Keep in mind that you are the best person to teach your teen about relationships, love, commitment. What teens learn about sex may help influence their future choices and health. For instance, if your teen chooses to abstain from sex, they avoid the risk of sexually transmitted infections and pregnancy. If your teen is sexually active, proper use of birth control can help reduce these risks.

Warning signs your teen is in an unhealthy relationship

Although it is a good idea to let your teen learn through experience, it is important to know when to step in. Some relationships are so unhealthy that they may be dangerous to your teen. Here are some signs you may need to step in and have a serious conversation with your teen, welcome or not:

  • Signs of extremely controlling behavior or extreme jealousy
  • Isolation from friends and family
  • Unexplained or poorly explained bruises or injuries
  • Loss of interest in activities that your teen previously enjoyed
  • Sudden change in behavior
  • Drop in grades
  • Extreme changes in personality, especially around their partner
  • Frequent arguments
  • A big age difference between partners


Keep in mind that you and your teen may not always agree on what’s best. Though you may not control over your child’s love life, you can be supportive through the joys and heartbreaks that will happen along the way.

Source: Adapted from “Your Child’s First Crush,” HealthyChildren Magazine, Winter 2020. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Why I Vaccinate: Parent Testimonials

​​​Did you know the overwhelming majority of parents vaccinate their children?

In an effort to transform statistics into real conversations about how children and families benefit from immunizations, the American Academy of Pediatrics (AAP) asked parents to send in personal stories and testimonials about why they vaccinate their children.

Here’s What Some of You Said:

  • “There are SO MANY things I cannot protect my child from, so I will take every safe and healthy way to protect her that I can find. Vaccinating her from potentially deadly diseases is a gift—one that she needs now that diseases we thought we had conquered are starting to come back.”   —Bonnie Stetz, Mom
  • “I vaccinate, because I want to keep my children safe. It’s the same reason that they wear helmets and seatbelts.”   —Kelly Hargraves, Mom
  • “I vaccinate my kids, because I believe in providing them with the best healthcare possible. Vaccinations play into that because they protect children from harmful, sometimes deadly diseases. Failing to vaccinate intentionally puts my kids (and others’ kids) at risk.  ”   —Marina Mayer, Mom
  • “I vaccinate, because I truly feel it takes a whole village to raise a child. I’m not only protecting my child but also those around her.”   —Cassie Thompson, Mom
  • “Vaccinating is just one of many ways that I strive to give my kids the best possible chance for healthy and happy lives. Plus, it’s the responsible thing to do for others who are too young for vaccines or who have compromised immune systems.”   —Heather Cooper, Mom
  • “The primary reason I vaccinate my children is because it is recommended by my pediatrician whom I trust. Our pediatrician’s practice sees hundreds of children day in, day out and have children of their own, not to mention years of medical training and expertise.”    —Anne Lee, Mom
  • “My wife and I vaccinate our children, because we trust science. We trust the scientific method and we trust the overwhelming amount of doctors who recommend vaccination. There is no possible way we can know everything as a parent, so there have to be authorities which we can trust.”   —Travis Harmon, Dad
  • “In a nutshell, I trust my pediatrician and the overall guidance of the AAP. I believe thorough testing has been done to ensure they are safe and that getting vaccinated is safer than not getting vaccinated.”   —Stacy Cordero, Mom
  • “As a parent and provider, I vaccinate. I have seen too many preventable illnesses and death. There is strong evidence that shows vaccines are safe and clearly worth the effort. As far as I am concerned, there is no reason not to vaccinate.”   —Ann Petersen-Smith, Mom

Source: American Academy of Pediatrics (Copyright © 2017). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Childhood immunizations during the COVID-19 Pandemic

Why is it so important for my kids to get caught up on their childhood immunizations during the COVID-19 pandemic?

Although you are probably juggling a lot of responsibilities right now, making sure your children are up-to-date on their shots is one of the best things you can do to protect them against some pretty serious but preventable diseases.

Pediatricians have seen a sharp drop in vaccinations since the start of the pandemic, which is a really frightening trend. When children are not vaccinated, they are at risk of getting diseases like measles, polio and hepatitis A and B that can cause lifelong disability or death. Falling vaccination rates can lead to new outbreaks of dangerous diseases. And that’s the last thing anyone needs on top of COVID-19.

Regular visits to the pediatrician

Immunizations usually take place at your child’s check-ups. (Here are the recommended vaccination schedules for birth through age 6 and 7-18.) Keeping these appointments is very important so your kids don’t miss out on shots or other important care, such as physical exams and health screenings.

But if your c​hild does miss a shot, you don’t need to start over. Just go back to your pediatrician’s office so your child can catch up with the vaccines they need to stay healthy.

​In addition to getting caught-up on routine immunizations, ​​here are some other reasons to visit your pediatrician right now:

  • Newborn visits
  • Hearing and vision screenings
  • To check on developmental milestones
  • To check blood pressure and other vital signs
  • To treat infections or injuries
  • Adolescent health concerns, such as menstrual care and depression screening​
  • Routine lab tests
  • For pre-participation physical examinations before returning to sports or other activities.

Call your pediatrician

Pediatricians are being extra careful to make sure their offices are safe. If you are worried about COVID-19, call your doctor’s office to learn about the strict cleaning and disinfecting they are doing to keep everyone safe.

Do you have other questions about vaccines or well child visits? Be sure to ask your child’s doctor. Pediatricians are seeing patients and available to answer any questions that you have. In fact, they would love to hear from you.​
More information

Written by Shaunte Anum-Addo, MD, FAAP, is a pediatrician at Children’s National Hospital in Washington, D.C., and a member of the AAP Section on Minority Health, Equity and Inclusion. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Mental Health During COVID-19: Signs Your Child May Need More Support

The ongoing stress, fear, grief, uncertainty created by COVID-19 pandemic has weighed on all of us, but many children and teens have had an especially tough time coping emotionally.

An estimated 40,000 children in the United States have lost a parent to COVID-19, for example. Many families have also lost financial stability during the pandemic. At the same time, children have had vital supports including school, health care services, and other community supports interrupted by the pandemic. And many have experienced or witnessed increased racism and xenophobia during the pandemic, particularly toward families of Asian descent.

Even with the protection of the COVID-19 vaccines now available to children old enough for them, pandemic-related stress and traumas may have lasting effects on the developing minds of children and teens.

Continue to check in with your child often and watch and listen for signs they are struggling. And remember that your pediatrician is here to help.

How is your child coping?

Invite your child to talk about how they are feeling. Feeling depressed, hopeless, anxious, and angry may be signs they could benefit from more support during this difficult time. Keep in mind that adolescents and young adults may try to hide their struggles because of fear, shame, or a sense of responsibility to avoid burdening others. Younger children may not know how to talk about these feelings but may show changes in their behavior or development.

Recognizing signs of stress in your child

Signs of stress and mental health challenges are not the same for every child or teen, but there are some common symptoms.

Infants, toddlers and young children…

may show backward progress in skills and developmental milestones. They may also have increased problems with:

  • fussiness and irritability, startling and crying more easily, and be more difficult to console.
  • falling asleep and waking up more during the night.
  • feeding issues such as frantic nippling, more reflux, constipation or loose stools, or new complaints of stomach pain.
  • separation anxiety, seeming more clingy, socially withdrawn, hesitant to explore, and seeming to fear going outside.
  • hitting, frustration, biting, and more frequent or intense tantrums.
  • bedwetting after they’re potty trained.
  • urgently expressed needs while seemingly unable to feel satisfied.
  • conflict and aggression or themes like illness or death during play.

Older children and adolescents…

may show signs of distress with symptoms such as:

  • changes in mood that are not usual for your child, such as ongoing irritability, feelings of hopelessness or rage, and frequent conflicts with friends and family.
  • changes in behavior, such as stepping back from personal relationships. If your ordinarily outgoing teen shows little interest in spending time with, texting or video chatting with their friends, for example, this might be cause for concern.
  • a loss of interest in activities previously enjoyed. Did your music-loving child suddenly stop wanting to practice guitar, for example? Did your aspiring chef lose all interest in cooking and baking?
  • a hard time falling or staying asleep, or starting to sleep all the time.
  • changes in appetite, weight or eating patterns, such as never being hungry or eating all the time.
  • problems with memory, thinking, or concentration.
  • less interest in schoolwork and drop in academic effort.
  • changes in appearance, such as lack of basic personal hygiene (within reason, since many are doing slightly less grooming during this time at home).
  • an increase in risky or reckless behaviors, such as using drugs or alcohol.
  • thoughts about death or suicide, or talking about it (see “A word about suicide risk,” below).

How your pediatrician can help

Staying in touch with your pediatrician is more important than ever during this pandemic. If you have any concerns, ask your pediatrician’s office about checking on your child’s social and emotional health. This can be especially important for children facing higher rates of illness or risk from COVID-19, such as children of color, those living in poverty, special health care needs or developmental differences​. Children who are refugees and those involved with the child welfare and juvenile justice systems may also be more at risk.

Pediatricians can screen for depression and ask about other concerns like anxiety or trouble coping with stress. The doctor may also ask about these symptoms in other family members, as this can impact your child’s health, and whether they know anyone who has become sick with COVID-19. It’s important to offer your teen some time to talk one-on-one with the pediatrician during the visit to ensure they have the chance to speak as openly as possible. Many pediatricians are also offering telehealth visits during the pandemic.

Dealing with the loss of a loved one to COVID-19

Children, adolescents, and families who experienced the loss of a loved family member or friend to COVID-19 are at increased risk for mental health challenges and may need special attention and professional counseling to manage their loss and grief.

Supporting your child

Your pediatrician can give you guidance on ways to best support your child and help them build resilience. Some children or adolescents may need more time and space to express their feelings. Some may do better with gradual conversations and other activities besides talking, such as painting or drawing to express themselves and manage stress. Others might be more comfortable with direct conversations or activities. They may need to talk to a trusted adult about how to keep up social connections safely, or their feelings of boredom, loss, and even guilt.

A word about suicide risk

Rates of suicide for both adolescents and adults increase during times of high stress. In addition to screening for depression, your pediatrician can screen for suicide risk.

Remember, not everyone who considers suicide will talk about it, and not everyone who talks about suicide will act on their words. However, any talk about suicide should be taken seriously. If you are worried about your child, it is critical to make your home safe by removing weapons and ammunition from the house and securing medications in a locked cabinet.

Seek help immediately by calling the National Suicide Prevention Lifeline at 1-800-273-TALK or texting the Crisis Text Line by texting ‘TALK’ to 741741. Reserve 911 for situations where self-harming actions are happening or are about to happen. In a non-crisis situation, talk with your pediatrician about any concerns you have about your child’s mental health.

Self-care and setting the tone

Parents set the tone in the household. Expressing extreme doom or fear can affect your children. It can be challenging to stay positive, especially if you’re struggling with your own stress. But try to stay positive and relay consistent messages that a brighter future lies ahead. It helps to set aside time to take care of yourself when possible, and seek the support you may need for your own mental health. Practicing mindfulness, focusing on the present moment, yoga or stretching can help the entire family build coping skills. Build in down time for the whole family to connect and relax, enjoying a nap, movie time or simply spending time together.


Keep lines of communication open between you and your child, and don’t hesitate to talk with your pediatrician about ways to help maintain your family’s mental health during this difficult time.

Source: American Academy of Pediatrics (Copyright © 2021). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Do Masks Delay Speech and Language Development?

During a child’s first few years of life, they are rapidly developing communication skills. Whether by smiling, cooing and babbling, pointing and gesturing, or saying their first words, children express themselves from birth. But a year and a half into the COVID-19 pandemic and no solid end in sight, some families wonder whether continuous use of face masks by daycare providers, preschool teachers, and other adults may negatively affect their child’s speech and language development.

While this is a natural concern, there is no known evidence that use of face masks interferes with speech and language development or social communication. Plus, children can still get plenty of face time at home with mask-free family members.

​How do babies learn to communicate?

Babies are hard-wired to communicate. From day 1, they are watching their loved ones’ faces and mouth movements. They are listening to them talk (for families that use spoken language), and making attempts to interact with their parents and caregivers. Each milestone builds on another.

Parents and other family members encourage this development by talking, singing, playing peek-a-boo, reading, and engaging their baby in numerous other ways every day. The more language a child is exposed to—and the more undivided attention a parent can give to their child as they feed them, bathe them, change their diaper, practice tummy time with them, push them in a stroller, and play outside with them—the better the child’s communication skills will likely be.

Can mask use cause delays in speech and language development?

A key part of learning to communicate for a child is watching the faces, mouths, and expressions of the people closest to them. Babies and young children study faces intently, so the concern about solid masks covering the face is understandable. However, there are no known studies that use of a face mask negatively impacts a child’s speech and language development.

And consider this: visually impaired children develop speech and language skills at the same rate as their peers. In fact, when one sense is taken away, the others may be heightened. Young children will use other clues provided to them to understand and learn language. They will watch gestures, hear changes in tone of voice, see eyes convey emotions, and listen to words.

Tips to better communicate with children while wearing a face mask

Here are some ways that people who wear face masks can help when they interact with your child:

  • get the child’s attention before talking
  • face the child directly and make sure nothing is blocking the child’s view
  • speak slowly and slightly louder (without shouting)
  • ensure a child is using hearing aids or using other hearing devices, if they have been prescribed
  • use eyes, hands, body language, and changes in tone of voice to add information to speech
  • ask the child if they understood; repeat words and sentences when necessary
  • reduce noise and reduce distractions

You can share these tips with your child’s day care provider, preschool, and others who regularly interact with your child while wearing masks.

How to boost your child’s communication skills as use of face masks continues

Remember, babies and toddlers learn the most from their family! Families can help with speech and language development and social communication through face time at home with family members who aren’t wearing masks. By providing dedicated time to converse with your child without screens or other interruptions—for example, at bath time and dinner time—children should reach their expected milestones.

Regardless of mask use, some children will take longer to reach speech and language milestones—and some may need help meeting them. Speech and language delays and disorders are common in young children, but these are highly treatable with help from a certified speech-language pathologist. If you have concerns about your child’s skills, don’t delay—seek an evaluation as early as possible. Children can be evaluated for free through their local early intervention program (no referral is necessary). After the evaluation, your child can receive free or low-cost treatment if needed. Children quality for these services based on the degree of their delay (each state has different requirements), not family income.

How are speech and language services provided with masks?

Some children were already receiving early intervention services, or were seeing a private speech-language pathologist, before the pandemic. Many families continued these services, but others took a break for various reasons and are now looking to start again. Still other parents and caregivers may have developed concern for the first time over the past year and a half. Regardless, families should know that speech/language therapy services are still occurring—and children are still making significant progress—at this time, even if an speech-language pathologist is wearing a mask.

Some speech-language pathologists have been providing services virtually (called telehealth). While young children may have a difficult time sitting in front of a computer, early intervention is often focused on parent coaching—giving caregivers techniques to boost their child’s communication skills. Speech-language pathologists are also still working directly with children, both through telehealth and in-person. In person, some providers use clear masks so their faces are still visible or masks with face shields to provide additional protection—or work with children outside when possible.


When it comes to use of face masks, the bottom line is safety first! Masks reduce transmission of COVID-19 and can make in-person schooling possible during the pandemic. Luckily, your child’s speech and language skills can continue to grow.

If you have any concerns or questions about your child’s communication skills, your pediatrician can help. They can evaluate your child’s progress and, if needed, provide provide you with contact information for the early intervention program in your area or a private speech-language pathologist. A searchable database of professionals is also available from the American Speech-Language-Hearing Association at

Copyright © 2021 American Academy of Pediatrics and American Speech-Language-Hearing Association. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.