In the midst of a public health emergency such as the current swine flu (or H1N1) epidemic, it is difficult to shield young children from the constant media cover-age and inevitable conversations going on around them. Your child is likely to have questions. Talking with young children about this topic may be difficult, but these conversations are important. Here are some sug-gestions you may find helpful:

Remember that children tend to 1. personalize situations. For example, they may worry about their own safety and the safety of immediate family members. They may also worry about friends or relatives who travel or who live far away.

Children 2. learn from watching their parents and teachers. They will be very interested in how you respond to news about the epidemic. They also learn from listening to your conversations with other adults.

Create an 3. open and supportive environment where children know they can ask questions. At the same time, it’s best not to force children to talk about things unless and until they’re ready.

Give children 4. honest answers and informa-tion. Children will usually know, or eventually find out, if you’re “making things up.” It may affect their ability to trust you or your reassur-ances in the future.

Use 5. words and concepts children can under-stand. Gear your explanations to the child’s age, language, and developmental level.

Be prepared to 6. repeat information and expla-nations several times. Some information may be

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Talking to your child about swine flu

hard to accept or understand. Asking the same question over and over may also be a way for a child to ask for reassurance.

7. Acknowledge and validate the child’s thoughts, feelings, and reactions. Let them know that you think their questions and concerns are important and appropriate.

Be reassuring, but 8. don’t make unrealistic promises. It’s fine to let children know that they are safe in their house or in their school. But you can’t promise that people they know won’t get sick.

Teach children about 9. common-sense precau-tions, such as appropriate hand washing and covering your mouth when you cough.

Let children know that 10. lots of people are help-ing the families affected by the swine flu epi-demic. It’s a good opportunity to show children that when something scary or bad happens, there are people to help.

Don’t let children watch 11. too much television with frightening images. The repetition of such scenes can be disturbing and confusing.

Children who have experienced serious illness 12. or losses in the past are particularly vulner-able to prolonged or intense reactions to graphic news reports or images of death. These children may need extra support and attention.

Monitor for 13. physical symptoms including head-aches and stomachaches. Many children express anxiety through physical aches and pains. An increase in such symptoms without apparent

Editor: Gregory K. Fritz, M.D.

Editor’s Note: Subscribers are permitted to photocopy multiple copies for patients and colleagues who would benefit from the material. Not for resale or mass distribution. Executive Editor: Karienne Stovell, kstovell@wiley.com. Associate Editor: Sarah Merrill. For reprint information, contact the reprint coordinator at (201) 748-6011.

The Brown University Child and Adolescent Behavior Letter, © 2009 Wiley Periodicals, Inc., A Wiley Company. 7/09

medical cause may be a sign that a child is feel-ing anxious or overwhelmed.

Children who are 14. preoccupied with questions or concerns about the swine flu should be evaluated by a trained and qualified mental health professional. Other signs that a child may need additional help include: ongoing sleep disturbances, intrusive thoughts or worries, recurring fears about illness or death, and reluctance to leave parents or go to school. If such behaviors persist, ask your child’s pediatrician, family physician, or school counselor to help arrange an appropriate referral.

As parents, teachers, and caring adults, we can best help children by listening and responding in an honest, consistent, and supportive manner. Fortunately, most children, even those exposed to loss or illness, are quite resilient. However,

by creating an open environ-ment where they feel free to ask questions, we can help them cope with stress-ful events and experiences, and reduce the risk of lasting emotional difficulties.

Source: This handout was adapted from an article by David Fassler, M.D., a child and adolescent psychiatrist practicing in Burlington, Vermont and Clinical Professor of Psychiatry at the University of Vermont. Used with the permission of the American Academy of Child and Adolescent Psychiatry, © All Rights Reserved 2009.

As parents, teachers, and caring adults, we can best help children by listening and responding in an honest, consistent,

and supportive manner.