Hopscotch Blog

At the park, at a playdate, at the first sleepover in years—I find myself hovering over my kids to see how they’re doing, help them negotiate social interactions if need be. Will they be able to make new friends? Will they know how to smooth over little squabbles? Will they be okay? We’ve tried to expose them as much as possible to the world around them, but the world around them has seemed…a mess at best and aflame at worst.

As challenging a time as this has been to be a parent, I try to remember how challenging this has been for our children. I can’t count the number of missed family dinners and vacations and quiet conversations with their wonderful, quirky, and loving and aunts and uncles and cousins and grandparents. Our school-aged children may have missed out on years of normal social interaction with their friends and classmates. And teens have had to resort even more to online versus “in real life” interaction to stay connected with their friends. So it’s not just you—many parents have real concerns about how to help their children build healthy social skills, especially in the aftermath of the pandemic. As a child and adolescent psychiatrist, I often get asked to help families find ways to help their children make up for lost time socially.

Some of these challenges will be addressed by getting our children back “into the swing of things” – attending school, participating in sports, traveling again to reconnect with family. But we shouldn’t lose sight of the role we have as parents to coach our children through normal and challenging social experiences. For example, what to do when your child is being bullied or is the one engaged in bullying another child? Evidence-based clinicians have found  that the most effective strategies are proactive, preventive approaches that help develop core social skills even before tough moments arise. Sometimes, it’s difficult to see “eye to eye” about who did what to whom, but we can all get on the same page about being kind and respectful to others, understanding where others are coming from, finding space to stick up for yourself, and making room for all different kinds of people and experiences. Let’s talk about some strategies to cultivate these healthy social skills in your kids.

How to cultivate:  Kindness and Respect

Children learn what is valued and demonstrated at home. In our home, we try to keep it relatively simple—we tell our kids we’re practicing kindness and respect. And those need to be practiced by everyone in the family: If I insist that my kids say “please” and “thank you,” but I don’t tend to do so with them or with my spouse, I send a mixed message. If we really want our children to value and demonstrate kindness and respect to their peers, family, and others, they have to see that behavior every day at home and in their worlds. Take a moment to assess ways you can build an environment of kindness and respect at home. You can build sharing gratitude into a family dinner routine. You can offer your children real choices (e.g. snack options, family game picks, movie night selections) throughout the day and respect their choices. 

It’s also important to recognize that we can’t assume children will know exactly what to say or what to do, either. If your child is regularly missing an opportunity for kindness or respect, ask yourself if there is a lesson they need you to help teach them. Ask them how it feels when someone does something nice for them. Teach them respectful ways to greet and say goodbye to others. Help them understand how and when something they say could hurt another’s feelings. And while limit-setting often has to happen in the moment, this kind of social teaching often works better with a little distance from what I call “the red zone.” When children are emotionally upset, it is challenging for them to think clearly or learn new skills. These are times to provide emotional support and save the teaching for when they can better learn from you. When one of my kids is upset about a difficult interaction with a friend and is already yelling or in tears, I’m going to have to wait until they’re calmer and can process what I’m saying to teach a social lesson. 

We also need to be careful to positively reinforce the specific behaviors we want to see more of. This means being aware of what your child is motivated by in your relationship. If they really respond to your attention, getting a lot of attention (even negative attention!) for disrespectful behavior can be counterproductive. In that case, you may want to quickly and calmly share your concern and that you will have to discuss the situation with them later, then move on. Come back to it when things are less heated. If your child is feeling jealous and struggling to regulate with tears or tantrums when you’re spending planned time with a sibling or your partner, calmly let them know that you won’t be able to engage with them when they’re struggling in this way; you’ll be happy to talk to them more about the situation later when they’re feeling more settled. You might gently direct them towards proven activities that help them regulate themselves, but otherwise may have to work hard to exercise “planned ignoring” to decrease the likelihood that the behavior will resurface again later. When you are able to engage them, most children respond strongly to specific praise. Move beyond a generic “Great job!” to “I really appreciate it when you help your little brother pick up like that without me asking. Thank you!” As parents, sometimes this feels a bit awkward. Try it out regularly for a week and assess how it’s going. You may have to adjust your words, tone, or frequency, but this is often a useful tool to build kindness and respect as their social foundation.

How to Cultivate: Empathy

Children begin to consider other’s experiences and needs gradually as they grow up. A toddler generally understands the world through a narrow lens of his or her own personal experiences. We’ve all experienced some version of this: Just as I’m getting dinner ready after work or juggling a challenging conference call with other home duties is exactly when a younger child needs my support or attention to get them a snack or to settle a sibling argument. As children get older, they begin to develop the ability to consider situations from alternate perspectives when prompted (generally around mid-elementary school) and eventually to more naturally understand another’s point-of-view (closer towards pre-teen years). We as adults can help with this transition by coaching them to consider others, what they might be experiencing, thinking, feeling. One concept that children often understand and can learn with practice and support is what many refer to as the old-school Golden Rule: treat others as you would want to be treated.

To practice this, you want to ask questions that will put your kid in someone else’s light-up sneakers—at an opportune time. Instead of asking them, “How would you feel if your sister did that to you?” just after they knock down said sister’s Magnatile tower, establish the consequence (e.g. apologizing and helping her build it back) and ask the question later during a quiet(er) time. Children’s natural defensiveness is often elevated in the moment, and more effective practice happens outside of these “red zone” situations. When you and/or your child observe negative or positive experiences happen to others, ask them, “What do you think that’s like for them? What do you think they’re feeling? Thinking?” 

Even if you’re not presented with an emotionally rich situation to observe, you can come up with common social scenarios for them to work through. “What would you do if someone were making fun of one of your classmates at school?” “How would you want someone to help you if tripped and fell in the hallway?” Children are still building their “social database,” and rehearsing these kinds of scenarios helps them to work out how they would want to respond and how they would want to be treated ahead of time. It can give them a “script” to navigate challenging social situations and help them develop a real curiosity for the lives and experiences of others.

How to Cultivate: Self-Advocacy 

While we want our children to understand others’ perspectives and experiences, we also want them to learn to advocate for themselves. While kids may feel comfortable sharing their wants, needs, and concerns at home (“Mom, I don’t like it when you sing that song!”), they often can struggle doing that at school, with friends, and elsewhere. Maybe they’re struggling with some classmates making a joke at their expense or one particular peer targeting them in a bullying pattern. We want our children to be able to recruit the support they need from peers and adults, but also to be able to stick up for themselves.  We can help our children build confidence in self-advocacy skills by encouraging them to practice putting their wants, needs, and concerns into words and expressing them directly to others. Let’s say they are struggling with a friend that always wants to play a favorite game in a particular way that your child is not enjoying. Maybe they share that they don’t want to play with this child anymore or want you to tell the other child (or child’s parent) their concerns. Instead, we want to help them practice expressing their wants clearly and directly. Often, kids need direct coaching in exactly which words to say and practice saying it a few times so they can get the hang of it. And then, check in with them later to see if they were able to follow through and troubleshoot if they weren’t.

Sometimes as parents, our good intentions short-circuit this practice when we anticipate our children’s needs and rush to resolve them before they express them directly. Or sometimes, the necessities of a family or public setting don’t allow us to accommodate our children’s requests, so we tell or show them that we don’t want to hear what they have to say. Helping them practice expressing themselves does not prevent us from addressing our children’s needs or require us to do exactly as they ask. In either situation, validating and praising them for calmly stating their perspective helps them learn to stick up for themselves. And when they practice with you, this can also be a wonderful opportunity to learn the age-old lesson that it’s not just what you say, it's how you say it! Teach them to communicate their needs in a way that allows others to hear them. If your child is playing with another child or struggling with some schoolwork, gets frustrated and yells, “Help me with this!”, try some planned ignoring here. If they are still struggling or have not encountered this social skill lesson much, help them to understand that we need to phrase that as, “Could you please help me with this?” or “I’d really like it if you could help me with this, please.” Help them understand the difference between a demanding tone and a respectful tone. If they’re not in the “red zone” just then, help them practice the words a few times. 

How to Cultivate: Engagement Over Avoidance

Developing and practicing social skills can be challenging or uninteresting at times for kids. It can be simpler to avoid a social interaction—or more fun to play on the tablet! One of our jobs as parents is not to let them fall into the avoidance rut too easily. Ultimately, we want them to be able to engage with the world around them! All different types of people and personalities and places. It’s okay to practice or work on social experiences they’re already relatively skilled at initially. This can help them gain confidence and understand that they can apply these skills in new and different situations. For example, if they are a little shy when meeting new kids, but usually warm up, encourage them to take the next steps and then positively reinforce their efforts. Next, you might try to encourage the same process with a new friend of the family or other adult in a new social setting, under your guidance and supervision. 

It’s also important to get them experience with things they’re not innately good at. Children need to have early experiences with the struggle of learning a new skill. We want to positively reinforce their effort more than the results. “I really love how hard you were trying to talk to that new girl on the playground!” (even if it didn’t quite work out!) When they experience the sequence of encountering a social challenge, getting support to navigate it, persisting with consistent effort in developing the skill, and then enjoying the success of real social connection, this can be a highly rewarding and motivating process that they can then begin to generalize to new social experiences. Ultimately, we want to help them understand social experiences as enjoyable learning opportunities. Messing up and being imperfect is just fine, as long as we’re growing and enjoying the experience.

How to Cultivate: Valuing and Promoting Diversity

Children (and many of us parents!) are creatures of habit. They tend to want to do what is comfortable, and familiar. It’s important to provide them with these experiences, as they can establish a positive emotional environment and build strategies to self-regulate in different domains of their lives. But especially in the context of helping them build their social skills, we also want to be mindful of helping them enjoy a diversity of people, places, and experiences. We want to help them view new experiences as positive opportunities to explore what’s interesting, what may be a fit for them, what might bring some new joy into their day. Similarly with people, we want to help them develop a curiosity about those who live different lives than theirs. This can start with role modeling at home. “Oh, interesting! I haven’t met someone from there before. I wonder what it was like growing up there?” Similarly to building other social skills, look for opportunities to provide specific positive praise if you witness them approaching a new person, place, or experience with a spirit of curiosity and positivity. 

My children are pretty chatty. When we’re all together and out in public, they’ll often be curious about others around us. When they ask questions, with a little bit of screening and shaping (“No, we don’t ask or comment about other people’s bodies…”), I like to try to find ways to encourage them to ask the other individual directly about his or her life and then find a way to praise them for this healthy social effort. Let’s say they see another child in a store wearing clothing from a culture we’re less familiar with. If my child asks me, “What’s that she’s wearing?” I’ll try to counter with something like, “Oh yea, that’s a really cool headscarf/yarmulke/ necklace! Why don’t you let them know you like it and ask them about it?” Sometimes it turns into a shared conversation with my child and me engaging the other family together. But with practice, I’ve seen my kid get curious, ask respectfully to learn more about another culture, and then start up an engaging conversation mostly solo! Afterwards, I praise them for their efforts in connecting with others and try to continue the curiosity - “What do you think holidays are like in their family?” “What kinds of food do you think they enjoy?” With a little luck and guidance from us as parents, our kids can learn that new social experiences can be really enjoyable learning opportunities.

I recently had to fly internationally to help my elderly parents return to the US. While I would have loved to have my kids with me on the trip to visit their grandparents’ home country, I was relieved not to have to drag them through the long security lines, complex masking rules, or just the exhaustion of modern travel for families. You may not believe me when I say this, but when I’m traveling, I am not diagnosing or judging anyone for anything! I feel for all families who are traveling, as parents try to wrangle overwhelmed kids, keep everyone fed and watered, and reach their final destinations all in one piece. Children’s experience of travel has also changed: What used to be perhaps an adventure - an exciting chance to explore new people, places, and experiences - can increasingly turn into an exercise in tedium, prolonged discomfort, and family stress.

The reality of unpredictable schedules, confined spaces, limited access to comforting routines and coping strategies, and the prolonged exposure to sibling dynamics can all add up to an emotionally taxing experience.

Travel generally presents a challenge to most children. The reality of unpredictable schedules, confined spaces, limited access to comforting routines and coping strategies, and the prolonged exposure to sibling dynamics can all add up to an emotionally taxing experience. If your child also lives with an emotional health challenge (e.g. anxiety, attention-deficit/hyperactivity disorder (ADHD), or autism spectrum disorder (ASD)), travel can be even more of an ordeal. What’s generally stressful for most children becomes an emotionally exhausting experience for children who struggle with avoidance, impulsivity, and/or feeling overwhelmed by sensory or social overload.

But over-accommodating their anxiety can lead to further avoidance and missing out on important experiences they need and want to have.

At the same time, all of us as parents have to recognize that avoidance can become the twin of anxiety. If travel anxiety builds to the point that children refuse to leave the house or to get into a car, fear and avoidance alternately provide fuel for anxiety’s fire. The more fearful I am, the more I avoid the things that I fear. The more I avoid, the more fearful I am of the unfamiliar and challenging. A similar process can happen for us as parents as we try to help our children navigate their travel anxiety. It can be much simpler to default to “problem-solving” mode, trying to fix the things that our children are anxious about or agree to avoid the experiences they’re fearful of. But over-accommodating their anxiety can lead to further avoidance and missing out on important experiences they need and want to have. What we need to do as parents is acknowledge that there will be tension, take a deep breath, and dive into helping our children face and overcome their anxieties. Of course, the actual process of working through anxiety is often really complicated—here are some evidence-based steps to take that can help.

Step 1: Understand what travel anxiety might look like in your child

We want to be careful not to confuse normal worries with anxiety. It’s natural to have some concerns about a new experience or an unfamiliar place. But generally, with a little support from family, most children can work through worry to enjoy a new experience. Anxiety refers to really missing out on important experiences due to worries that might not distress most other children, often accompanied by physician signs of stress like stomachaches or headaches, fidgetiness, or difficulty falling asleep. Travel anxiety can take on different forms. It can look like sleep problems before a big trip. Or like increased irritability leading up to and during the travel journey. Or new or worsening motion sickness or nausea in a moving vehicle. It can even present in the form of panic attacks, with acute bursts of anxiety, a feeling of one’s heart racing, breathing difficulties, sweatiness, and/or shakiness. With all these different ways that  travel anxiety can present in children, we want to think about why they’re feeling anxious.

Step 2: Discern why your child might feel anxiety about traveling

When it comes to travel, all children have to go through a disruption in their usual routine. As adults, we sometimes tend to forget how challenging this can be for a child. While their brains are still developing strategies to cope with surprises, changing course, suddenly making new plans, a routine serves as a kind of scaffolding for their brains. It provides structure where they need it, an outline of what is to come, a blueprint of what they need to do to be okay. When our family routines are disrupted by travel, anxious children in particular can really struggle without the scaffolding that routine provides. 

Ask yourself, Do they struggle with the changed schedule of a travel day? Do they seem to miss the familiar home activities that help them regulate themselves? Do they continually ask what will happen next? With travel, children are expected to follow the “old” rules, but often don’t know all the “new” rules that travel requires.

Travel also presents new social experiences that can be challenging for children. Anxious children can find the interaction with adult travel workers and officials (e.g. attendants at the travel counter, security officials) especially difficult. Travel also involves a great deal of new social stimulation. Children will be around large groups of unknown people. They will be navigating new physical environments. There are often a great deal of sights and sounds to process. All of these new social inputs can overwhelm a child’s ability to regulate, contributing to feeling emotional and exhausted.

All of these new social inputs can overwhelm a child’s ability to regulate, contributing to feeling emotional and exhausted.

Sometimes, children can have more specific anxieties. Perhaps a fear of enclosed spaces or fear of being in a crowded area. Or perhaps a fear of flying or of heights in general. Children often struggle to put these fears into words, and repeatedly asking them why they’re anxious often yields mixed results. Parents often need to be observant, make inferences about what may be bothering their child, and sometimes even test out different possibilities. If you are noticing your child struggle with travel anxiety, try to take a deeper dive into exactly what aspects of their travel experience they’re struggling with. This will help you plan ahead.

Step 3: Prepare yourself and your child

In general, we do a lot of research when we plan family trips: What’s the best deal on tickets, where’s the best destination for kid activities? When your child has travel anxiety, you just need to add a few more items to your research agenda. Try to imagine the different stages of your journey: 

What are you going to need to support your child on the trip? 

What’s it going to be like for them in the airport or in the car? 

Are there any sights, places, or experiences that would be familiar or exciting on the way? 

What are the types of experiences most likely to be overwhelming for them? 

What’s helped in those types of situations before? 

Are there some options of calming places or activities if they get overwhelmed? 

As you go through these preparatory questions, you’ll begin to develop a Plan A and Plan B for most stages of your journey.

Okay, I know she starts to feel cooped up about two hours into the car ride, so let’s plan to stop for snacks and a stretch a little before then. If she’s still struggling, we may need to stop for an early lunch and reset for the next stretch.

As parents, we need to acknowledge that travel preparation and planning can be stressful. Coming up with great Plan Bs and letting go of your ideal timeline or itinerary can be tough. It’s important to have some space to work through that. We want to work hard to keep venting and other intense emotions to other adults, but in that context, it’s okay to share our disappointment, anger, or frustration. It’s also important to carve out time to engage in activities that you find calming or enjoyable. Don’t feel guilty about getting out for that early morning hike. It’s okay to leave the kids with another caregiver for a bit while you read a book in the sun. We need to have strategies to recharge, for our families and for ourselves.

Think about the 5 Ws! Help them understand as much as they want and need about why you’re going on the trip, where you’re going, when they’ll be doing different things during the day, who they’ll be interacting with, and what they’ll be expected to do (or not do).

As we are doing our travel preparation and planning, we can also help our kids prepare for the trip. Think about the 5 Ws! Help them understand as much as they want and need about why you’re going on the trip, where you’re going, when they’ll be doing different things during the day, who they’ll be interacting with, and what they’ll be expected to do (or not do). If you know they’ll struggle with talking to a ticket attendant or security officer, for example, help them understand the process and consider a little exposure to some of those experiences beforehand. Can you have them help you check out at the grocery store? Or approach a friendly security officer at their school?

You can also help them by understanding and recognizing “reroute” moments, times when you have to make unavoidable, unexpected, and unclear changes in plans. Before the trip, when you have “reroute” moments in your day, spend some time letting them know what’s happened, how you’re thinking through the situation, and what decision you’re making and why. Afterwards, review with them how you were able to work through the sudden change to “reroute” and get back on track. Practicing this beforehand can take the edge off some of those sudden and uncertain moments that are bound to happen in travel.

Children can also really benefit from hands-on strategies to help them calm down in the moment. Homemade “sensory calm down kits” are a great way to help a child regain control over their anxiety. Help them pack a small bag with items that provide sensory stimulation that are calming and enjoyable for your child:Have a few items to color or draw with, a few items with interesting tactile textures, or an item with a pleasant smell or a silly sound. Encourage your child to prepare the kit well before the trip and practice using it to keep themselves calm. A transitional object can also be a great tool for travel anxiety. Often soft or huggable, transitional objects are items that provide children with a sense of security and comfort. Hugimals, weighted stuffed animals, are a great example of a creative combination of a transitional object that also has a strong sensory component. Weighted objects can help children feel safe and secure in the midst of the stresses of travel.

Step 4: Work through tough moments

Despite our best-laid plans and strategies, travel anxiety can inevitably catch up with our kids. What do we do in those moments? Given the public nature of many travel settings, we as parents can be tempted to overly accommodate our children’s anxiety avoidance or irritability. Or we can respond with irritability and frustration of our own. As much as possible, we want to encourage you to allow your child to experience the anxiety, to sit with it for some time, and stick with it until it begins to fade into the background. As distressed as they may be, we can help them understand that even challenging experiences generally become less distressing with time. We can support them by helping them utilize some of their positive coping strategies or to use their transitional object, but we want to be careful of over-accommodation.

As much as possible, we want to encourage you to allow your child to experience the anxiety, to sit with it for some time, and stick with it until it begins to fade into the background. As distressed as they may be, we can help them understand that even challenging experiences generally become less distressing with time.

This is easier said than done, of course! This may mean tolerating an anger outburst in a public setting. It may mean having to witness your child in temporary emotional distress. It may mean delays or other complications on your trip. It will most certainly mean a significant expenditure of time and energy on your part! Part of navigating this as a parent is managing our expectations. If we go into a trip expecting some difficult moments, this can be a very different experience than simply hoping and expecting that “everything will be fine.” Similarly, it can be helpful to anticipate that other people in public settings may glance over at your family (or even offer their unsolicited advice!) and that we simply cannot put a lot of weight into other peoples’ opinions. The truth is that, while we’re wanting our anxious children to work through exposure, you and your family will be going through an exposure process of your own. It’s not easy, but just being able to recognize it, discuss it within the family, and crafting strategies to respond can go a long way.

Step 4: Take care of your family’s feelings after the fact

When we are supporting our children navigating travel anxiety, there are often moments of “big feelings.” If your child has reached a point of total exhaustion, you may need to wait until they’re out of the “red zone” of the emotional storm to talk to them about what’s happened, teach them regulatory strategies, or brainstorm potential future solutions. Similarly, if you have multiple children, you may need to find ways to emotionally support your other children after particularly taxing family travel anxiety challenges.

Ultimately, if we can recognize and differentiate between travel worries and travel anxiety and gain a better understanding of what may be contributing to a child’s travel anxiety, we can develop strategies that help prevent or mitigate it. If and/or when children still get dysregulated, if we can find ways as parents to help children understand anxiety’s general resolution over time, we can help them build the skills and confidence to go anywhere their travels take them in life.

“We’ll see you tomorrow??” I put on my best fake smile as I assured yet another extended family member, that, yes, our family (including two toddlers at the time) would be at the umpteenth holiday party of the season… tomorrow evening. The cast of characters would be largely the same, but the house and dinner and decorations would be different. Kind of. I took a moment to acknowledge how exhausted I felt. At balancing work and family gatherings. At the forced cheer and small talk. At the delicious meals that left me feeling stuffed and bloated the next morning. Then I looked over at my daughters, both running around, playing, laughing, and thought… “They want to go… The family wants us to go… Why don’t I want to go?” 

Why are the holidays so stressful for families?

Whether it’s Christmas decorations in stores prior to Thanksgiving or bribing your kids to be on their best behavior at public gatherings, there is no denying it—the holiday season is a stressful one for parents! It all boils down to tension between expectations and reality. All kinds of expectations (and all kinds of realities). Maybe it’s the difference between what our children want and what we can provide for them. Maybe it’s the tension between what our extended families expect from us and what we can actually deliver. Or maybe it’s the space between what we desire  of our children’s behavior and what they’re actually capable of. To further complicate things, many families struggle financially during the holidays. 

How can parents mentally address the stress?

Let’s just take a beat to acknowledge holiday stress! Yes, the music’s great. Yes, your family will make delicious meals. Yes, your kids’ faces will light up when opening a present. AND… it’s also okay to say to ourselves, “This is stressful!” or “I wish I didn’t have to go to that holiday party.” or “I’m feeling tired/drained/sad/anxious/overwhelmed.” From lack of time to financial stress to gift-giving headaches to the challenges of family get-togethers, a large proportion of us experience a spike in fatigue, stress, and irritability during the holidays. And when we feel stressed, our kids soak up that stress like the sponges they are. Not to mention balancing family and societal expectations for how they should think, feel, and behave during the holidays.

What do you want the holidays to mean for you and your family?

Underneath the sales and the decorations and the dinners, every holiday means something different to each family and even to each individual family member. Sometimes, it’s important to take some time to think about (or remind yourself) what really speaks to you about a particular holiday. Let’s take Thanksgiving. Maybe you love the intermingling of family generations, getting to catch up, regaling children with classic family stories, or getting all the grandchildren together to play in one wonderfully chaotic space. Or maybe you love sharing a long-standing family culinary tradition, getting joy out of feeding others or teaching your children how to make a particular dish. Perhaps you’re from an indigenous cultural background, and Thanksgiving is a complicated experience for your family - you may want to get together with your family, but it may not have a celebratory feel.

How can you redefine the holidays for your family?

When we get down to the essence of a holiday, there is often a difference between what society tells us the day is supposed to be about and what it really means (or what you want it to mean) to you and your family. We get so many messages around a holiday like Christmas about buying the “perfect gift” for our loved one that we may miss more meaningful or fulfilling experiences - the connection with family or an opportunity to give back to the community. One way to push back and reclaim what you want for yourself and your family during the holidays is to be explicitly mindful of what you and your family enjoy and feel fulfilled by. 

Reflect deeply about the experiences and situations that bring you joy. Talk to your spouse or children about what experience meant the most to them from previous holidays. Evaluate past experiences based not on your or others’ expectations but on the actual emotional outcomes. If we are honest with ourselves, holidays can really be about all kinds of experiences with different meanings. Reconnecting with family, spoiling each other with a little planned excess of food and celebration, sharing cultural traditions and values, an opportunity to serve others less fortunate, a chance to celebrate community, or a time to “show off a bit” and share what your children have been up to. As a family, you can make a decision that you value the experience of being together over gift-giving and find a way to go on a short trip or volunteer together. You can decide that this is an important time to update the grandparents on what all the grandkids have been up to and put on a kid-centric talent show after dinner. Or you might decide that it’s really important to you that your children understand how to prepare a traditional meal and really get them involved, take pictures or videos, and share the recipe with them afterwards.

How do you create more meaningful holiday experiences for your family?

Once you’ve identified what you and your family really want out of a holiday, you can take steps to craft experiences that align with those ideas and feelings. If your child loves hearing her grandparents tell stories from when you were a child, perhaps you can set up a time (in-person or even virtually!) for them to enjoy a snack or a craft while sharing that funny story about when you were a naughty toddler. If you feel brightest giving something back to others during the holidays, be sure to set aside time to volunteer (with your family!) If you love the opportunity to pass down cultural traditions or values, create an engaging activity that teaches those experiences in a developmentally appropriate way to your kids.   

I remember feeling homesick a few years ago during the holidays:. My girls were young. My parents lived far away. I was struggling to find ways to help my children connect with my family’s cultural heritage in the face of the seemingly more exciting Christmas celebrations—my wife is Catholic so she carried on those traditions with them. I grew up in a Hindu household, and while I remembered lively holiday celebrations growing up, I didn’t feel I had the bandwidth to fully prepare and connect my young daughters to what could be an overwhelming cultural experience. So instead, we decided to find a way to celebrate Saraswati Puja, which focuses on celebrating knowledge, language, music, and the arts, at home. We tried to be creative about what the celebration meant to me growing up and what we wanted the experience to be about for our children: A chance to revel in reading, music, and the arts!

We asked our children to find their favorite books, which we helped them read to their grandparents over Skype. We found some fun coloring sheets related to the Goddess Saraswati and had a “coloring contest,” kids vs. parents. And then we put on some catchy Indian dance music. To our surprise, our kids ran up to their rooms, found fancy, colorful Indian clothes (salwar kameez) from their grandparents, and proceeded to have an epic dance party! They insisted we record videos of their dances to send to their grandparents. Videos that they, to this day, still enjoy watching and giggling over. With a little creativity, perseverance, and adaptiveness - a new tradition was born. 

How do you minimize holiday stress for your family?

Part of navigating the space between others’ expectations and what you and your family really want or need out of a holiday is getting more comfortable with the idea of saying, “No thanks.” You are the leader of your family. You get to - and have to - decide what your family’s holiday experience is going to be like. If your children really enjoy playing with their cousins, but struggle with an overzealous aunt or uncle, it’s okay to set limits with that family member. If there are 4 separate family holiday parties between Christmas and New Year’s that tend to overwhelm you and your kids, it’s okay to let your family know that you’ll just be attending one or two (a lesson it took me a few years to learn!).

Remember that our children are sponges, and soak up the joys and worries and patterns they experience all around them. If we are hoping to help our children have a less commercialized experience over the holidays, we need to find a way to de-emphasize gift-giving for meaningful holiday experiences with loved ones. If we are hoping our children will learn to enjoy spending time with extended family members, we need to craft experiences that explicitly allow them to enjoy each other’s company. If we want our children to internalize values or beliefs that are critical to our faith or worldview, we need to get them involved in activities that help them enjoy learning those values in a developmentally friendly way.

And remember throughout the holiday season that we need to extend ourselves the kindness and respect we teach our children to embody. Give yourself some grace if you lose your cool. Remember that tomorrow is another day and you can try again. Remember that our children are resilient and it’s not one specific experience that will determine who they are, but the sum total of all the love and care and guidance you give them that will shape them. You can reclaim and reshape the holidays in a way that’s meaningful for you and your family. And in doing so, you’ll be teaching your children the value of reflection, celebration, and connection.

As parents, we learn pretty quickly that transitions are tough for kids - from getting them to turn off the iPad (when you've asked 4 times) to leaving a play date when “counting to 3” doesn’t work anymore. One of the most tricky transitions is, of course, going back to school. Even we can remember our stomachs rumbling with nerves walking into a new classroom.

So why are transitions like this so challenging? Children can struggle with the change in routine and may not have the emotional vocabulary to explain what they're feeling. Parents can feel overwhelmed by the energy required to shift family patterns to the "new normal." Children sometimes need extra emotional support and guidance from parents to manage all the ups and downs that come with these transitions. We've all been there! Thankfully, there are a few evidence-based techniques that are proven to help parents guide their kids through transitions:

Create (and stick to) a schedule

Although children often express frustration at sticking to a schedule, most parents recognize that their kids generally do better with some structure. Children can struggle with the unexpected - unknowns can transform into frustrations and fears - and having simple processes that they can predict in their day can create anchor points that support self-regulation. The part of children's brains that can help with making a plan and figuring out what to do next takes a lot of time and practice to mature. In the meantime, they need our help to provide the "training wheels" while they're figuring out "how to ride." For example, if your child is struggling to get dressed in the morning, it may be helpful to write or draw out a schedule in 15-minute periods, clearly showing them what they should be doing to prepare for the day during that time.

Figure out if it's "won't" or "can't"

Here’s a common scene in many houses during the morning rush to get out the door: your kid won’t get their backpack ready no matter how many times you ask. If children regularly struggle with a task like this, consider if it's more of a "can't" than a "won't." A "won't" means that they know how to do a task and can do it regularly, but are not for a particular reason. A "can't" means that there is something about the task that makes it difficult for a child to consistently complete. If it's a "won't," you can consider using basic reward or disciplinary strategies to address the behavior. But if it's a "can't," you may need to consider what else your child needs to understand or what help they may need to complete the task. Think about their age and development: If you're not sure what your child can or should be able to do at this age, check in with their teacher, other parents with similar aged children, or your pediatrician. Your child may need step-by-step support to get their backpack ready or tidy their room, checking in with you between each step until they’ve mastered the whole process. 

Find the “right” reward

When you’re navigating a transition like back-to-school, it’s key to learn what rewards motivate your children and what consequences matter to them. Rewards can range from simple to complex. For many children in the early school years, parental attention is enough of a reward, and we as parents need to use that judiciously. Use your attention to reward specific behaviors you want to see more of. If your child is doing well getting prepared for the school day, instead of moving on to your next "to do" or even saying "Great job!", try, "I really like how you got your backpack ready before playing with your brother." And remember, negative attention will do if positive attention isn't available! Sometimes, we really have to actively ignore the "small things" to strategically reward specific positive behaviors you want to see more of.

Open the lines of communication

So far, we've been talking about different actions we can take as a family to make transitions easier. We can also practice healthy communication strategies that help us navigate the day. If you've got a child who tends to worry a bit or lose focus throughout the day, invest some time to talk about what's to come. That could be discussing changes to the family routine or simply going through the schedule or sequence for the day. We want to do this in language that makes sense to your child and to check for understanding along the way. For example, you might write or draw out a typical schedule for the day, post it up on wall or refrigerator, and ask your child to come and check to see what’s next on their schedule with you throughout the day until they’ve got it down. If they ask questions about what a process or word means, teach them what you mean or modify it so it makes sense to them.

Validate their anxious feelings

If you find your child struggling emotionally in anticipation of changes to come, help them find ways to express themselves. Resist the "righting reflex" to fix the problem for them, and instead help them to explore what they're feeling. Share about times that you've felt apprehensive. Normalize that it's all right to have anxious thoughts and feelings, and that it's important to recognize and express those feelings to themselves and to you.

At the same time, we want to be careful about avoidance, often the "twin" of anxiety. We tend to avoid the things that we are fearful of or unfamiliar with. Sometimes this can be entirely appropriate—a child wanting to avoid talking to a new adult they've just met. But at other times, our children can become avoidant of things they don't need to be fearful of i.e., going to school, spending time with a friend, or talking with a known loved one. We want to teach them that it's okay to have anxious thoughts and feelings, but that we don't want those anxieties to be the only guides to our actions. We want them to learn that they can "borrow" strength and wisdom from trusted sources, and that they can withstand anxieties from most sources with a little practice and support.

Cut yourself some slack

It's okay to feel the weight of the emotional work of parenting. It's important to find ways to unplug and recharge, especially when you're feeling overwhelmed. We all can find ourselves losing our cool as parents from time to time, especially during stressful times like back to school. Sometimes this is stepping away from the situation to take a few deep breaths, connecting with a supportive loved one, or regrouping your thoughts and planning for the situation.

It can also be important to regularly engage in recharging activities. Generally, any physical activity is helpful. Taking even a brief walk a few times a week to clear your mind can bring more clarity and calm to parenting your child through life changes. There also needs to be a space for joy in life. When you're finding yourself drained, actively engage in something that brings some joy in your life. We tend to think that we cannot possibly make time for these types of activities ("There's so much to do!"). And yet, parenting "on empty" can be challenging and further draining. Taking a little time to find a little joy for yourself can help you reconnect with some of the joy of parenting.

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Mindfulness is one of those buzzwords that seems to be sticking. Social media platforms portray mindfulness as sitting on a meditation cushion and if you are like me, you may have seen that and thought that sitting uninterrupted for any length of time seems like a faraway dream. What does mindfulness even mean? What is it for?

Mindfulness is defined in the dictionary as “the quality or state of being conscious or aware of something” or “a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations, used as a therapeutic technique.” In thinking about our social media story of the meditation cushion, meditation uses mindfulness, but meditation is not the only way to be mindful!

Let’s take the first definition of mindfulness. I’ll paraphrase this to mean, “the state of being aware.” Mindfulness is a practice of being aware or contacting the present moment. What’s the present moment you ask? Whatever is happening right now! Have you ever been around your kids at the end of the day and as they are trying to tell you about their day, you are still thinking about a work project? (Or is that just me sometimes?)

This example is thinking about the past. Whenever we are in a mindset of the past or future, we need a way to bring us to the present. Mindfulness is one way to do just that. One strategy that I employ for myself, that I also use with any aged client, is starting small. Noticing, or being aware, of where we are (physically and mentally!), is sometimes just enough to help you plug back into the present now that you’ve oriented back to it.

Another mindfulness technique that can be useful for connecting into the present moment, is employing the senses. This is also a great strategy for getting out of your head! This is such an easy strategy to use with your kids as well. Adding this on a walk outside can produce an “Awe Walk” effect.

1) Begin with identifying 5 things that you can see
2) Next, identify 4 things that you can feel
3) Then, notice 3 things you can hear
4) Next, identify 2 things you can smell
5) Finally, notice 1 thing that you can taste

You can modify this strategy based on where you are and the age of the child. You may also find benefit identifying one thing for each sense.

The second definition of mindfulness adds to the present moment experience. In the first definition, we are simply becoming aware, bringing attention where it wasn’t before. The second adds acknowledgement and acceptance. These “A” words sound great, but what do they look like in practice? Acknowledgement points to the noticing and not actively resisting a thought or feeling. A saying I’ve heard and really taken to the bank is, “What we resist, persists.” That being said, when we can acknowledge that thought or feeling, then, it can sometimes lessen the intensity or frequency of the thought.

Thoughts and feelings, just like people, want to be acknowledged. Once we acknowledge it, we can then observe our response to the thought, such as, if it is causing us stress or if it brings us a level of relief. Another way to get to the observation piece, if we’re really struggling with a thought, is to use this phrase before a thought: “I’m having a thought that _______.”

For example, right now, “I’m having the thought that I’m hungry.” This gives me a chance to bring the thought to the center of attention and decide my next course of action. Will I ignore it, in which case my stomach might decide to make its presence known by growling, or, maybe I choose to grab a snack and then continue writing this material. Spoiler alert, I chose to eat a snack! This phrase, “I’m having the thought that _____”, creates some distance between you and the thought, leading to a less charged response. It also helps bring some objectivity to your thoughts and especially on challenging days, that objectivity can help your responses be more clear-headed.

The second piece to the second definition of mindfulness is acceptance. Acceptance is a non-judgmental way to approach our thoughts and feelings. We can practice this by labeling our thoughts or feelings. This strategy is similar to how when you are driving down the road, you may see signs for different towns. Just because you see the sign (or for our metaphor, the thought), it doesn’t mean you have to stop in the town. You can keep a neutral view as you get to your other destination (or the end of your day!). This acceptance can help us know if we need to stop and get gas (like the snack example earlier) or help you know what you need to help you get to the next moment. When we assign value judgments such as “good” or “bad” to a thought or feeling, we can get hooked to it. Acceptance, despite how we usually think of that word, means that we’re actually able to be unhooked!

You may be thinking, “All of that sounds great, but what does practicing mindfulness in this way do for me?” I’m so glad you asked. Several parenting studies, show how mindfulness has impacted their parenting and co-regulation. In a noted study, after receiving even brief mindfulness training and implementing strategies, caregivers reported decreased negativity and self-reported increased caregiver self-regulation.

Caregivers also reported that as they implemented these strategies, they noticed within their children improved interactions, decreased negative affect, increased social skills and academic readiness (Lenguam Ruberry, McEntire, et al., 2021). Mindfulness can be such an excellent practice and can build habits that the whole family can do together, while also feeling the benefits together! 

Access free mindfulness resources by signing up for a FREE Hopscotch Family account.  Learn more below!

References:

• Lengua, L.J., Ruberry, E.J., McEntire, C. et al. Preliminary Evaluation of an Innovative, Brief Parenting Program Designed to Promote Self-Regulation in Parents and Children. Mindfulness 12, 438–449 (2021). https://doi.org/10.1007/s12671-018-1016-y
• Robinson, B. (2020, November 20). What are "Awe Walks"? Psychology Today Blog. Retrieved January 7, 2022, from https://www.psychologytoday.com/us/blog/the-right-mindset/202011/what-are-awe-walks.
• Simpson, J. A., Weiner, E. S. C., & Oxford University Press. (1989). The Oxford English Dictionary. Oxford: Clarendon Press.

Let’s get this out of the way up front: suicide is a difficult topic to talk about. As a child and adolescent psychiatrist, I’ve had the privilege of sitting with countless kids and parents as we’ve navigated these conversations together. It’s not easy for parents to see their children hurting, and it’s hard for kids to share something that feels scary or even shameful. But what I have learned is that children and teens often know and can do more than we give them credit for as adults. They know when something isn’t right at home or with their friends. They can bring lightheartedness into moments that we, as parents, didn’t recognize needed them. But there are also situations and feelings that can overwhelm any child or teenager. 

When things seem the darkest, kids can struggle with upsetting thoughts—not knowing how to move forward, not knowing if they can find a way through, not wanting to stay alive to keep trying. It’s difficult to think about a child or teen contemplating suicide, but we can’t let our uncertainties and fears keep us from safeguarding their health - just as we do in every other facet of their lives. Because suicide is a very real issue for our children right now: it is the second leading cause of death among individuals between the ages of 10-14 and 25-34, and the third leading cause of death between the ages of 15-24. Thankfully, one thing kids and families have taught me over the years is that we can navigate even the most unthinkable situations, by learning about what’s happening, communicating openly, and making plans to connect with and care for each other. 

Addressing major emotional challenges with children and teens can be challenging: They  get mixed messages about expressing their emotions and how families, friends, and society will respond. As parents, we do not always know how to address such a serious topic directly and questions abound. What do we say and when? How do we navigate social media access during difficult emotional periods? When do we need to bring this to the attention of school or a pediatrician? Will bringing this up now have other long-term consequences? 

Most importantly, you don’t need to navigate these challenges alone. Hopscotch, your Hopscotch clinician, and your child’s healthcare team are here to support you and your child. First and foremost, though, if your child is having suicidal thoughts, bring this to the attention of their healthcare team now. If you’re working with a mental health provider, call them to discuss what’s happening and make a plan. Connect with your child’s pediatrician or primary care provider. And remember, every region has a crisis mental health support system. As the national 988 mental health crisis line system goes online, this may be the most useful “go to” resource to keep in mind if things are feeling overwhelming.

How to Recognize Suicidal Symptoms in Your Child

When young people are struggling with suicidal thoughts, they are often struggling with intense feelings of sadness. Depression generally presents as a mood change from baseline, but it can look different in children and teens. Children often do not have the emotional vocabulary or skills to talk about what they’re experiencing. Some may look sad and withdrawn, but others can appear irritable or agitated. There will often be a retreat from activities they used to enjoy. Depression can also impact the way we think—struggling with guilt, hopelessness, and/or helplessness. It can also change our daily patterns drastically with eating, sleeping, and energy levels. And most concerningly, depression can be sometimes accompanied by dark and challenging thoughts that can span from wishing “I wasn’t around anymore” to “I want to kill myself” to having explicit plans to end one’s life.

Sometimes we have to differentiate these depressive symptoms from emotional transitions that young people often make in their teen years, especially increasing movement away from family towards same-age friends, typical “generational” clashes about safety versus freedom, and some general frustration and disappointment with newly understood social realities. Teens wanting to spend more time with their friends and less time with the family is typical. A young person impulsively blurting out “I just want to kill myself!” in the middle of a heated argument about curfews or other boundaries may mean something different than a tearful late night conversation describing feelings of hopelessness or despair. And while as parents, we may be tempted to compare (what we recall about) our adolescent experiences with our children’s experiences, it is important to give them the space to struggle with their own realization of some of life’s “hard truths”—unfairness, awareness of others’ pain and suffering, or real concerns about how things are in the world around them. Young people finding intense ways to express these emotional upheavals - while challenging - may need to be approached differently than gradually worsening mood, worsening functioning, and persistent suicidal thoughts. 

How to communicate with your child about suicide 

As stressful as it may sound, if your child expresses they are having difficult thoughts - from “I wish I weren’t here anymore” to “I just want to go to sleep and never wake up.” to “I just want to die” or even “I’ve been thinking of killing myself” - there are ways to help your child navigate them. We need to acknowledge that this is a shocking and challenging experience as a parent. Then create the space you need to take a moment,, and then engage your child. One of the key communication principles here is to resist the “righting reflex.” Initially, spend time trying to understand what they’re experiencing, how they’re feeling, and what they’ve been doing about those feelings. There is no evidence that talking about one’s suicidal feelings makes it more likely that one will attempt or complete suicide. On the contrary, there is evidence that helping young people express what they’ve been struggling with can improve their emotional state. Even though it’s hard, talking about this helps. 

Of course, we would not talk to an 8-year old about this topic the same way as a 17-year old. If you’ve noticed your child struggling with depression and are concerned they may be struggling with suicidal thoughts, here’s what to say: 

• For an elementary school-aged child, you often have to give them a menu of thoughts or feelings before you can explore with them. “Sometimes when we’re feeling really down for a while, we can have some tough thoughts… maybe wanting to go to sleep and never wake up or wanting to not be alive any more… is anything like that happening to you? What’s that been like?”
• For a middle school-aged child, you might check for their understanding about depression first. “What do you know about what it’s like to be depressed?” If they are unsure, you may have to teach some basic concepts. After they’ve demonstrated their understanding, you can ask, “Has that been something that’s been going on for you? What’s that been like?” At this stage, you can begin to ask more explicitly about suicidal thoughts: “Have you been having any thoughts about not wanting to be alive any more? About wanting to end your life or kill yourself?”
• For a high schooler, many will have some knowledge about depression, but you can check for understanding as above. You can ask if any of their friends or peers have struggled with depression and then check to see if anything similar is happening for them. At this stage, if it is clear they are having suicidal thoughts, it is important to ask directly about any specific plans or intentions to harm themselves soon.

For any age group, if you discover that your child is struggling with suicidal thoughts, you need to dig deeper. Again, not problem-solving (yet), but seeking understanding of what they’re experiencing, what they’re feeling, and what they’re doing about those feelings. This is not the time for anger or shaming or guilt trips, but rather understanding and, of course, expressions of your love and concern and support for them. And again, this is the time to reach out to your child’s healthcare provider team to get the support and guidance you need.

What to Do When You Think Your Child is at Risk for Suicide

If your child is struggling with suicidal thoughts, you are not alone! This is a time to get your child’s whole healthcare team on board. If your child is working with a therapist or counselor, you need to connect with them first to brainstorm a safety plan and discuss next steps. If you do not currently have a mental health provider for your child, you can search for a Hopscotch clinician in your area here (currently available in Delaware, Florida, New Jersey, New York, North Carolina, Ohio, Pennsylvania, and Texas). Your child’s pediatrician can be a strong ally to assess your child and help determine next steps, especially if you are not currently connected to a therapist. 

While you are getting support in place, what should you do if you don’t feel comfortable leaving them alone? First, we want to make sure we scan the physical environment for safety concerns. If there are firearms in the home, they should be removed. All medications (prescription and over-the-counter) should be locked away in a safe or other space that is inaccessible to your child. If your child has been having specific safety concerns related to other potentially dangerous household objects (e.g. alcohol, knives or other sharp objects, cleaning chemicals, rope), these should also be removed. Next, you need to develop a plan for adult supervision. This can be challenging given the difficulties of balancing work and family life, but we need to treat this just as any other health crisis. Your child may need to be supervised by another parent, an extended family member, or a trusted family friend, who needs to understand that there is a safety concern and that direct supervision is required.

But sometimes, we will not be able to develop a safety plan that we feel comfortable with or we cannot find a way to ensure our child’s safety in a meaningful way. In these situations, it is important to know your regional crisis mental health resources. Every region in the country has access to a crisis mental health hotline. Nationally, the launch of the 988 mental health crisis number will also connect families to either regional or national systems to get support in a mental health crisis. If your child is struggling emotionally, it can be helpful to put these numbers into your phone preemptively. And of course, your local emergency response resources are available to support your family in extreme safety concerns by taking your child to your regional psychiatric emergency department or children’s emergency department or even calling an ambulance if necessary to transport you there. If there is any concern that your child has already done something to harm him/herself, it is always safest to call EMS immediately.

While this can all feel overwhelming, your efforts to prepare in advance of suicidal thoughts can help your child make sense of what is happening to them during a difficult time, ensure they have an avenue of support that is open to them, and help you understand your options if things get more challenging. Most importantly, know that you are not alone in this. Reaching out to the team you’ve assembled for your child - be it their therapist or pediatrician or psychiatrist - can help support you as you support your child.