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We Skipped a Step

In April of 2020, the world realized that COVID-19 was not going away. The phones in my office started ringing, and haven’t stopped since. The mental health needs of children, high before the pandemic, seem to have skyrocketed. Maybe it’s that COVID took the cork out of the bottle, and parents were seeing these symptoms for what they were. Maybe it’s that rates of anxiety, for one, have been climbing in children for decades. Either way, the child mental health crisis is not the focus on this post today. Instead, I wanted to talk about what I’m seeing in my office today:

Higher rates of kids with school refusal than ever. While I used to get just a few calls about school refusal cases a year, now they come in way more frequently, and with a higher acuity.

More severe symptoms of anxiety and related disorders, in younger and younger children.

Middle school children with major deficits in social skills, in the absence of a clear reason why they should be missing these basic skills.

Teens want to make plans with friends but just don’t know how, or assume that no one wants to hang out with them so they don’t make efforts to get together in person.

It seems like, at almost every developmental stage, children are missing some key developmental milestones - things that they would naturally achieve but don’t seem like they are.In my new book, Parenting Anxious Kids, I start each chapter with a list of things that are considered normal for that age and stage of development. It seems to me, however, that kids are not meeting these developmental norms.

My guess is that it has to do with this missing step.

The pandemic caused this weird rift in space and time, where the days repeated themselves, going somehow extremely slow and fast at the same time. For adults, life has largely shifted back to normal. Kids are different, though, because development builds on itself. In my anxiety work, we talk about a relationship between anxiety and developmental milestones such that the more anxious a child is, the more they avoid and withdraw. Because kids are learning so much in such a short period of time, this avoidance happens in a developmental context. As a result, kids miss out on important skills while they’re attending to their anxiety, which makes it even harder for them to catch up with their peers. Take this example: Teenage Craig oversleeps and doesn’t try out for the soccer team. Because of his anxiety in social situations, he avoids going to meet with his coach and explaining the situation, despite the fact that the coach would most likely be understanding. Therefore, Craig doesn’t have that corrective experience, learning what happens when you need to try and fix a mistake. The problems compound because he now doesn’t have access to all that social reinforcement that being a part of a team might provide. This leaves Craig even more anxious about what to do next time.

I believe that this same process happened on a much grander scale due to the COVID years. Instead of only anxious kids, like the ones I see, getting caught in the trap between development and missed skills, leading to deficits that are hard to overcome and grow over time, now it’s all kids.

Kids and teens missed out. Then they were dropped right back into the world and told to catch up on two years of social context as if nothing had happened, and it seems like they just don’t know how. I’m not sure what the solution to the missing step problem is. In my office, we teach anxious kids practical skills based on evidence to help them increase their willingness to do uncomfortable things and live meaningful lives. But how do you scale interventions for a generation of kids? And would it even work if we could? What I do know is that we need solutions to bridge this gap, and help kids account for their missing step.

by Regine Galanti, Ph.D.