Good afternoon.  I'm Angela Brown, Health Communication Specialist in CDC Center for Preparedness and Response Division of Emergency Operations.  
Thank you for joining us today's EPIC Webinar Supporting Children and Adolescents During COVID‑19.  Today we will hear from 
Dr. Melissa Brymer if you do not wish your participation to recorded, please exit at this time.  
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	We're fortunate to have Dr. Melissa Brymer as our speaking today.  Melissa is the director of terrorism and disaster programs of the UCLA Duke University national center for traumatic stress and its national child traumatic stress network.  In this capacity she has been involved with the development of acute interventions, assessments, and educational materials in the area of terrorism, disasters, and school crises.  She is one of the primary authors of the NCTSN NCPTSD psychological first aid and skills for psychological recovery and has served as a consultant for many federal, state, and local agencies across the country and internationally after disasters, terrorism, mass violence and public health emergency, for example COVID‑19.  She also serves as a lead advisor to Newton public schools and has established many long‑term disaster mental health programs for children and families.  She's a consultant for the United States Department of Education and a subject matter expert for the disaster mental health subcommittee for National Biodefense Science Board, the Office of the Assistant Secretary of Preparedness and Response and for Substance Abuse, Mental Health Services Administration.  
Thank you for joining us today.  Melissa, please begin.  
	>> Thank you so much, Angela.  I appreciate the invitation for today and for all of you being with us so that we can talk about what are those ways we can support children and adolescent during these times.  Next slide.  
	Angela mentioned that part of the NCTSN which is the National Child Traumatic Stress Network, our network is funded by SAMHSA, and our mission is to raise the standard of care for all types of children who have been impacted by a trauma, whether it's a medical trauma, child abuse, physical abuse, community violence or in this case a public health emergency such as COVID‑19.  Next slide.  
	Our network is a national network.  We actually have currently as of today 116 centers currently funded by SAMHSA.  And as you can see we're across the map.  We originally started in 2001 with just 17 sites, so it's been really exciting to expand our mission and our growth.  
	Next slide.  So you know, when back in early January it was important for us to be thinking about how will this pandemic impact different child serving system, whether it's our child welfare, our juvenile justice residential programs, our acute interventions, our schools, health care and mental health systems, even our military and veteran families.  And with that, we had to think about not every child is going to be impacted in the same way.  So what are some of those considerations that we have to keep in mind, those developmental, actual, ethic, racial impacts, other health comorbidities or disabilities, those that have had trauma histories.  And we've been trying to keep this in mind as we create guidance to help support families during this time.  
	Next slide.  So you know, as you all know, there's such unique aspects to COVID‑19.  There's the invisible threat in terms of who's infected, who's not, specially if you end up testing positive and have no symptoms.  
	We still worry and many of our families worry how bad will it get in our communities, how long will this last.  And because there's such a global impact there's no community who has not been touched by this.  
	So we need to keep that in mind as we're creating programs and support services for our kids and families.  Next slide.  
	  And so early on in this network, we really tried to take a snapshot of how has child serving systems in our kids been impacted by COVID‑19?  Very early on, with we've had to quickly adapt to services being delivered by telehealth.  We've had to make sure there's additional knowledge and education about traumatic stress and losses.  
	Our schools had to quickly remove to remote learning, and even now have to think about different modalities of teaching, whether they're going to start off remote, whether they're going to have to have different tracks.  Some of our schools are thinking about 100 percent remote for some kids and some kids might have a hybrid or be able to come back to school full time.  
	But having to negotiate what are those safeguards to put into place to everyone can be safe.  We've had to think about what services have been limited from our child welfare to our foster care and even our transitional age youth and thinking about some of them have described 'that health care access has been reduced, especially when there's been significant community spread of COVID and we're hearing more and more about the level of impact to our providers and also them having to evaluate their own risk of themselves of being exposed as well as the risk to family members.  Next slide.  
	We've heard very clearly that there's been risk to congregate living facilities such as our.  Some of our child populations especially some that were already vulnerable are immigrant and unaccompanied alien children, children with disabilities.  And I'll be talking more later on about some of the additional risks as well as some of the impacts to our minority groups, including our black families, our families of American Indian native communities.  And in particular, there's been an additional need to get evidence based practices out there.  But our providers have really had to think about how do we actually train during these times using these learning platforms but also thinking about how do we enhance adult learning principles as we're making sure that we integrate these practices on an online platform.  
	Next slide.  
	And so we really need to make sure that we 
think about and discuss the health disparities in vulnerable populations that are being more at risk.  And it's been very clearly a documented by CDC and others of the disproportionate rates to black, Hispanic, Latino and American Indian Alaska natives.  There's been many different reasons why.  But we also need to appreciate that many of these vulnerable populations are part of works fors that are deemed essentially and that may not be ‑‑ they may not have that PPE available to them to help them with safeguarding.  So we really need to think about how we all play an important role of addressing disparities during this time of COVID.  
Next slide.  And so it's important to reflect that our kids are handling things in different ways.  Some of our kids have appreciated this family time that we've had that some of them are saying I don't want to go back to school or to preschool, that I'm to okay with staying home with everybody.  
Other kids, like our friend Ben here is saying you know what, things aren't going so well.  Mom thinks she has it under control but she is' pretty stressed out and not all of us have been great at becoming teachers and helping to navigate some of the home schooling that's been going on.  
	Next slide.  And for those of you who are parents, having to juggle being a parent right now, being a teacher as well as doing your jobs and many of your jobs have become more stressful in this and having to navigate sometimes your kids shows up to some of our Zoom discussions, just seeing how difficulties.  
	And you know, sometimes families have worked well‑being together and sometimes especially our teenagers are really missing their friends right now, and there's additional clashes that are going on.  Next slide 
	So you know, thinking about we're all impacted by this.  So what would your quote be right now?  Are you one that is thinking things are going well or are things a little bit stressful right now, especially be the return back to school?  
	Next slide.  So I think it's important to acknowledge that all of us are impacted in some way by COVID.  We need to acknowledge the uncertainty is stressful and that we can't guarantee how long this is going to last, that the anxieties that our kids are expressing, that you might be expressing is appropriate during these circumstances, that frankly, we are going to have our good days and our not so good days and that we're not going to be perfect in everything we do right now.  And that being deliberate in balancing work life and home a life is essential especially for those who are still who are still working at home and trying to think about ways to create those balances and supports right now.  
	So as we've been developing our programs and our services for children, we've really tried to keep in mind five basic principles of interventions, and you'll see helpful an many colleagues have created we had a task force back in 2006 that culminated into a paper.  So if you think about the first one the first intervention strategy we're keeping in mind is safety.  What are those things we need to convey to our families, to our communities about what are the protective health behaviors that we need to be doing to ensure reduction of exposure?  We have to continue to monitor what are some additional adversities that are attributed because of COVID‑19, whether some of our families are experiencing economic hardships, the health disparities that I addressed.  We know that some of our colleagues that work this child abuse field talk about there has been additional calls and cases during this time.  When there these economic hardships we are concerned about suicides and as well as the stigma of racism that has been pretty clearly documented in many communities.  
	So making sure that we communicate what steps to take and how we can all support ourselves and making sure that we're limiting our media viewing, especially if it's causing additional distress amongst those that we're serving and those within our family.  
	Next slide.  The second intervention strategy is calming.  So we know that in any type of disaster, especially in COVID, we know that there's additional distress, anxiety, that some of the people we're working with are dealing with bereavement and we have to provide basic education on what are some of the trauma and grief reactions.  How do we think about utilizing anxiety management techniques throughout our day.  
And when and how can we actually make sure that services are provided to those that are most impacted by some of these adversities that I talked about.  And so these broad based educational platforms that all of you have been making sure gets out is critically important so that we can highlight what are those calming strategies that can be used to help mitigate some of that distress that some of our families are experiences.  
	Next slide.  So safety, calming, self efficacy.  Self efficacy is really promoting that each one of us and each one of our communities has strengths.  How do we tap into those strengths even in these times of uncertainty?  How do we help people to bring ‑‑ come together 
and connect people with the resources that they may need?  And we saw this early on with some of the food bank drives that were created in many communities.  And with that, how do we tap into when we have to make decisions about the future of our communities about reopening of our businesses, of our schools, that we use the public in that decision‑making because when we have more input, those policies and procedures are more likely to be effective.  And so making sure that we tap into those different strengths that we have in our community, which includes tapping into those promoting activities that truly help others, and we've seen that throughout the last few months, whether it has been those food drives, encouragement of grocery stores and other stores to have senior hours so that they can shop 
with a little bit more protections, having those community meetings so that there can be discussions of issues that are happening in the community that needs to be problem solved.  These are all important strategies to be thinking about as we're moving forward with COVID.  
	Next slide.  Connectedness is our fourth and this is the one that has the most research to it.  And this is the one that has been really challenged in COVID, because although we talk about social distances, we really were talking about physical distancing.  So there has had to be truly problem solving, how do we stay connected?  And we really want to be emphasizing how do we stay engaged right now and making sure there's those quality engagements and that sense of solidarity to help us through these hard times.  
Next slide.  
	And finally, that last category is hope.  In these times it's important to remember that COVID and the current struggles that we're dealing with are temporary.  We don't know what temporary means right now, we don't have an exact timeline, but we know that other communities and other times we've been through hard times, how do we help to highlight how families have gotten through those hard times, how communities have gotten through those hard tiles and thinking about ways that we gave people affirmation, gratitude, support they can get through this, help them to hold on those elements that the are controllable and let them see that some of their goals for their future can still happen.  They might be adapted somewhat but allowing people to still have those visions.  
	So taking these principles in mind, the network has created several resources.  And you can go on the bottom of these slides you'll see that our website is NCTSN.org and there's a long description of where to get this resource.  All you have to do is go to our home page 
and there's going to be a box that says COVID‑19 resources.  Everything I'm describing is in that box.  So you go to our home page and it's right in the COVID‑19 resources.  So it's been really important to make sure we communicate with families how do we talk with kids, even our little kids about what's been happening and why there's been changes within our communities because of COVID‑19.  This includes how do we clarify miscommunications or misperceptions or information that's out there.  Checking in to see if our kids have been exposed to any racism or stigma because there might have been a family member who has been sick or they're an essential worker and there's confusion about your child's safety.  Validating our kids' feelings and thinking about what are helping to make sure those good practices are happening, but also we want kids to be kids.  So one of our resources is how do we make sure that kids are still playing and doing those activities?  
So we have a whole list of fun things that kids can do.  Some of that is with technology, some of that is let's put that technology away for a little while and let's go back to the basics of some of those good old games that we used to love when we were kids.  And there's some resources on how to start to wind down because every family needs that routine of calm down quiet time.  
Next slide.  We also know that we have another resource on supporting children of building in more details of what we can do to support our kids during this time.  That piece of creating a new routine is essential.  And even though we might have to adjust this routine at different points of time during COVID, keeping as much of that routine together is important.  So if school's about to resume, what's that new schedule and how do we make sure that we communicate that new schedule with our kids, but also highlighting that we have to stay flexible during this time, that there might be adjustments to that schedule.  We really do need to acknowledge the misted developmental milestones that might have occurred or coming up, so those birthday parties they were forward to, some of our kids had to miss their prom or graduation and they're starting to wonder if they'll be able to actually go to college in the fall.  Schools have done a wonderful job in many situations of adjusting or trying to make the most of these celebrations, but we still have to acknowledge that this has been tough on our kids and making sure that we understand some of the challenges that they're going through, that we reassure them that we're there for them, that others are there for them, even if they can't be physically with them right now.  
	Next slide.  As some of my colleagues always talk about we need to make sure that there are resources for our young kids.  So I don't know if you've gotten to see, but we have a preschool series called Trinka and Sam.  It's an e‑mail book that's downloadable.  And you're preschool mice have been through a hurricane, an earthquake and a wildfire and Trinka and Sam are now dealing with COVID.  It's a great way to talk about 
what's going on in our community.  Sam's mom is an essential worker, she's a health care worker and why has there been changes when she comes home or that sometimes she decides not to come home because she doesn't want the expose the kids to potentially COVID.  
	We had to do something a little bit different with this series.  And our Trinka and Sam has an addendum and it's called the Trinka and Sam questions.  Our kids have lots of questions.  So you can take those pages for those kids who want more details from a scientific way and you can add those pages to that book.  Some of our kids have had family members who have been sick or who have died.  And you can add those pages in, too.  If you're kid has not experienced that you may not want to add those discussions with your kid, and so that's why we wanted to have that in the addendum and not the full picture ‑‑ the full book.  So you can see that it has been translated in multiple languages.  And again it's downloadable from our website.  Next slide.  
	So it's also been important for us to think about how do we make sure we think about keeping routine, helping to support kids as much as possible, but with that, there are going to be times that kids have additional worries or additional reactions.  And so our colleagues from Yale University, one of our partners in network, have created a resource on some of the worries, some of the clingy behavior you might be seeing in some kids, the sleep difficulties that have been described.  And they've created a resource on what are some of these reactions, why your kid might be experiencing them.  And then some basic tips on what you can do to reduce these reactions.  
This resource is both in English and in Spanish.  And again you can grab this from our website.  
Next slide.  I think it's so critical when we're talking about supporting kids, we also need to make sure that we're supporting us as add doubts.  So our Yale colleagues have also created a resource on if you are experiencing certain types of anxiety, we're hearing from so many people that sleep problems is something that's predominant amongst many of us, that we might be having our feelings, our thoughts are just feeling overall loneliness or social isolation.  So again this resource is what are some of these reactions 
how will I be seeing these behavioral changes, maybe in my body, in my behavior, in my thoughts, how do I cope, but also why does it work?  When we understand why something works we're more likely to actually make sure that we implement them.  
And so again, this resource is both in English and Spanish.  Next slide.  And so I think it's also important when really highlighting ‑‑ I hope you guys each take away what's one thing you would want to share with others that you're doing really well?  I feel like I'm being an optimist.  I'm able to each day teach my child something.  Is there something that we're appreciative of that we're seeing good things in our community that we want to highlight.  Do we want to be promoting our strengths it's so important that we show ourselves gratitude and kindness during this time and not always look at the negative things of how we should be doing stuff versus the good stuff that you are doing.  Next slide.  So many of our people that we work with are dealing with grief right now.  There's been significant death because of COVID‑19.  So we needed to create a resource to first how is the death from COVID‑19 different from other deaths?  And we all know that some of those good‑bye rituals, those mourning traditions have had to be adjusted because of this public health emergency.  
	So how do we help kids with still being able to honor the loved one that has died, acknowledging the difficulties because they haven't been able to go to the hospital to say good‑bye to their loved one.  They might not have had some of those funerals.  And are there things that can be done to adjust to allow kids to get that support that they need during this time?  
Is there ways to problem solve ways to still say that good‑bye to potentially have those write a letter or those things that might help to provide comfort for kids.  So this resource is something to help navigate through some of those adjustments.  Next slide.  
	With COVID, there's been significant economic hardships, and I don't need to describe to you just how prevalent this is.  So it's been important for us to have a series of fact sheets for our community leaders, for our parents, for our educators, including for our older youth.  So our high school, college age students.  And we actually took those five principles that I talked about before, safety, calming, connectedness, self‑efficacy, and hope.  And we put those for our economic hardships.  How is safety being impacted, including being thoughtful that when there is those financial gaps and those financial concerns, 
are their basic needs being met?  Is there concerns about mental health and potential increases of suicidal ideation because there's that fear that hope is going to still be there.  
And you'll see there's tips on how do we help people problem solve and get the support they need, see some of the temporariness of this and find other ways to get their needs met during this time with this economic financial difficulties.  
Next slide.  Schools, huge topic right now.  And they're subject diversity on how cools are going to look in the next couple of weeks to the next month.  But we all can agree that we want the best for our kids, we want the best for our educators.  So it's important for us to have a trauma informed lens on how has COVID impacted our kids, how do we make sure there's that well‑being for our staff and students.  Is there ways to even remotely think about how do we adjust learning to bring in some of these social, emotional elements.  Those kids who have had additional adversities, both from trauma and a loss lens, are we making sure we give them services, that we provide education just like we have been during these times, but the schools to educate why are we feeling this way, what are some of those needs and what are those evidence based treatments that are available either at school or in the community to address some of these issues?  And so we have a resource that spells out some of these trauma informed perspectives, including making sure that we're promoting cultural responsiveness during these times.  Next slide.  
	You'll see here we have some resources for our juvenile justice system, from our judges to legal professionals and court personnel who if we make sure that they understand what are their safety concerns, what are things that they can be doing for themselves as well as for the youth that they serve and then thinking about all the supervisors to the youth to the front line workers, again, what are those steps that we can be doing to enhance each of us that are working in those systems?  And so some of you might be interested in these resources.  Next slide.  
	I mentioned with the economic hardships that during these times we have to be making sure that how do we support our youth who might have some suicidal ideation?  And so one of our colleagues from both UCLA Duke has actually created a resource on how the actually do assessments of youth who might be suicidal using telehealth.  So some of you might want to make sure you have that guidance as well as thinking about how some of our youth such as our LGBTQ youth might be more vulnerable during this time, what are ways we can to be doing outreach and how do we be sure that we're assessing for suicide and supporting them during this time.  When there has been a suicide that's a completed suicide, how do we support those families with that death as well.  And so you'll see that we have different resources both how to assess and prevent as well as if there was a completed suicide.  Next slide.  
	I think it's been absolutely critical that we make sure that we provide support for families who might be experiencing intimate partner violence.  And so we have a fact sheet that are a ten part series that we just translated into Spanish about ways that kids might be impacted by intimate partner violence.  Coping strategies that can be used and what other resources are available.  So make sure to take a look at those resources.  
Next slide.  
	I think it's absolutely critical we're talking about suicide, domestic violence, child abuse, that we make sure we educate everyone in our community that if they can't get access to 
mental health provider, that there are amazing hotlines that are available.  So we have that suicide prevention life line, the disaster distress hotline.  There are some that are specific to certain populations, Strong Heart are for Native American help line and the Veterans Association, has a veteran's hotline that is geared toward our military veterans.  So it's important that we also educate that if you're in distress, get help.  And there's resources that are available now so that you can start that journey of getting help.  Next slide.  	
And with this, it's been critical to think about how do we ‑‑ even if we are supporting our communities or if I'm actively working with certain clients, it's important in this time to stop and see how is COVID impacting.  
So many of you who do this work it's important to think about psychological first aid, which is that early intervention that makes us ask those questions.  Am I making ‑‑ am I getting my basic needs met?  Do I have difficulty coping right now with some of my reactions and I need some basic support?  Do I need help problem solving, reconnecting with some of my support systems?  And so PFA does a great job of this.  I know there was a talk that SAMHSA did that covered psychological first aid in more details.  Our website has the English version of manual as well as the translation.  And we do have an online course that's free on our learning center.  And we also have a mobile app for both the iOS and Android mobile devices.  So I would say take a look at that and think about encouraging your team to take the online course.  Next slide.  
	So COVID is ‑‑ COVID we are dealing with changes in our community, where there might be surges that the we need to be thinking about, what's happening now and some of those urgent needs of those that we serve.  But then we also have to support families with some of the secondary adversities that might have because of the economic impacts.  Their jobs might not have come back.  Some of their social relationships might have been strained.  So skills for psychological recovery is for that intermediate intervention, it's when we have that time for a little bit more support with somebody to help them truly problem solve, ways they can get their goals met, making sure that they're doing those things to take care of themselves.  Back in March, we all the launched our online course.  
So if you haven't had a chance to take a look at it, it's good time to take a look at it.  So again the SPR manual is on our website and the learning, again, these are all tree resources and you get CE credits as well by learning a little bit more about skills for psychological recovery.  
And thinking about those skills that you can provide those that you're serving to help with some of that distress and increase positive coping.  Next slide.  
	So I'm just nearing our end so we can have some discussion together.  But I always think it's critical that we take that moment and making sure that you're taking care of yourself during this time.  So I always, since I'm a school and a kid person don't forget your ACCs.  Are we think about awareness, are we actually doing those body scans of what kind of stress ‑‑ ABC, what kind of stress is your body experiencing right now?  Are you doing things overworking, overeating, ignoring your feelings because the stress is too much right now.  Are we then thinking about the B, the balance.  Are we creating balance between home life and work life.  Are we doing those things that we're intentionally doing those things that enhance well‑being.  Every night I make sure I go outside for a walk, that I intentionally take those breaks throughout the day, even if it's just for a minute so I can reset my cognitions.  
And that we really need to think about how do we stay engaged even in this time that our work setting might be altered.  And so regularly connecting with co‑workers, with friends, people of our faith, using time ‑‑ making those connections and frankly celebrating success.  
It's easy for us to look at how much work has to be done, but don't forget what you have done and will be doing and the changes that you're making in family's lives in and in your own life right now.  So I think it's important that we attend to these aspects.  Next slide.  
	And praising yourselves for the good job that you are doing and making sure that we praise our parents and care givers for the roles they've been doing.  And with that I think we have plenty of times for questions an answers and look forward to a great dialogue.  
	>> Thank you for that presentation, Melissa.  Jonathan, will you read the first question, please?  
  	>> Hi everyone, thank you.  Yes, we have some excellent questions, too.  
	Melissa, the first question that came in is kind of asking to clarify about what is meant by survival brain, emotional brain and executive brain.  
	>> I'm not sure I have those answered right this second.  (Laughter) 
	>> Sometimes that happens.  Just if you could follow up by e‑mailing EPIC at CDC.gov, we can follow up on those questions.  
	>> Definitely.  
	>> The next question was can you suggest ways volunteers can help kids right now given that they can't be with them physically?  
	>> I think there's a lot of different ways that we can volunteers can participate.  So I've seen for example some communities have summer camps that are remote right now and they're all looking for volunteers.  I know that some organizations are wanting to, how do we get the word out to our youth about that we have there for them, that there are supports for them?  And so sometimes some of my wonderful volunteers know how to use some of these technologies and as much as I wish I could, I'm not ‑‑ I'm not a TikToker for example, but some of our volunteers have these talents that we can get some of these messages out to those platforms that kids are using so we can make sure that they know that we care for them, that we want to support and that there are things they can be doing to take care of each other.  So volunteers should definitely be willing to participate with great organizations that are doing this kind of work.  
	>> Great.  Okay.  We had one questioner ask if the resilience of children has changed over time, if they're more or less resilient than they used to be?  
	>> Sometimes we feel like our resilience has changed.  And so that goes back to my concept of hope.  We're hearing a lot of people use the word exhaustion right now.  
And so sometimes we have to be reminded of those strengths that we have.  And so I will go to that child or even to that parent, what skills have you used in the past under other times you've been stressed or other times there's been something difficult that happened in the family, are you using those right now?  Are they working?  And many times we'll find that families are using or do have creative way, they're just forgetting that they have those.  And so sometimes we just need to give some of those reminders.  The uncertainty of how long do I have to maintain this is also making people question their resiliency.  And sometimes we might have to help people to chunk, okay, what your routine going to be from now to ten of the year for the school year, what's that going to be like.  Rather than having to have a plan until the end when we're not sure that looks like right now, 
so we might have to chunk time so it feels more manageable to get through this everything.  
	>> Okay.  Thank you.  Our next question was about setting family cleaning schedules.  And I wanted to bring that up because I wanted to know if it's helpful for children to be a part of sort of the survival routine of the family?  
	>> That is definitely in our family handout that part of that routine is doing chores.  I know that there's any kids on ‑‑ listening they probably have shaking their head like no ‑‑ but we all have to show that we have a ‑‑ we all have part in supporting our family.  And a kid's task is those chores and helping them with developmentally appropriate but having that as part of that routine.  And it's sometimes also as those chores change as they get older, life skills so they can do these tasks when they're out on their own.  So absolutely those have to be there 
	>> And all the parents are watching now going yeah, but getting them to actually do chores, you continue understand.  
	>> (Laughter) Well, that's different.  Absolutely.  And that's where sometimes we have to do that positive parenting and praising when they start those chores or when they do that, how do we highlight I love how you started cleaning your dishes after dinner, I really appreciate you doing that, because sometimes when we're under stress we focus on what they're not doing, so sometimes we actually have to make sure that we're promoting and praising stuff they are doing, even if they didn't quite finish it, praise that they started it so that kids want our positive attention and if there's ways we can be praising some of these tasks you'll see those behaviors will increase.  
	>> The next question asks about convincing children to do certain things to embrace the sense, to own protectiveness toward their grandparents who may be more vulnerable, can you speak to that?  
	>> Absolutely.  First we have to acknowledge that for some of our kids they have strong connections with their grandparents, they miss their grandparents.  Part of not wanting to protect is they're missing that bond.  So can we help to problem solve things they could be doing.  
If Zoom or FaceTime is not working can they send letters.  Can they bake things and put it outside their door.  Because some of it is I just miss them.  So if we don't acknowledge how much they're missing and how much that hurts, they're not going to want to follow through.  So I think we need to first acknowledge and then highlight that this virus impacts certain people differently and that ‑‑ and it's very clear that some of our elderly have to be protected and that we can't be with them in that same way right now.  And having those discussions, some of the kids want to know why and that's why for example Trinka and Sam with we end up adding in more details because how the virus is spread, why are more people more vulnerable because they want to understand a little bit more.  So if they understand why this is actually going to protect their older adult, what they can I do in the mean time to make sure they still have that bond and that connection, and is there other things, activities as a family you can be doing so that you don't miss those connections altogether.  And we have to acknowledge to our older adults, too, that this is hard on them.  I've heard from many grandparents who are just devastated that there's a new family member been introduced to their family and they haven't been able to see that baby and not have that bond, and how difficult it is.  So we need to make sure we're acknowledging that on their side of they know what they're missing and how hard it is.  
	>> And the next question I was going to read asked what can I do about helping my grandson understand that he can see me but not touch me at this time, because, I mean, they hug a lot?  
	>> They do hug.  So is there a special stuffed animal that you can each have, for example, depending on how old your child is, and that you hug that stuffed animal and then they hug their own stuffed animal.  I've seen certain family members will instead of hug is there now a sign or something that you guys both do that shows that affection but might not be the hug.  So we can't have the hug, but is there other endearments that the you share that is your sign of showing love and support, or is there a song that you guys would sing to say hello or good‑bye.  Kids like those little special signs that can have that connection.  So let's not take it ‑‑ not the hug shows we care about somebody but it doesn't mean we have to take that away completely, we can adapt it and I hope that's where we can get so they can still have those beautiful connections together.  
	>> You're suggesting get matching for young kids ‑‑ get matching stuffed animal and like this stuffed animal for you that's me and your stuffed animal is you in my place and then you hug the stuffed animal at the same time.  What a great idea.  
	>> (Laughter) 
	>> Okay.  
	>> And it gives you that comfort when you can't have that hug, you have something to squeeze as well which is what kids need sometimes.  They're sad that they couldn't have that but at least they have that other object to hug right in a that is safe too do.  
	>> That is really a great idea.  Mandy works at a public library and was asking if it would be okay for them to print and share with their patrons some of your materials.  
	>> Absolutely.  We have seen librarians, you guys are our biggest advocates of getting messages out to our families.  So I hope you do.  And Trinka and Sam, a lot of libraries have used Trinka and Sam, too.  
	>> Okay.  So to that end Linda was asking about sharing the slides, and I assume other materials as well with school personnel.  So I wanted to add to that.  Can you make suggestions for sharing some of these thoughts for parents to encourage their schools to adopt some of these practices?  
	>> So I think there's a couple of strategies that I've seen communities use.  So PTAs in many school districts have a big voice and so PTAs sometimes have newsletters, even electronically now days where messages can get out to other parents.  And there can be connections to the resources.  We can be encouraging that school websites a lot of times have community resources.  So are they linking to these resources or others that you might know of that talk about how to support kids during these times?  So are we making sure that there are those linkages to your school website and also any kind of mental health authority or community based mental health practice that they can also be linking to them.  
Social media I know is a positive and a negative, but we can also help our schools get messages out, hey, we know that times ‑‑ this a stressful time to make decisions about what type of placement you want for your child when some school districts that are making you choose between all completely online or a hybrid.  Can also be ‑‑ I hope you're taking care of yourself.  So we can help schools to make sure that there's the ‑‑ we get that this is stressful decision‑making, here's things you can do the take care of yourself and make sure we add those types of messaging and then connect to resources that the help with positive coping.  
Right now is just make these decisions.  And I think we can encourage our school boards, our educators, let them know there's these additional resources and even creating a couple of these messages.  
	>> Great.  Thank you.  Going to take one last question before we close out the Webinar.  This questioner is asking a question that I actually share anxiety over this, by is that the social isolation could be helping ‑‑ could be causing children to become more socially awkward because they're not having that practice.  
	>> Absolutely.  I have a few kids in my practice or that are anxious kids and they love being at home right in a.  And they've told their parents they refer the remote learning ‑‑ prefer.  Not because it's the right thing but they have a comfortableability.  So part of what we need to be doing and school counselors will need to support kids on how to actually reintegrate and helping them make sure that they don't stay socially isolated forever.  There is this temporary piece of this, but we actually have to spend time for those kids that are in this comfort zone and we need to make sure they get out of that.  
so just as we do with anxiety treatments, helping them to get reengaged, how do they maybe participate in sports when it's okay or different clubs or getting involved in different ways in the community, think we have to really look at that engagement piece and make sure that they don't stay disengaged.  
	>> Okay.  That's great.  Well, thank you.  And looks like we're kind of running low so I'm going to toss this back to Angela.  Angela?  
	>> Thank you again for joining us for today's Webinar.  If you have additional questions you may e‑mail them to EPIC@CDC.gov.  As a reminder, today's presentation has been recorded and you can earn continuing education units for your participation.  Please follow the instructions found on emergency.CDC.gov/EPIC.  The course access code is EPIC 0722 with all letters capitalized.  Again, we'd like to thank you for joining us today and have a wonderful evening.  Good‑bye 
(Time ending:  3:57 p.m.)