The Argentine Society of Pediatrics (SAP) warned that the isolation generated in the months of the pandemic is manifesting itself in the health of children and adolescents, since a significant increase in cases of various conditions called by specialists “functional disorders” has been seen in the clinics, since they do not have a specific organic origin. These symptoms are linked to changes in daily life, loss of routines, schooling from home and the restriction of face-to-face encounters, which are added to adults who are often overloaded with tasks or worries.
From the SAP recommended that parents and relatives accompany and support the child in this pandemic setting, in addition to visiting the trusted pediatrician, give rise to the listening, talking about emotions, limiting the use of screens, promoting play, sports and recreational physical activities. Encourage spaces for dialogue and time shared with the family group. Reinforce self-esteem, be careful with criticisms of devaluation and rigid behaviors in parenting and avoid overprotection that leads to dependency, promoting the progressive autonomy of the child or adolescent.
The doctors pointed out that the intensity of virtuality and the close encounter with Covid-19 infections generates an impact on the emotional state suffered by children. In the doctor’s offices, small children with abdominal pain, headaches, pain in the lower limbs, in the chest area, among others, appear and disappear as a response of the body to chronic stress situations, without having a specific organic origin.
“When stressful situations cannot be verbalized, they usually express themselves with symptoms such as pain, without a demonstrable organic lesion. This is called ‘functional symptoms’. When they are intense and affect daily activity (such as eating, sleeping, playing or learning) they become disorders and often motivate medical consultation. Some families have a greater tendency to have functional symptoms, “he explained. Juan Pablo Mouesca, pediatrician, child and adolescent psychiatrist, member of the SAP.
The medical specialist in childhood and adolescence Ángela Nakab He added that “in children and adolescents, so-called somatic complaints or functional symptoms are observed, which is the way the body expresses what it feels. The boys have immaturity of their psychic apparatus, they are in a stage of continuous development and they live daily demands, challenges and needs ”.
“In stressful situations they use their resources to face them, always supported by the support of their attachment figures and it is important to contain parents and pediatricians and that be attentive and can observe these demonstrations and offer support to resolve them “, Held.
Within the framework of the restrictions resulting from the community spread of the coronavirus, the Secretary of Childhood, Adolescence and Family of the Ministry of Social Development of the Nation published the Guide Emotional impact in pandemic – Guide of resources for the emotional containment of girls and boys from 6 to 12 years old.
There it was already mentioned that the “Preventive and Obligatory Social Isolation” (ASPO) as the Preventive and Obligatory Social Distancing (DISPO), constitute a deeply complex situation, which it affects our health, our work, our relationships, our routines and care –among many other variables– and has a strong impact on the emotional states of children, adolescents and adults ”.
Among the profound changes in daily life, the specialists mentioned the loss of habitual routines, schooling from home, the restriction of face-to-face encounters, adults overloaded with tasks or worries, the intensity of virtuality and the close encounter with others. contagions by Covid-19, and assigns them a leading role in the impact of the emotional state suffered by children.
“Uncertainty, economic problems, unemployment, COVID-19 disease, mourning for the deceased, lack of physical contact with family and friends and work within the home are factors that affect the entire family group”, added pediatrician Marta Chorny, member of the SAP’s Ambulatory Medicine Committee.
“Parallel, caregivers have less capacity for restraint for children, and these have fewer places to be contained: schools, early childhood centers, clubs and religious places are not available for the meeting or they do so in a reduced way ”, Mouesca pointed out.
At the same time, the very dynamics of the pandemic limit the resources for the care of these health groups because the care centers, such as Hospitals and sanatoriums are specially equipped to care for COVID-19 infections to the detriment of general care.
In this framework, the mental health care centers do not attend in person or do so in a spaced manner and, at the same time, there are few places of psychological care.
The SAP also mentioned that “even, the intervention programs in the field -that is, those that go to the homes- and the organizations for the protection of the rights of children and adolescents (NNyA) such as the zone ombudsmen or local services protection of rights, in few cases they maintain a face-to-face service. In conclusion: there are more stressors, but fewer places where this demand can be heard and adequately attended ”.
Isolation and the need to stay long hours in the home has increased intra-family conflicts and in many cases the coexistence of the extended family, which results for children with learning difficulties and conflicts in relationships with their peers and is the triggers of functional disorders.
In other cases, child abuse has been detected, gender violence of which children are witnesses, in addition to sexual abuse, which the SAP considered increased with the pandemic.
These situations increased in recent months and “Somatic complaints are a frequent form of presentation” and the risk of not addressing what may be the causes that lead to these disorders will deepen the discomfort and suffering, altering the quality of life, ties, schooling and relationships of the child with his family, “he said.
So, Rut Vanesa Mariñas, pediatrician of the Permanent Study Committee of Adolescents (CEPA) of the SAP, stressed that “it is necessary for these conditions to be treated.”
“Adolescents who suffer from chronic nonspecific pain such as frequent headaches, pain in the whole body, gastrointestinal, in the joints, among others, associated or not with a psychological disorder (such as depression, anxiety, anguish, hypochondria) should consult the adolescent doctor and be approached by an interdisciplinary team, which will take into account the comprehensive health of the patient in its biological, psychological and social aspects; this is the only way to respond to this type of pathology ”, he pointed out.
Raquel Sanguinetti, pediatrician of the SAP’s Ambulatory Medicine Committee, he remarked: “Functional disorders in childhood and adolescence manifest as a complaint presented by patients for which there is no organic explanation and where there is no obvious physical damage.”
“The presentation varies with age, recurrent abdominal pain is more frequent in early childhood, headache somewhat later, and insomnia and fatigue are added in adolescence. They are all symptoms that we see very frequently in daily clinical practice ”, he closed.
To make a diagnosis of functional disorder, pediatricians need the evaluation of the extended medical history of the child, a good physical examination, collecting semiological data and searching for warning signs.
“Pain is not invented, they feel it. And the pains come in a wide spectrum: from mild, universal and transitory, to severe, rare and disabling, “they said.
Given this, the doctors advised parents not to fall into the error of attributing any type of pain to these disorders, but to consult the pediatrician, who will determine if it is something purely functional or if it requires studies to rule out other medical conditions.