What We Have Seen and Learned From A Year of Practice During COVID-19
What We Have Seen and Learned From A Year of Practice During COVID-19
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The Yellin Center

News from The Yellin Center: March 2021

What We Have Seen and Learned From A Year of COVID-19

It’s hard to believe that it’s been a full year since COVID-19 came into our lives and turned our world upside down. It’s often difficult to understand how a crisis has changed things until time has passed and things have returned to normal. But sometimes, especially if a crisis is long lasting, the changes that it has brought about can be evaluated – for better and for worse – even while the crisis is ongoing. That is the case for us here at The Yellin Center.
There can be no question that the deaths and illness that have affected so many are the most painful consequences of this pandemic and our thoughts are with those who have struggled with illness or lost loved ones. The crushing economic toll on so many families has created real need, along with anxiety and uncertainty. 
We have observed a number of recurring themes over the past year, and while the experiences we have encountered with students and their families are strictly anecdotal, we believe that recounting and discussing them can be helpful to parents, teachers, and other professionals.

Where Things Have Gone Right

As we do when we evaluate students, let’s start with the positives that we are seeing come out of the pandemic learning paradigms, with many students learning exclusively online and many others mostly in hybrid in-person/remote settings.
Parent observations during remote learning can provide new perspectives on what is going on with their child, creating a more complete picture. For example, when a teacher is working in-person with an entire class, she may observe a child talking to his classmates after the teacher gives instructions. To the teacher, this may look like difficulties with attention or self-control, but the parents sitting with the child who is learning remotely can see that he is losing focus or reaching out to classmates because he was confused with the teacher’s instructions and having difficulty understanding the language the teacher used. 
It has also been the experience of the families with whom we work that teachers are using the Direct Message feature on Zoom to preview/prompt/support individual students and provide scaffolding in a non-stigmatizing way.
All kinds of meetings in which we had participated by telephone or in person are now done on Zoom. We have found that this works really well for Committee on Special Education (CSE) meetings. In addition to allowing our clinical team to attend remotely, more members of the school-based team, as well as community based service providers and both parents, can participate easily. 
The same benefits apply for the post-assessment meetings we frequently hold with schools, to review our reports and discuss our findings. We plan to continue this way of meeting after the pandemic and hope that schools agree. 
We have found telemedicine or virtual visits very effective for Consultation, Demystification, Follow-up, Medication Management, and Counseling. Such virtual visits are particularly valuable for brief check-ins after initiating medication treatment. When starting medication or changing prescriptions or dosing, it is important to check in often to make sure the student is tolerating the medication well and benefitting from it. A Zoom check-in several times in the first weeks is an excellent way to do this. Even once pandemic restrictions end, we plan to use Zoom to speak face-to-face to college students or families that live further away when in-office check-ins are problematic.
On occasion, we are asked whether we provide remote assessments. We have done a good deal of research into this method of assessment and have made remote assessments available at times, either as part of an assessment or, less commonly, as a full assessment. However, we are not yet convinced that remote assessment is as effective as in-person assessment and therefore continue to screen carefully for those situations where we believe they are appropriate to offer. Most families continue to prefer in-person assessments and we have been able to modify our space and our practice to provide assessments that are safe for families and staff.

Where Students, Families, and Schools are Struggling

Older Students: For many older students, the pandemic occurred just at a time when they were moving toward more independence and beginning to venture out into the world on their own. That all came to an abrupt stop, along with reminders from parents and others that the world that had been opening up to them was no longer safe. Many older students have struggled with too much time at home and too much proximity to their families.
Older students with attention and executive function challenges also have been struggling with the time management demands of online learning. Particularly challenging are asynchronous online lessons, when students proceed at their own pace. Many students have trouble navigating through the school day, unsure about when to sign on, when to complete assignments, and how or when to submit their work. 
Family Situations: Parents’ situations during the pandemic have had significant impacts on their children. Those parents who can work from home have to balance their work with supervising their children’s online learning, but at least can usually keep their jobs and their income. For parents who must be present in-person at their workplaces, the decision to keep their job or supervise their children can be fraught with economic and personal sacrifices, which have been disproportionately borne by lower income families. 
Children with Special Needs: In our experience, some of the most significant impact of pandemic learning has fallen on students with special learning needs who had been obtaining services from their public schools. Children who had been doing well in co-learning classes (ICT, here in New York City), where a regular and special education teacher worked together in one classroom, have often been broken into “pods,” working with only one teacher. In these situations, the special education teacher is often not available consistently or predictably. 
There have been delays in school evaluations and in reimbursements to families who are seeking tuition payments at private special education programs. And student IEPs (Individualized Education Programs) have frequently not been fully implemented, as schools struggle to provide basic services, let alone specialized supports. 

Helping Children with the Pandemic's Emotional Toll 

Dr. Hima Reddy has observed the emotional toll of pandemic learning and the social isolation faced by the students we serve. She offers some suggestions as to how families can help mitigate the impact of pandemic limitations on their children’s well-being:
As we reach the one-year mark of the COVID-19 pandemic, it’s important to understand the impact of the “new normal” on our mental health. We have demonstrated resiliency and adaptability; we have shown ourselves capable of reorganizing our time, our social world, and our work-life balance. However, these shifts have come with a toll on our mental health and wellness and that of our children; our mind and bodies are often still yearning for what was once before. Here at The Yellin Center, we have seen a higher rate of anxiety, depression, social isolation, and academic burn-out in every age group. We need to ask our children and ourselves what we miss and take steps to make our children’s lives – and our own – richer and more manageable.

What do we miss?

Children, adolescents, and young adults thrive with structure and a predictable, regular routine.  Students refuel themselves through dialogue and conversation, whether in the classroom or in the hallways. All of us think and feel better when we move our bodies more.  

Which of these resonate, and how often do we want to replicate them in our own homes?

Plan for the Week
  • Put up a monthly calendar in your child’s room.  Write a schedule every evening with your child – checking off the day’s events as well as planning for the next day.
  • For example, you may only have two events for your younger children - school and playground-time after school
Prioritize Connection and Community Every Day
  • Card games and board games – Uno, Battleship, Monopoly Junior, Chess, Settlers of Catan, Stratego, Connect Four, Dungeons and Dragons
  • Socially-distanced playdates
  • Family and friends book club
Practice Wellness Activities as a Family
  • Dance party with younger children
  • Breathing and meditation
  • Playing sports or online workouts
  • Cooking healthy, nutritious food together
Pause and Reflect on Lessons Learned
  • Take time to ask your children what they have learned over the past year
  • Praise them for their resilience
  • Acknowledge the challenges - what have they found most difficult?
  • Help your child identify and discuss their emotions. The ability to label their feelings and connect them to an internal or external experience is an important step in emotional development
Practice Kindness
  • Our children learn how to respond by observing us actively problem-solve and in the quieter moments in between.
  • Accept that there will be days where we are not our best selves.  It is appropriate to feel sad, irritable, worried, and confused at times. Being kind to ourselves and to each other will help us all get through this challenging time. 

Other News

In case you missed an excellent interview of Dr. Yellin by Laura Hart of Robofun from this past January, it is available on YouTube. Dr. Yellin describes how the approach of The Yellin Center can help identify students’ specific strengths and challenges. 
Starting last September, Dr. Yellin worked with colleagues from the Q.E.D. Foundation on a series of three webinars on Supporting Your Learners in Remote Learning Environments. Each of these programs—How Does it Work?, Identifying Strategies, and Observations and Opportunities—are available for viewing on YouTube. More webinars are being planned and we will share that information as soon as it is available.
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The Yellin Center | 104 West 29th Street | 12th Floor | New York, NY 10001 | www.yellincenter.com | info@yellincenter.com | 646-775-6646
©Paul B. Yellin M.D. P.L.L.C.

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