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Talking With Children:

TIPS FOR CAREGIVERS, PARENTS, AND TEACHERS DURING INFECTIOUS 

DISEASE OUTBREAKS 

What You Should Know

When children and youth watch news on TV

about an infectious disease outbreak, read about

it in the news, or overhear others discussing it,

they can feel scared, confused, or anxious—as

much as adults. This is true even if they live far

from where the outbreak is taking place and are

at little to no actual risk of getting sick. Young

people react to anxiety and stress differently

than adults. Some may react right away; others

may show signs that they are having a difficult

time much later. As such, adults do not always

know when a child needs help.

This tip sheet will help parents, caregivers,

and teachers learn some common reactions,

respond in a helpful way, and know when to

seek support.

Possible Reactions to an Infectious 

Disease Outbreak

Many of the reactions noted below are normal 

when children and youth are handling stress. 

If any of these behaviors lasts for more than 

2 to 4 weeks, or if they suddenly appear later 

on, then children may need more help coping. 

Information about where to find help is in the 

Helpful Resources section of this tip sheet.

PRESCHOOL CHILDREN, 0–5 YEARS OLD

Very young children may express anxiety and

stress by going back to thumb sucking or wetting

the bed at night. They may fear sickness, strangers,

darkness, or monsters. It is fairly common for

preschool children to become clingy with a parent,

caregiver, or teacher or to want to stay in a place

where they feel safe. They may express their

understanding of the outbreak repeatedly in their

play or tell exaggerated stories about it. Some

children’s eating and sleeping habits may change.

They also may have aches and pains that cannot

be explained. Other symptoms to watch for are

aggressive or withdrawn behavior, hyperactivity,

speech difficulties, and disobedience.

 Infants and Toddlers, 0–2 years old, cannot

understand that something bad in the world

is happening, but they know when their

caregiver is upset. They may start to show

the same emotions as their caregivers, or

they may act differently, like crying for no

reason or withdrawing from people and not

playing with their toys.

 Children, 3–5 years old, may be able to

understand the effects of an outbreak. If they

are very upset by news of the outbreak, they

may have trouble adjusting to change and

loss. They may depend on the adults around

them to help them feel better.
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TALKING WITH CHILDREN: 

TIPS FOR CAREGIVERS, PARENTS, AND TEACHERS DURING INFECTIOUS DISEASE OUTBREAKS 

EARLY CHILDHOOD TO ADOLESCENCE,

6–19 YEARS OLD 

Children and youth in this age range may have 

some of the same reactions to anxiety and 

stress linked to infectious disease outbreaks as 

younger children. Often younger children within 

this age range want much more attention from 

parents or caregivers. They may stop doing their 

schoolwork or chores at home. Some youth may 

feel helpless and guilty because they are in a 

part of the world currently unaffected by the 

outbreak, or where the public health system 

protects people against outbreaks in ways it 

cannot in other parts of the world. 

 Children, 6–10 years old, may fear going to

school and stop spending time with friends.

They may have trouble paying attention and do

poorly in school overall. Some may become

aggressive for no clear reason. Or they may act

younger than their age by asking to be fed or

dressed by their parent or caregiver.

 Youth and Adolescents, 11–19 years old, go

through a lot of physical and emotional

changes because of their developmental stage.

So it may be even harder for them to cope with

the anxiety that may be associated with

hearing and reading news of an infectious

disease outbreak. Older teens may deny their

reactions to themselves and their caregivers.

They may respond with a routine “I’m okay” or

even silence when they are upset. Or they may

complain about physical aches or pains

because they cannot identify what is really

bothering them emotionally. They may also

experience some physical symptoms because

of anxiety about the outbreak. Some may start

arguments at home and/or at school, resisting

any structure or authority. They also may

engage in risky behaviors such as using

alcohol or drugs.

How Parents, Caregivers, and 

Teachers Can Support Children 

in Managing Their Responses to 

Infectious Disease Outbreaks

With the right support from the adults around

them, children and youth can manage their stress

in response to infectious disease outbreaks and

take steps to keep themselves emotionally and

physically healthy. The most important ways to

help are to make sure children feel connected,

cared about, and loved.

 Pay attention and be a good listener.

Parents, teachers, and other caregivers can

help children express their emotions through

conversation, writing, drawing, playing, and

singing. Most children want to talk about

things that make them anxious and cause

them stress—so let them. Accept their

feelings and tell them it is okay to feel sad,

upset, or stressed. Crying is often a way to

relieve stress and grief.

 Allow them to ask questions. Ask your teens

what they know about the outbreak. What are

they hearing in school or seeing on TV? Try to

watch news coverage on TV or the Internet

with them. Also, limit access so they have time

away from reminders about the outbreak.

Don’t let talking about the outbreak take over

the family or classroom discussion for long

periods of time.

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3

TALKING WITH CHILDREN:

TIPS FOR CAREGIVERS, PARENTS, AND TEACHERS DURING INFECTIOUS DISEASE OUTBREAKS

 Encourage positive activities. Adults can

help children and youth see the good that

can come out of an outbreak. Heroic actions,

families and friends who travel to assist with

the response to the outbreak, and people

who take steps to prevent the spread of all

types of illness, such as hand washing, are

examples. Children may better cope with an

outbreak by helping others. They can write

caring letters to those who have been sick or

lost family members to illness; they can

organize a drive to collect needed medical

supplies to send to affected areas.

 Model self-care, set routines, eat healthy

meals, get enough sleep, exercise, and

take deep breaths to handle stress. Adults

can show children and youth how to take

care of themselves. If you are in good

physical and emotional health, you are more

likely to be readily available to support the

children you care about.

Tips for Talking With Children and 

Youth of Different Age Groups During 

an Infectious Disease Outbreak 

A NOTE OF CAUTION! Be careful not to pressure children 

to talk about an outbreak or join in expressive activities. 

While most children will easily talk about the outbreak,

some may become frightened. Some may even feel 

more anxiety and stress if they talk about it, listen to 

others talk about it, or look at artwork related to the 

outbreak. Allow children to remove themselves from 

these activities, and monitor them for signs of distress.

PRESCHOOL CHILDREN, 0–5 YEARS OLD 

Give these very young children a lot of emotional 

and verbal support. 

 Get down to their eye level and speak in a

calm, gentle voice using words they can

understand.

 Tell them that you always care for them and

will continue to take care of them so they feel

safe.

 Keep normal routines, such as eating dinner

together and having a consistent bedtime.

EARLY CHILDHOOD TO ADOLESCENCE, 6–

19 YEARS OLD 

Nurture children and youth in this age group: 

 Ask your child or the children in your care what

worries them and what might help them cope.

 Offer comfort with gentle words or just being

present with them.

 Spend more time with the children than usual,

even for a short while.

 If your child is very distressed, excuse him or

her from chores for a day or two.

 Encourage children to have quiet time or to

express their feelings through writing or art.

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4

 Encourage children to participate in

recreational activities so they can move

around and play with others.

 Address your own anxiety and stress in a

healthy way.

 Let children know that you care about them—

spend time doing something special; make

sure to check on them in a nonintrusive way.

 Maintain consistent routines, such as

completing homework and playing games

together.

When Children, Youth and Parents, 

Caregivers, or Teachers Need More 

Help

In some instances, children may have trouble 

getting past their responses to an outbreak, 

particularly if a loved one is living or helping with 

the response in an area where many people are 

sick. Consider arranging for the child to talk with 

a mental health professional to help identify the 

areas of difficulty. If a child has lost a loved one, 

consider working with someone who knows 

how to support children who are grieving.1 Find 

a caring professional in the Helpful Resources 

section of this tip sheet. 

1 National Commission on Children and Disasters. (2010). National 

Commission on Children and Disasters: 2010 report to the President 

and Congress (AHRQ Publication No. 10-MO37). Rockville, MD: 

Agency for Healthcare Research and Quality. Retrieved from 

http://archive.ahrq.gov/prep/nccdreport/nccdreport.pdf [PDF - 1.15 MB]

*Note: Inclusion of a resource in this fact sheet does not imply endorsement by the 

Center for Mental Health Services, the Substance Abuse and Mental Health Services 

Administration, or the U.S. Department of Health and Human Services.

Helpful Resources 

Substance Abuse and Mental Health Services Administration 

(SAMHSA)

5600 Fishers Lane -- Rockville, MD 20857

Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727)

Email: info@samhsa.hhs.gov

SAMHSA Store: https://store.samhsa.gov 

SAMHSA Disaster Technical Assistance Center

Toll-Free: 1-800-308-3515 Email: DTAC@samhsa.hhs.gov

Website: https://www.samhsa.gov/dtac 

Hotlines

SAMHSA’s Disaster Distress Helpline

Toll-Free: -877-SAMHSA-7 (1-877-726-4727) 

(English and español)

SMS: Text TalkWithUs to 66746 

SMS (español): “Hablanos” al 66746

TTY: 1-800-846-8517

Website (English):

https://www.disasterdistress.samhsa.gov

Website (español): https://www.samhsa.gov/find-help/disasterdistress-helpline/espanol

SAMHSA’s National Helpline

Toll-Free: 1-800-662-HELP (24/7/365 Treatment Referral 

Information Service in English and español)

Website: https://www.samhsa.gov/find-help/national-helpline

Child Welfare Information Gateway 

Toll-Free: 1-800-4-A-CHILD (1–800–422–4453) Website: 

https://www.childwelfare.gov/topics/responding/reporting/how

Treatment Locator

SAMHSA’s National Helpline

Toll-Free: 1-800-662-HELP (1-800-662-4357)(24/7 English 

and español);

TTY: 1-800-487-4889

Website: https://findtreatment.gov

Resources Addressing Children’s Needs 

Administration for Children and Families 

Website: https://www.acf.hhs.gov

Additional Resources 

National Suicide Prevention Lifeline

Toll-Free (English): 1-800-273-TALK (8255) 

Toll-Free (español): 1-888-628-9454 

TTY: 1-800-799-4TTY (4889)

Website (English): https://www.suicidepreventionlifeline.org

(español): https://suicidepreventionlifeline.org/help-yourself/enespanol

National Child T raumatic Stress Network 

Website: https://www.nctsn.org

PEP20-01-01-006

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