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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aggressive or withdrawn behavior, hyperactivity, 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.

Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov
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TALKING WITH CHILDREN:

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

Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov

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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TALKING WITH CHILDREN:

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

Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov

 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 cuddling 

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, a hug when 

appropriate, 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. 

 Support children spending time with friends 

or having quiet time to write or create art. 
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TALKING WITH CHILDREN:

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

Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov

 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]

Helpful Resources 

Hotlines

SAMHSA’s Disaster Distress Helpline

Toll-Free: 1-800-985-5990 (English and español)

SMS: Text TalkWithUs to 66746 

SMS (español): “Hablanos” al 66746

TTY: 1-800-846-8517

Website (English): http://www.disasterdistress.samhsa.gov

Website (español): http://www.disasterdistress.samhsa.gov/

espanol.aspx

SAMHSA’s National Helpline

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

Information Service in English and español)

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

Child Welfare Information Gateway 

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

Website: http://www.childwelfare.gov/responding/how.cfm 

Treatment Locator

Behavioral Health Treatment Services Locator 

Website: http://findtreatment.samhsa.gov/locator/home

SAMHSA Disaster Technical Assistance 

Center

Toll-Free: 1-800-308-3515

Email: DTAC@samhsa.hhs.gov

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

Resources Addressing Children’s Needs 

Administration for Children and Families 

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

Additional Behavioral Health 

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): http://www.suicidepreventionlifeline.org

Website (español): http://www.suicidepreventionlifeline.org/

gethelp/spanish.aspx

National Child Traumatic Stress Network 

Website: http://www.nctsn.org

*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.

·

HHS Publication No. SMA14-4886 

(2014)