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Actualizado: 30 dic 2020

Abril, 2020

Dolores Torres

Psicóloga del Servicio de Atención Terapéutica Fundación Catalana Síndrome de Down

By now we are all aware that quarentine is a preventive public health measure that is applied to prevent the spread os an infectious disease end that consequently is altering our day to day.

What we still do not know, however, is what will be its psychological impact on the population and especially on the population of children and young people with Down syndrome. .

From the psychological perspective, we must take into account as a starting point that not all people perceive the situation in which we are immersed in the same way. In addition, in the case of people with Down syndrome, disability places the person in a situation of greater vulnerability to fear and anxiety generated by this uncertain and unknown situation.

Faced with a circumstance like the one we are experiencing these days, emotional reactions such as anxiety, fear, sadness, anger ... which have an adaptive function to a completely new experience such as confinement, are awakened.

Thus, any form of expression of nervousness, restlessness and fright in the current situation must be interpreted from the beginning from the adaptive perspective, that is, totally "normal" in relation to the moment we are living.

Therefore, the first consideration we want to present is that confinement is an experience that is testing the adaptive capacity of the population.

What are the implications of confinement in the development and parenting of children and youth with syndrome Down?

From the decree of a state of alarm for the management of the health crisis situation caused by Covid19, we have seen one of the main rights we have limited: that of free movement. The ordered measure of confinement has therefore led us to an anomalous situation that alters the day to day of all of us. From an emotional perspective, it is an experience that initially leads to social separation and loss of freedom. Regarding social separation, we must bear in mind that the social environment constitutes the natural environment for human development. The child, as a social being that he is, throughout his growth towards adult life is structuring his personality through his relationship with others. The importance of the relationship with the other is directly linked to the emotional and affective development of the child since the human being only develops normally when he establishes links with others. For this reason, in the current circumstances of uncertainty and social separation. Special care must be taken to maintain and preserve a relationship of security and trust with the child as they will be essential for emotionally healthy development.

On the other hand, the loss of freedom generates emotional instability and this manifests itself in irritability and frustration. In the population of children and young people with Down syndrome, adaptation difficulties and emotional distress can occur, manifested mainly through oppositional behaviors and frustration since they have reduced reasoning capacity.

Frustration is a normal feeling and daily force in children's day-to-day lives and we know that it is an emotion that appears when we cannot satisfy a desire. Its management requires progressive learning and it is trained from an early age so that it can be as constructive as possible and does not affect family well-being.In a situation like the one we are experiencing, perhaps we must bear in mind that it is a priority to promote coexistence family harmony. If we make efforts to understand these behaviors, we will be able to reduce the discomforts that arise, both for the child and youth as well as for the adult, and we will reduce stress on the family climate.

Can we have an "emotionally healthy" confinement?

The feeling of uncertainty that the confinement situation can cause us generates unease and mistrust, putting at risk the emotional stability of the whole family and therefore the raising of the child. Get maximum peace of mind to reduce feelings negatives of fear, worry, anger ... it is not easy in these circumstances but it can help us to have the most emotionally healthy confinement possible by taking into account some aspects such as the ones we expose below: - It is highly recommended that the child and young person with Down syndrome understand the purpose of confinement. To understand the situation, we can do it with explanations that refer to specific experiences (we don't go to school, we don't go to the park, we don't go to friends' houses ...) and with visual aids. At the same time we adults have to take certain measures of emotional protection such as avoiding over-information, we don't go to school, we don't go to the park, we don't go to friends' houses ...) and with visual aids. At the same time, adults have to take certain measures of emotional protection such as avoiding overinformation, ignoring rumors and putting aside those negative ideas that persistently run through our heads.

It is important to understand that the restriction of freedom causes adverse effects and above all enhances the feeling of isolation. In children or young people with Down syndrome, it can favor the appearance of behaviors of emotional disconnection in the form of soliloquies (talking alone or with an imaginary friend), sensory behaviors (such as the need to hold objects with different textures), appearance or increase of repetitive movements (so-called stereotypes), etc.

If we improve communication and social contacts, both in terms of the social and family environment and with health professionals (physical and mental health), we will help reduce isolation and the risk of regressive behaviors.

- We must also consider what positive learning is derived from negative experiences. When confinement is imposed and lasts longer than we all would like, we have the opportunity to live this experience from a perspective that allows us to educate children and young people in the values ​​of civility, responsibility and solidarity.

Showing a behavior that seeks the good of the other in a disinterested way (it confines us by not infecting ourselves and so as not to infect others), also helps us feel good and gratifies us.

What can help lessen the psychological impact of confinement?

Although we do not have scientific evidence that can give us answers to this question, there are some elements that should be taken into account when anticipating the emotional impact of confinement: - Fear of infection. Concern for one's own health or the possibility of infecting others in the confinement environment is a stressful factor that can increase the emotional impact. Clear information must be provided both on preventive measures and on what is a situation in which we are all subjected (colleagues from school, work). From this "normalization" of the situation, it could favor the restructuring of the experience of the situation and the emotional impact could be reduced. - The loss of the usual routine and of social and physical contact generates boredom, frustration and a feeling of isolation. Our well-being as social beings is based especially on the quality of our interactions; Strengthening relationships with the social environment with a proactive attitude and avoiding confrontation can promote a positive relationship climate. Not having inadequate or insufficient supplies (food, water, medical care, material for teleworking or tele-education ) generates frustration, anxiety and anger. In this exceptional situation, priority should be given to having access to and having basic basic needs.

- Adults must try to have sufficient and clear information from public health authorities in order to avoid the discomfort that lack of transparency can generate.

- We will also have to pay attention to the length of the confinement time since if the stress situation continues to lengthen we could find the appearance of behaviors or manifestations compatible with a psychopathological disorder such as the case of post-traumatic stress.

The situation we are facing at the moment leads us, at the same time, to a general fear of what will come after this isolation.

The economic and physical and mental health consequences are, at this time, difficult to predict and calculate, but we must prepare ourselves to know how to manage this psychological discomfort that could increase.

For this reason, and to alleviate the psychological impact of people in the face of a stressful life event, structured actions and procedures will be necessary to facilitate a psychological recovery process to be able to return to functional life and prevent suffering and pain from chronify.

"Accepting uncertainty is a wise attitude, it means realizing that we are finite" (Victoria Camps, Emeritus Professor of Ethics and Politics at the University of Barcelona).



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