Distress In Children Research Articles

Development of a scale for assessing the level of distress for children and adolescents with cancer

Development of a scale for assessing the level of distress for children and adolescents with cancer

Sleep Habits of Early School-Aged Children with Type 1 Diabetes and Their Parents: Family Characteristics and Diabetes Management

ABSTRACT Study Objectives School-aged children with type 1 diabetes (T1D) and their parents are at risk for sleep disturbances, yet few studies have used objective measures to assess sleep characteristics in young children with T1D. Methods Forty children (ages 5–9) with T1D and their parents wore actigraph watches and completed sleep diaries for 7 nights. Parents also completed questionnaires about demographic information, diabetes distress, fear of hypoglycemia, and family routines. Children’s clinical data (HbA1c and blood glucose data) were extracted from the medical record. Results Most of the children and their parents obtained insufficient sleep. Based on actigraphy data, children slept an average of 7.9 hours/night and parents slept 6.7 hours/night, below the recommendations of 9–11 and 7–9 hours of sleep, respectively. Shorter child sleep latency was significantly associated with better glycemic levels, and parents’ sleep duration and efficiency were related to child’s glycemic levels. Parental fear of hypoglycemia and lack of family routines were associated with poorer sleep quality in parents and children, and with parental diabetes distress. Conclusions Sleep duration and quality is a modifiable target for potentially improving glycemic levels and parental distress in early school-aged children with T1D.

One Size Really Does Not Fit All: The Importance of Incorporating Culturally Relevant Adaptations in Reunification Therapy

Reunification therapy is specialized family therapy to address parent–child relational disruption (i.e. child resistance to or refusal of parent contact), typically during or following a high‐conflict divorce or custody dispute. The literature discussing reunification therapy interventions with families involving racial diversity, SES, religiosity, and other socio‐cultural aspects is limited to non‐existent. In the move towards being culturally sensitive to the ever‐present multitude of identities that exist within family systems, professionals are challenged to develop a balanced approach between providing competent practice that is culturally sound and considering empirical evidence. This paper offers suggestions for enhancing evidence‐informed interventions to address parent–child contact problems within diverse populations by incorporating culturally specific interventions to increase parenting skills, reduce parent and child distress, and repair attachments through therapeutic experiences.

Parental Distress and Perception of Children's Executive Functioning after the First COVID-19 Lockdown in Italy.

The spread of the novel coronavirus (COVID-19), and the consequential first italian lockdown to minimize viral transmission, have resulted in many significant changes in the every-day lives of families, with an increased risk of parental burnout. This study explores the impact of the first COVID-19 lockdown in Italy on parental distress and parental perceptions of children’s executive functions (EFs). Participants were 308 Italian parents with children between 4 and 17 years of age; they were recruited through online advertisements on websites and social media, and they were given an online survey. The measures were: the balance between risks and resources (BR2) and the executive functioning self-report (EF). Findings of the study suggest that the most distressed parents perceived their children as less competent in EF, highlighting a cognitive fragility on attention, memory, and self-regulation (Pearson correlation coefficient, p < 0.05); significant differences were found between parents of children exhibiting typical and atypical patterns of development (ANOVA, p < 0.05). The study reinforces the need to provide families with psychological aid to support parental competence in restrictive lockdown conditions.

Clinical characteristics of children with airway malacia complicated by pneumonia

BackgroundAirway malacia is an important cause of noisy breathing, recurrent wheezing and respiratory infections, chronic coughing, and episodes of respiratory distress in young children. As the clinical manifestations of airway malacia are not common, many clinicians have insufficient understanding of this disease. So the purpose of this study is to summarize the pathogenic bacteria and clinical manifestations of airway softening complicated with pneumonia in children.MethodsChildren hospitalized with airway malacia complicated by pneumonia were eligible for enrollment from January 1, 2013 to December 31, 2019. Medical records of patients were reviewed for etiology, clinical characteristics, and laboratory examination results.ResultsA total of 164 pneumonia patients with airway malacia were admitted. The male-to-female ratio was 3:1. The age of patients ranged from 1 month to 4 years old. The median age was 6 (3–10) months. The most commonly detected pathogen were Mycoplasma pneumoniae (25/164, 15.24%), Streptococcus pneumoniae (18/164, 10.98%), and respiratory syncytial virus (16/164, 9.76%). Common signs among the 164 patients with confirmed airway malacia included cough (98.78%), wheezing (67.07%), fever (35.37%), intercostal retractions (23.17%), dyspnea (10.98%), cyanosis (11.11%), and crackles (50%). Compared with those without airway malacia, the incidence of premature delivery and mechanical ventilation was higher, and the duration of symptoms before admission (median, 13.5 d) and hospital stay (median 10.0 d) were longer. Of the children with pneumonia, 11.59% of those with airway malacia required supplemental oxygen compared with 4.88% of those without airway malacia (p < 0.05).ConclusionThe median age of children with airway malacia was 6 months. The most common pathogen in patients with airway malacia complicated by pneumonia was Mycoplasma pneumoniae. Patients with airway malacia complicated by pneumonia often presented with a longer disease course, more severe symptoms, and had delayed recovery.

The pragmatics of managing children's distress in Murrinhpatha, a traditional Australian language

This paper examines the strategies that speakers employ in response to children's crying in the remote Aboriginal community of Wadeye, in northern Australia. Drawing on spontaneous interactions amongst Murrinhpatha speaking families, we analyse instances of crying by children aged 0;6 to 8;11 years, and the ways in which they are responded to. Results indicate that adult Murrinhpatha speakers manage children's distress through a variety of verbal and non-verbal strategies, and multimodal combinations thereof. The selection of strategies directly relates to the developmental stage of the crier. Adult caregivers respond differently to the crying of infants, of children who can walk unaided but are producing little if any language, of children who can talk intelligibly, and children more advanced again who have a degree of social independence. In the particular strategies that caregivers apply, they guide children towards a developmentally appropriate self-sufficiency. Caregivers encourage autonomy in ways that reflect a child's current abilities, be it physical, linguistic, emotional, or social. By exploring responses to crying in an under-researched cultural and linguistic context, this paper offers a unique perspective on the pragmatics of managing distress and what this reveals about local constructions of personhood within the context of carer-child interaction.

Continuous positive airway pressure in managing acute respiratory distress in children in district hospitals: evidence for scale-up.

None declared.

In Their Own Words: Children's Perceptions of Caregiver Stress during COVID‐19

Research ObjectiveTo use text and chat transcripts from a national child helpline to examine how children perceive, identify, and describe caregiver stress during the coronavirus disease 2019 (COVID‐19) pandemic.Study DesignWe obtained 105 deidentified text and chat transcripts from March through June of 2020 from the Childhelp National Child Abuse Hotline, which supports the needs of abused, neglected, and at‐risk children. The helpline is staffed 24 hours a day, 7 days a week with professional crisis counselors who serve families from all over the United States. Transcripts were analyzed with Atlas TI software using inductive, thematic analysis to identify how child helpline users: 1) perceived drivers of caregiver stress and 2) used words to describe manifestations of caregiver stress.Population StudiedText and chat transcripts were included if they originated from children under age 18 and one of the presenting issues included “COVID‐19,” labeled by a Childhelp counselor. The majority (86%) were from children ages 13 to 17.Principal FindingsChildren perceived multiple drivers of caregiver stress during COVID‐19, including intrapersonal (e.g. caregiver health concerns), interpersonal (parental discord, perceived dislike of child), and extrapersonal (financial insecurity, sheltering in place) stressors. Regardless of the driver, caregivers' stress was internalized by children (Table 1). Children were most likely to use the words “anger,” “control,” and “blame” to label manifestations of caregiver stress, and often cited examples of externalizing behaviors, including yelling, name calling, and blaming of others (Table 2).TABLE 1Examples of perceived drivers of caregiver stressDriverRepresentative QuoteFinancial insecurity“They say…I'm the [reason] they don't have enough money every week”COVID‐19 sheltering in place“…ever since quarantine…there have been more occurrences of him shouting and yelling at us at small things.”TABLE 2Examples of words children use to describe manifestations of caregiver stressDescriptorRepresentative Quote“Blowing up”“She sort of blew up screaming, slamming things, breaking things…”“Blaming me for everything”“She tells me that I am the reason she has lost friends, or that…her and my step dad got a divorce”ConclusionsIn text and chat inquiries to a national child helpline during the COVID‐19 pandemic, children identified, described, and internalized multiple drivers of caregiver stress, often feeling as though they were to blame. Providers serving children should address household stress spillover effects by directly acknowledging children's perceptions and concerns using their own words.Implications for Policy or PracticeChild helplines can help make child distress more “visible” during a time when mandatory reporters such as educational personnel and daycare providers have limited contact with at‐risk children. Texts and chats, which are accessible to school‐age children and offer privacy from nearby caregivers, are an important mechanism by which children in crisis can sound their own alarms. We illustrate the real‐time impacts of caregiver stress on children during the COVID‐19 pandemic, in which close proximity and heightened duress likely increase children's sensitivity and vulnerability to caregivers' variations in mood and behavior. Findings can inform policy efforts to expand access to supportive services and highlight the promise of text and chat modalities to address children's needs.

Effect of Distraction Intervention for Needle-Related Pain and Distress in Children: A Systematic Review and Meta-Analysis.

A systematic review and meta-analysis conducted to evaluate the combined effect of distraction intervention for needle-related pain in order to provide the basis for developing an effective nursing intervention for children. We searched three electronic databases, PubMed, Embase, and CINAHL, for original articles published in the period from 1 January 2011 to 31 July 2019. In addition, a manual search was performed on the basis of references in the literature and the references of the articles in pursuit of comprehensive data until 10 December 2019. Meta-analysis was performed by the synthesis of the effect size, homogeneity, heterogeneity, and trim-and-fill method using MIX 2.0 Pro. Well-planned RCTs, single-center studies, high-quality studies, participants older than 10 years of age, and visual and clown distraction interventions were effective for needle-related pain and distress management among children. The results showed evidence supporting the effect of distraction interventions for children’s needle-related pain and distress. Through this review, strategies were identified to design better interventions to improve the outcomes.

The persistent effects of natural disaster exposure on child and adolescent psychological distress: evidence from a Hurricane Katrina displaced cohort

BACKGROUND AND AIM: This study evaluates the association between exposure to cumulative natural disasters and psychological distress among Gulf Coast children and adolescents. METHODS: We used data from the Gulf Coast Child and Family Health Study, a longitudinal cohort displaced by Hurricane Katrina. The exposure of interest was the number of additional natural disasters the respondent had experienced. Child psychological distress was based on their caregiver endorsing one of the following in the past month: feeling sad or depressed; having problems sleeping; feeling nervous or afraid; or having problems getting along with other children. We conducted bivariate analyses followed by logistic regression, evaluating moderation by race; annual household income; parental educational attainment; household financial constraints; stable housing; family functioning; parental coping; and parental mental component score. RESULTS:Among 141 respondents with children, about 28% reported their children having psychological distress in the past month. Those respondents whose children had psychological distress experienced over twice the number of disasters, on average, than those without psychological distress (0.45 [SD 0.86] vs. 1.10 [SD 1.64]). None of the sociodemographic, vulnerability, or resilience variables significantly moderated the association between additional disaster exposure and child/adolescent psychological distress. Each additional disaster experienced by a respondent was associated with a 90% increase in the odds that his/her child exhibited symptoms of psychological distress (OR 1.90; 95% CI 1.01, 3.55). Those whose caregivers reported coping somewhat or not well at all with parenting responsibilities were over three times more likely to have psychological distress (OR 3.33; 0.11; 0.93) than those whose caregivers were coping very well. Children and adolescents in high functioning families were also significantly less likely than children in low functioning families to exhibit symptoms (OR 0.32; 95% CI 0.11, 0.93). CONCLUSIONS:These results demonstrate the persistent effects of exposure to natural disasters on child/adolescent psychological distress. KEYWORDS: Natural disasters, Children's environmental health, Mental health outcomes

Pediatric Palliative Care Parents’ Distress, Financial Difficulty, and Child Symptoms

ContextParents of patients with a serious illness experience psychological distress, which impacts parents’ wellbeing and, potentially, their ability to care for their children. Parent psychological distress may be influenced by children's symptom burden and by families’ financial difficulty. ObjectivesThis study examined the associations among parent psychological distress, parent-reported patient symptoms, and financial difficulty, seeking to determine the relative association of financial difficulty and of patient symptoms to parent psychological distress. MethodsCross-sectional study of baseline data for 601 parents of 532 pediatric palliative care patients enrolled in a prospective cohort study conducted at seven US children's hospitals. Data included self-reported parent psychological distress and parent report of child's symptoms and family financial difficulty. We used ordinary least squares multiple regressions to examine the association between psychological distress and symptom score, between psychological distress and financial difficulty, and whether the degree of financial difficulty modified the relationship between psychological distress and symptom score. ResultsThe majority of parents were moderately to severely distressed (69%) or severely distressed (17%) and experienced some degree of financial difficulty (65%). While children's symptom scores and family financial difficulty together explained more of the variance in parental psychological distress than either variable alone, parental distress was associated more strongly, and to a larger degree, with financial difficulty than with symptom scores alone. ConclusionsParent psychological distress was associated with parent-reported patient symptoms and financial difficulty. Future work should examine these relationships longitudinally, and whether interventions to improve symptom management and ameliorate financial difficulties improve parental outcomes.

Child Adjustment During COVID-19: The Role of Economic Hardship, Caregiver Stress, and Pandemic Play.

The coronavirus disease 2019 (COVID-19) led to many lifestyle changes and economic hardships for families with young children. Previous research on risk and resilience highlights that children's adjustment to family hardships is influenced by caregiver stress, but individual child behaviors and characteristics may protect children from negative outcomes. Interestingly, many children have been reported to incorporate COVID-19 themes in their pretend play. Theory suggests children may do so to cope with pandemic-related stress, but no empirical studies have explored this possibility. The purpose of this study was to understand the process by which COVID-19 economic hardships experienced by a family were related to children's emotional well-being and development and to investigate how this process may vary as a function of children's engagement in pandemic-related pretend play. Caregivers (N = 99; mostly high earning families) of preschoolers ages 3–6 years (51% girls, 82% White) living in the United States participated in an online survey at two time points during the pandemic. Result revealed that COVID-19 economic hardships were related to increased caregiver stress, which, in turn, was associated with children's emotional distress and poorer self-regulation. However, engaging in pandemic-related pretend play appeared to protect children's well-being by weakening the adverse association between caregivers' stress and children's emotional distress. Thus, addressing caregiver stress levels and allowing children an outlet to cope with challenges through pretend play could have crucial protective effects on early development and well-being during times of crisis.

Diabetes Related Distress in Children with Type 1 Diabetes before and during the COVID-19 Lockdown in Spring 2020.

Our aim was to compere diabetes-related distress (DD) in young patients with type 1 diabetes mellitus (T1DM) and in their parents before and during the national COVID-19-related lockdown when schools operated on-line. Problems Areas in Diabetes-Child (PAID-Ch), Teen (PAID-T) and Parent (P-PAID-Ch, P-PAID-T) questionnaires in paper version were used to evaluate DD before COVID-19 pandemic (November 2019–February 2020) and during the lockdown (April 2020) the same surveys were performed by phone. We enrolled 76 patients (median age (Q1–Q3): 13.6 (11.8–15.2) years; 21 children, 55 adolescents; T1DM duration 3.7 (1.7–6.8) years). Initial PAID score was lower in teenage boys than in girls (34.0 (24.0–42.0) vs. 44.5 (40.0–50.5), p = 0.003). In teens PAID score decreased significantly during the lockdown (−3.0 (−11.0–3.0), p = 0.018), more in girls than boys (p = 0.028). In children (−3.0 (−14.0–7.0), p = 0.131) and parents PAID did not change (teens’ parents: 3.0 (−9.0–10.0), p = 0.376; children’s parents: −5.0 [−9.0–1.0], p = 0.227). In the studied group COVID-19 pandemic-related lockdown was associated with decrease in DD in teens with T1DM, particularly in girls, while no significant change in DD was observed in children or parents. DD decrease in teens during the pandemic should attract attention to the potential “rebound” of DD related to return to regular on-site school routine.

Children and Families’ mental health during the first COVID-19 lockdown in Italy

Background: This study aimed to screen a wide range of emotional and behavioural variables emerging during the first COVID-19 pandemic-lockdown in a sample of parents and children, residents in the southern part of Italy, and explore which variables could predict children’s wellbeing. We hypothesised that difficulties in adapting routines to pandemic restrictions, parents’ emotional wellbeing, and attitude towards the pandemic could influence the children’s behavioural attitudes. Methods: 221 parents completed the survey and gave information about 246 children. Ad hoc questionnaires were created and then exploratory reduced in factors. Strengths and Difficulties Questionnaire (SDQ) for parents assessed positive and negative behavioural attitudes in children. Depression Anxiety Stress Scale (Italian DASS-21) scored depression, anxiety and stress in parents. Results: Children presented higher emotional distress (Mean difference (M diff )=0.6, 95% C.I. 0.2, 0.9, p=0.013) and better prosocial behaviour (M diff =0.5, 95% C.I. 0.1, 0.9, p=0.011) than the Italian normative sample. Parents were more depressed than expected in the general population (M diff =1.0, 95% C.I. 0.3, 1.6, p=0.005). Having developed a morbid attachment to an adult (B=0.37, 95% CI 0.05, 0.69, p=0.024), a higher parental depression (B=0.1, 95% CI 0.02, 0.18, p=0.014), and children’s suffering from nightmares (B=0.35, 95% CI 0.03, 0.67, p=0.032) explained the 31.9% of the total variance in children’s emotional distress. Children’s anxiety was related to parents’ fear of the pandemic effects (r=0.32, p=0.001) and avoiding communicative approach (r=0.24, p=0.011). Conclusion: The first lockdown determined emotional distress and regressive mechanisms in children in the contest of higher parental discomfort, fear of the infection and avoidant communication. Following parents’ indications, it could be helpful to provide families with informative and age-appropriate support.

Crying in a Russian preschool: Teachers' pragmatic acts in response to children's distress

The paper examines teacher pragmatic acts (verbal and embodied) in response to children's crying in a Russian preschool. It focuses on crying episodes associated with children's inability or unwillingness to follow the norms and expectations surrounding children's conduct (e.g., crying when not allowed to do something). The paper employs discourse analysis; the data are 40 h of video- and audio-recorded interactions. The analysis shows that teachers used directives and other pragmatic acts (e.g., assessments, explanations) that encouraged children to stop crying. The directives were produced in multi-party participation frameworks where peers were referred to or recruited as active participants. Teachers used positive and negative assessments of crying. Crying was presented in a negative light in contrast with positive non-crying behaviors; positive assessments (praise and affectionate touch) were offered when crying stopped. The consequences of crying were presented as negatively affecting others. It is argued that such discursive treatment of crying contributes to socializing children to conformity. The paper contributes to our understanding of how through the use of pragmatic acts, child crying is discursively treated in ways that invoke norms of pragmatic conduct (e.g., not crying when asked to participate in a planned activity) and social values regarding group membership.

Pediatric Coping During Venipuncture With Virtual Reality: Pilot Randomized Controlled Trial.

BackgroundVirtual reality (VR) has shown promise in reducing children’s pain and anxiety during venipuncture, but studies on VR lack objective observations of pediatric coping. Notably, the process of capturing objective behavioral coping data can be labor- and personnel-intensive.ObjectiveThe primary aims of this pilot trial were to assess the feasibility of conducting a trial of VR in a pediatric emergency department and the feasibility of documenting observed coping behaviors during pediatric procedures. Secondarily, this study examined whether VR affects child and caregiver coping and distress during venipuncture in the pediatric emergency department.MethodsThis stratified, randomized, controlled pilot trial compared coping and distress between child life–supported VR engagement and child life specialist support without VR during painful procedures in children aged 7-22 years in the pediatric emergency department. An external control (reference group) received no standardized support. Primary feasibility outcomes included rates of recruitment, rates of withdrawal from VR, and rates of completed Child Adult Medical Procedure Interaction Scale-Short Form (CAMPIS-SF) observations. Secondary clinical outcomes were applied to venipuncture procedures and included CAMPIS-SF coping and distress (range 0-1.0), pain and anxiety on a visual analog scale (range 0-10), and cybersickness symptoms.ResultsOverall recruitment was 93% (66/71), VR withdrawal rate was 27% (4/15), and of the completed procedures, 100% (63/63) CAMPIS-SF observations were completed. A total of 55 patients undergoing venipuncture in the pediatric emergency department were included in the analyses of clinical outcomes: 15 patients (15 caregivers) randomized to VR, 20 patients (15 caregivers) randomized to child life specialist support, and 20 patients (17 caregivers) in the reference group. Patient coping differed across groups with higher coping in the VR group and child life specialist group than in the reference group (P=.046). There were no significant differences in the distress and pain ratings for patients and caregivers between the groups. Caregivers rated the lowest perceived anxiety in the child life specialist group (P=.03). There was no apparent change in cybersickness symptoms before and after VR use (P=.37).ConclusionsReal-time documentation of observed behaviors in patients and caregivers was feasible during medical procedures in which VR was utilized, particularly with the availability of research staff. VR and child life specialists improved coping in children during venipuncture procedures. Given the high participation rate, future studies to evaluate the efficacy of VR are recommended to determine whether an off-the-shelf VR headset can be a low-cost and low-risk tool to improve children’s coping during venipuncture or other related procedures.Trial RegistrationClinicalTrials.gov NCT03686176; https://clinicaltrials.gov/ct2/show/NCT03686176

Symptoms and Suffering at End of Life for Children With Complex Chronic Conditions

ContextChildren with cancer and cardiac disease suffer with high symptom burden at end of life (EOL). Little is known about the EOL experience for children with other complex chronic conditions (CCCs). ObjectivesTo evaluate symptoms and suffering at EOL for children with noncancer, noncardiac CCCs as well as parental distress related to child suffering. MethodsThis study is a secondary data analysis of a cross-sectional, single-center survey of bereaved parents of children with CCCs who died between 2006 to 2015. The primary outcome was parent-reported child suffering in the final two days of life. ResultsAmong 211 eligible parents contacted for participation, 114 completed the survey, and 99 had complete primary outcome data (participation rate 47%). Most children had congenital/chromosomal (42%) or progressive central nervous system (22%) conditions. Twenty-eight percent of parents reported high child suffering in the final two days of life. Parents reported that pain and difficulty breathing caused the greatest suffering for children and distress among themselves. Some parents also reported distress related to uncertainty about child suffering. Parents were less likely to report high child suffering if they were confident in knowing what to expect when their child was dying (AOR 0.20; 95% CI 0.07–0.60) or felt prepared for medical problems at EOL (AOR 0.12; 95% CI 0.04–0.42). ConclusionNearly one-third of parents of children with CCCs report high suffering in their child's final days of life. Parent preparedness was associated with lower perceived child suffering. Future research should target symptoms contributing to parent and child distress and assess whether enhancing parent preparedness reduces perceived child suffering.

Emergency department strategies to combat the opioid crisis in children and adolescents.

The opioid crisis has greatly affected not only adults but also children as well. As clinicians develop effective approaches to minimize pain and distress in children, the risks and benefits of opioids must be carefully considered. Children of parents with opioid use disorder are also at risk of living in unstable environments, performing poorly academically, engaging in future drug use, and having increased stress, which affects their development before entering adulthood. This statement focuses on the effects of the opioid crisis on children and adolescents and is intended to inform institutional policies, improve education, advocate for evidence‐informed guidelines, and improve the care of children affected by the opioid epidemic who are seen in the emergency department.

Clinical Holding in Pediatric Venipuncture: Caring by Empowering the Caregiver.

The use of restraint in the child-adolescent population is highly controversial due to the consequences it can have for patients and their families, although it is sometimes necessary to employ restraint to perform techniques safely and effectively. Clinical Holding is committed to the involvement of parents during venipuncture in the context of family-centred care. This study assesses levels of distress and pain in children undergoing this procedure, as well as satisfaction in parents and nurses. Parents assist in the restraint of children and provide accompaniment during venipuncture. Levels of distress and pain were not particularly elevated. Satisfaction levels among parents and nurses were high. A positive correlation was found between anticipatory and real distress (r = 0.737, p = 0.000), and between real distress and real pain (r = 0.368, p = 0.035). A negative correlation was observed between real pain and parent satisfaction (r = −0.497, p = 0.003). Parental participation during venipuncture contributed to better management of distress and pain. In the future, it would be advisable to incorporate the other pharmacological and non-pharmacological measures recommended by Clinical Holding to ensure care of the highest quality and safety.

The impact of COVID-19 on adolescent psychiatric inpatient admissions.

COVID-19 has disrupted the lives of individuals and families across the globe. For many, the impacts of this global pandemic have been insurmountable and have resulted in significant stressors. Although medical advances have allowed individuals to slowly begin to restore their sense of normalcy, COVID-19 has resulted in unprecedented mental health impacts for many, especially children and adolescents. The present study examines whether stressors related to COVID-19 and whether subsequent quarantine/isolation were possible contributors to psychiatric crises that led to adolescent psychiatric inpatient admissions. Electronic medical records of those admitted to Strong Memorial Hospital’s Child and Adolescent Inpatient Unit between March 13, 2020 and January 1, 2021 were reviewed. Admission and discharge notes were analyzed to determine the presence and context of keywords related to COVID-19. Approximately, 53% of all adolescent psychiatric crises that led to inpatient admission were related to COVID-19 stressors. Results of this study will be used to help understand the extraordinary mental health impacts of a global pandemic and will assist mental health service leaders to better plan for patient flow should there be another wave of quarantine/isolation. Additionally, these results can help inform and develop pandemic-related strategies and interventions that can reduce overall distress in children and adolescents.