Common complaints
Getting an infection can be mild. That is why it is especially important to look at the concomitant infection and the persistent symptoms. The World Health Organisation (WHO) has a guideline for children and young people specific definition developed for Long COVID, because COVID-19 affects them differently than adults.
Children and adolescents often experience multiple complaints: mood symptoms (sad, tense, angry, anxious, depressed), extreme fatigue, sleep problems, headache, shortness of breath and/or shortness of breath, stuffy nose and dizziness and palpitations. Also cognitive dysfunctions (confusion, concentration problems, sensitivity to stimuli and memory complaints) and post-exertional malaise (PEM): the worsening of symptoms that occurs after all forms of exertion – physical, cognitive, social, and psychological).** (see the image below for an overview of the complaints). Still taxing these children could potentially cause irreparable damage. There are also children with post-COVID who do not improve or are taxable.
Children and young people with Long COVID are often unable to fully participate in school, sports, do something fun with friends, or go to a party. The extreme fatigue and/or stimulus processing makes this difficult.
Young people and Long COVID
The group of young people who still have complaints after three months is large. Based on data from the ONS study of the United Kingdom, this amounts to more than 15.000 children aged 2 to 16 years who have had – mild, mild and severe – limitations due to Long COVID for more than three months in the Netherlands, and more than 20.000 aged 17 to 24 years. They may continue to have serious complaints after a mild course of the disease, such as concentration and memory problems, shortness of breath and fatigue. Such complaints can hinder learning and study progress, especially among students.*** For young people who have a mbo- or hbo– and follow a university education, it is important to report study delays to the educational institution as soon as possible. In this way, together with the study supervisor and/or dean, it can be investigated how the study delay can be limited or delayed. For example, education programs often offer the possibility to adjust timetables, schedules and test dates if a young person experiences problems.
Long-term persistent complaints can lead to more mental complaints and stress in young people. Sometimes young adults can use support for the uncertainty and/or fears that their long-term physical complaints entail. For some, life has come to a complete standstill and there is little prospect of recovery, which also affects their future prospects. For young people, too, there are suitable options available for psychological and social support via the digital Help Guide developed by C-support.
There are also young people who already live on their own and, due to their health problems, have less or no work and therefore less or no income. Not all young people are entitled to supplementary benefits, such as unemployment benefit or social assistance benefit. In addition to possible mental effects, this also entails financial problems that also affect the possibilities for housing. As a result, some young people move back in with their parents. These young people can go to neighbourhood teams and/or the municipality for help.
What does C-support do?
Children and young people, together with their parents, can contact C-support for individual advice and answers to questions about health and psychosocial complaints. The aftercare advisor listens to the complaints experienced and the consequences this has on physical and mental health. We discuss what is needed to make complaints more bearable and to possibly reduce them. If necessary, we consult with one of our medical advisors. Advice is also given about possible treatments to be followed by healthcare providers, such as occupational therapy, physiotherapy, speech therapy or dietetics, taking into account the care and/or assistance that is already involved. The aftercare advisor shows the way and stands by the child or young person and his/her parent(s). Where necessary, we provide additional information to professionals such as a general practitioner, youth doctor, insurance doctor, occupational therapist or physiotherapist, but also the school, compulsory education officers, safe at home or other involved service providers.
Education
Education is an important part of the development of children and young people. When a child or young person has Long COVID, it can have serious consequences for school time and cognitive and social emotional development of children.
Due to the Long COVID related complaints, such as PEM, POTS (Postural Orthostatic Tachycardia Syndrome) or extreme fatigue and/or loss of concentration, it is sometimes not possible to (partly) follow education. The absence can lead to an educational disadvantage. It is then important for parents and the student to discuss with the school, and possibly other experts involved appropriate education in primary or secondary education. The Knowledge Center for MBO Appropriate Education provides a vocational education institution with information about organizing this.
In consultation with the internal supervisor or care coordinator, agreements can be made about the care at school and the content of the education, taking into account the resilience and limitations of the child or young person. The youth doctor and/or occupational therapist can also play a role in this.
Custom Made
For children/young people with Long COVID, it is important that they find a balance between effort and relaxation. By aligning education as closely as possible with the student's capabilities, recovery can be contributed to. Dosage of teaching material, lesson time, and/or teaching method and use of resources could contribute to this. Customization can be applied, taking into account the complaints, limitations and resilience of the child or young person and his or her (im)possibilities and those of the school. Examples include:
- to draw up a schedule in consultation with a pediatric occupational therapist;
- scheduling rest periods between lessons;
- working in a low-stimulus environment;
- the use of aids such as headphones in the classroom;
- distance learning, for example video calling or an AV1 robot
(also see Robot education for chronically ill children). - make agreements about the essential (core) subjects or really necessary tests to be taken;
- choice to choose creative subjects in case of lower cognitive load capacity;
- extra time for tests;
- make a profile choice quickly;
- take a spread exam;
- alternating practical and thinking subjects (cognitive load and physical load)
Gym classes and sports
Physical activity combined with social contact is important for the development of a child or young person. This can provide relaxation and contribute to the state of mind. However, physical exertion can be very taxing if a child or young person has Long COVID symptoms and that does not benefit recovery. Symptoms such as PEM en POTS are reasons why children are unable to participate in sports or gymnastics.
It is important that the school and the gym teacher pay attention to this. Therefore, make clear agreements, depending on the load capacity, about what the child or young person does or does not participate in and whether an exemption is necessary. A gym teacher can also insert rest breaks in between, and only have the lessons followed partially. A (child) occupational therapist can advise on this. Also in regular sports, an adapted program can contribute to the possibility of still being able to 'participate'. Or if sports are not possible, to facilitate social contact before or after training, or in another way. This allows the child or young person to at least keep in touch with teammates.
Impact on the family
When a child or young person in a family is ill, the extra care and attention that is needed can have major consequences for the other family members and environment. The family has to take the sick child into account and this puts extra pressure on the other family members. For parents, this can mean a caregiving role with a demanding care task that sometimes also requires adjustments in work (hours) due to the care of the child or young person at home.
Also, more attention may be paid to the sick child than to brothers and sisters. They also have to adapt to the situation due to the sensitivity of the sick child. Keep quiet, adjust their daily routine, holidays that are filled differently. Long COVID not only affects the patient but also everyone around him. >> Read more about the psychological and social consequences and tips on how to deal with them here.
There are various agencies where children and young people can ask for help. For advice, answers to questions and information about research, there are several websites. For this, look at frequently asked questions or the useful links on this page.
Frequently Asked Questions
Schedule a periodic progress meeting at school to evaluate progress and make agreements for the adapted education to be followed. The occupational therapist and/or practitioner of your child or young person can support you in this, in the context of personal resilience. Seezon can support your child at school. When a student has a long-term, chronic or life-threatening condition with (possible) consequences for their school career, it is possible to Consultant Education for Sick Students (OZL) to be activated. This can provide temporary assistance and guidance to the school, the parents and the student. The OZL consultant provides or supports, among other things:
- contact between school, hospital, student and parents;
- information and advice to teachers about teaching sick students;
- information for teachers, parents, (healthcare) professionals and classmates about dealing with sick pupils;
- education and guidance of the sick pupil at home, in hospital and at school;
- (organizing) lessons at home or in the hospital together with the school, if the school's own teachers are unable to do this;
- information about diseases and their possible consequences for school performance;
- creating an action plan for the sick student together with the school.
NB: There are children and young people who are unable to go to school or to build up activities. The advice given in this answer does not apply to this group of children.
In the event of a Safe Home report, it is always appropriate to enter into a conversation with Safe Home, no matter how unjustified the report may feel. For more information about their working methods, see safehome.nl Tips:
- Get well informed about what the report is about. Try to discuss unexplained complaints that arise from Long COVID and/or areas where this has an effect. Explain what this looks like and what this does to your child.
- Always remain in conversation with the relevant agency that Veilig Thuis uses to investigate whether and what kind of help is appropriate. For example, a neighborhood team, youth worker or social worker. This is not there to work against you, but to jointly look at possibilities that can be helpful.
- You can at the BIVKZ right with questions. They represent the interests of parents and chronically, seriously ill or care-intensive children at VT Notifications in the Netherlands.
File formation Safe at Home:
Veilig Thuis is legally obliged to enter into a conversation with the directly involved parties within 5 working days. If the suspicions are not correct and there are no concerns about safety (domestic violence or child abuse), the report is refuted and Veilig Thuis ends its involvement. There are then no further steps. The reporter is informed whether or not the report will be processed. If Veilig Thuis itself enters into a conversation with the family or household, Veilig Thuis always provides feedback to the reporter at the end of its involvement. The file will be retained unless an active request is made to destroy the file. In subsequent reports, it is always checked whether there is already a file. If there is a file and the report has been refuted and no steps have been taken as a result, no new investigation will be conducted. A file is kept for 15 years.For questions about psychological and social problems:
- Digital Help Guide: points the way in psychological and social problems in various domains where questions arise, including:
- Need a listening ear
- Help with personal problems
- Meaningful life and social assistance
- Youth Health Care (JGZ): within a municipality, the JGZ is concerned with the health, development and growth of your child. You can go here for free advice, information, basic medical care and support in growing up and raising children. This also includes the Consultation Bureau for children aged 0-4 and GGD Youth Health Care for children aged 4-18.
- Center for Youth and Family (CJG): offers help and advice on parenting issues. It is a place where parents, children and professionals can go with questions about health, growing up and parenting.
- Youth help online: here you will find more than 20 helplines that offer you fast, anonymous and free support. Via chat, phone or email. Reliable and professional.
- Mentally vital: (part of the Trimbos Institute) provides information about mental health, offers exercises and helps you find help.
For questions about educational support:
- Network Ziezon: support for sick children in education. The network also offers a lot of knowledge and information for parents, teachers, school boards and partnerships.
- Parents & Education: information about education and more for parents with school-age children.
- Partnership for appropriate education: information about appropriate education, the working methods and additional support options for parents with school-age children.
- Carefree to School Foundation – practical tips: tailor-made at school for pupils (primary/secondary education) and students (vocational education) with a chronic illness. Here is a your guides with tips for making practical arrangements with the school.
- Carefree to School Foundation – distance learning: distance learning options for pupils/students who can only attend school/training for a few hours. With a route map for students for whom distance learning could be a good solution.
- OZL – Educational Support for Sick Students: looking for opportunities to offer sick students the right form of education. Regional care: educational support in Gelderland, Brabant and Limburg.
- Educational consultants: if parents have a dispute with the primary care facility (collaboration), they can contact an education consultant. This person supports the advocacy of the child and talks to parents, school, municipality and/or collaboration to find solutions and appropriate care.
- NJI educational care arrangement: especially for children who need educational and care support, there is a collaboration between education and youth care and parents. The development of the child at school is central. Educational-care arrangements are available for individual children and for groups of children.
For questions about development support:
- Youth care under the Youth Act: for children and young people there is the Youth Act. This act regulates almost all care and support for children and young people under the age of 18. Here you can find out how to apply for youth care and what it entails. Sometimes care for young people is also provided under the Health Insurance Act, the Long-term Care Act or the Wmo.
- Regulation assistance for care children: does your child have an illness, disability (such as EMB) or developmental delay? Then various forms of help and support are possible. Also look at: Regulation assistance Wmo youth.
- Wlz care for youth: the Long-term Care Act regulates care for people who need lifelong and life-wide support, at home or in a care institution. Children and young people can also receive Wlz care if they meet the conditions.
- Integrated Early Help: for questions about developmental delays and/or behavioral problems in young children up to 8 years of age.
Children with Long COVID fall under authorized absence. The youth doctor, also called school doctor, is the designated person to formulate advice through discussions with the parents, student, school and any advice from an occupational therapist. A (resilience) statement is not necessary. The resilience of a child with Long COVID can vary greatly per day and week. If a statement states that the resilience has a certain duration and a child has a relapse (or PEM), then a declaration of tax liability on paper can put parents in a difficult position. Advice based on insights from the youth doctor who coordinates this with the child or young person, parents, school and if necessary in consultation with therapists and the truancy officer is sufficient for compulsory education. Together we can look at whether and how appropriate participation in education can be resumed. See also advice on school participation after corona measures expire. The youth doctor works from a youth health care team and works together with the district team. In the event of long-term absenteeism due to illness, the school contacts the youth health care, parents can also ask their questions there. The youth doctor has medical professional secrecy. If necessary, the youth doctor can request information from the treating physician of the youth and/or the vulnerable family member with the permission of the pupil and parents.
