Roughly 200,000 children in the U.S. have lost a caregiver to COVID-19. In South Dakota, mental-health experts say these cases can have added complications as kids grieve, and a range of support is needed for a strong emotional recovery.

Nikki Eining is therapist with Avera Behavioral Health and board member for the Center for the Prevention of Child Maltreatment. She said loss of a biological parent falls under the scope of Adverse Childhood Experiences.

Eining explained it can affect the child's development, because they lost a relationship that's difficult to replace.

"I might not be receiving that nurturing piece from that caregiver anymore," said Eining, "when I've developed that bond to that caregiver as an infant or a toddler, or even an early elementary-aged youth."

With social-distancing requirements, the child may have not had a chance to say goodbye, and those rules may have kept their support system at bay during the mourning phase.

Eining said that's why it's important for adults in their lives to help build new trusted relationships that offer a sense of bonding. That involvement can come from outside the home, including neighbors, teachers and coaches.

Maureen Murray, director of mental health and prevention services with Youth and Family Services in Rapid City, said her office has responded to a handful of these cases.

She said in situations where a child has to suddenly adapt to a new environment, that can extend the grieving even longer.

"A move, a different school system, loss of friends," said Murray, "even if the surviving parent is struggling with their own grief and is not there emotionally for the child."

She said it's dangerous to assume all kids are resilient, noting some will not show how much they're struggling emotionally.

Murray said providing safe spaces for them to talk when they are ready is important, while adding therapy, such as individual sessions or grief camps can help.

In eastern Kentucky, advocacy groups are expanding summer learning opportunities for families.

Isolation and learning loss plague many rural Kentucky kids once school lets out, and research shows children can lose up to 34% of what they learned during the prior school year during the summer.

Alissa Taylor, Kentucky state director of children's safety programs for Save the Children, said transportation is one of several barriers for rural kids.

"They don't have access to the resources, public services, and exposure to the arts, those type of things that other kids are getting during the summer," Taylor pointed out. "We know that sparks creativity, it encourages continued learning throughout the summer."

According to a 2019 Center for American Progress survey, 3 of 4 parents said they have had at least some difficulty finding child care during the summer.

Taylor noted Save the Children is offering around 60 summer opportunities in 19 eastern Kentucky counties, including full-day, four- to six-week camps for elementary-aged children.

"There's either bus transportation, or a gas-voucher program that's offered for families to get their kids to the camp," Taylor emphasized. "They're provided two meals a day. They're having fun, we know that they're learning while they're having fun, and they want to keep coming back."

She added the feedback from families has been positive, including one mother who said the summer programs allowed her to keep earning a paycheck during the summer.

"We know that jobs are really hard to come by," Taylor acknowledged. "The summer camp and her kid having something to do was an excellent way for those kids to continue learning and for her to stay employed."

More than half of survey respondents said costs for child care during the summer are a significant challenge.

Groups fighting for children's health are asking Gov. Gavin Newsom and lawmakers to require insurance companies to cover hearing aids and related services for kids.

Advocates want to see language in the budget trailer bill which would mandate the coverage.

Michelle Marciniak, co-chair and co-founder of the nonprofit Let California Kids Hear and the mother of a child with hearing loss, noted hearing aids can cost about $6,000 a pair and they need to be replaced every 3 or 4 years.

"Parents are making difficult financial decisions," Marciniak pointed out. "They're hosting fundraisers, GoFundMe pages, they're putting it on their credit cards. And some are forgoing them altogether. And it really doesn't need to be this way."

Opponents of a mandate argued it would raise costs for insurance companies, who will pass it on to consumers. In 2019, a bill to mandate hearing aid coverage for children - Assembly Bill 598 - passed both chambers in the state Legislature - but was shelved in favor of the current state-run program called Hearing Aid Coverage for Children. That program costs more than $16 million dollars a year but currently serves only 200 out of about 8-thousand eligible children. Experts say it's a flop because so few audiologists participate in the program - and that is blamed on low reimbursement rates for providers, administrative red tape, and overburdened clinics.

In 2019, a bill to mandate hearing aid coverage for children, Assembly Bill 598, passed both chambers in the state Legislature but was shelved in favor of the current state-run program called Hearing Aid Coverage for Children. The program costs more than $16 million dollars a year but currently serves only 200 out of about 8,000 eligible children. Experts said it has been a flop because so few audiologists participate in the program, which is blamed on low reimbursement rates for providers, administrative red tape, and overburdened clinics.

Marciniak acknowledged California does a great job at screening children for hearing loss, but does a terrible job at making intervention affordable.

"Now, over 30 states have recognized that this is a developmental emergency for children, and they have acted on it by requiring health plans to cover pediatric hearing aids," Marciniak emphasized. " And we believe this is the best, most efficient delivery system that's connected to a child's medical home."

Just one in 10 children has hearing aids covered by a private insurance plan in California. Experts estimate 1,000 deaf or hard-of-hearing kids are born in the state each year. Lawmakers and the governor have until June 15 to finalize the budget.

Utah Gov. Spencer Cox joined the Children's Collaborative for Healing and Support last week to announce a pilot program in the state designed to support grieving children and connect them to services.

According to the Children's Collaborative, there are more than 60,000 young people in Utah who have experienced the death of a parent or caregiver. The pilot's purpose is to help kids get the help they need.

Gov. Cox noted in Utah, one in 15 children will experience the death of a parent or sibling before they reach the age of 18. He said family's shouldn't suffer alone.

"We have the resources already available and we need to use them," Cox urged. "Not only do children suffer the emotional pain of losing a caregiver, they often experience trauma and when not provided support they have long-term consequences like low self-esteem, depression and poor performance in school."

Gov. Cox added it is important to remember losing a parent can also mean sudden financial and housing insecurities, which leave some youth homeless. According to the Children's Collaborative, the Utah pilot program will lay the groundwork for it to be implemented in other communities nationwide.

According to the group, the program will use both a "school based identifying strategy and a data matching system using public records on a state level," to offer assistance.

Rich Nye, superintendent of the Granite School District, said tragedies, like losing a loved one, have an immediate impact on how well children preform in school and the type of education they receive. Nye considers partnerships like the Children's Collaborative as a "key to unlocking the full potential," of communities.

"Because it is partnerships like these that reach down within the community, at the individual level," Nye emphasized. "Schools are uniquely positioned, given our role as hubs in the community, of connecting children and their families to these resources."

The Children's Collaborative for Healing and Support was created by the COVID collaborative. The pandemic took more than 1.1 million American lives and the group eventually discovered 340,000 children lost a parent or caregiver to COVID-19.


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