A new school year is often full of promise, but a lot hangs in the balance this year. The Centers for Disease Control and Prevention (CDC) is endorsing a return to full-time in-person learning with proper COVID-19 precautions.

Some of the motivation for returning to in-person learning stems from the toll in-home learning may have on children and teens. A year after the first COVID-19 cases in the United States, 46 percent of 977 parents surveyed noticed symptoms of a new or worsening mental health condition in their teen.

“Children who were isolated during the pandemic had less opportunity to learn the social skills needed to build healthy relationships,” says Laura Luff, an integrated care psychologist at Fellsway Pediatrics in Boston Children’s Primary Care Alliance. “They were not able to benefit from the pleasures of friends or learn resiliency and conflict resolution skills.”

Although much of the work is done by children themselves, Luff suggests a few ways caregivers can offer support at every age. Cultivating strong friendships isn’t easy for every child — pandemic or no pandemic. Neurodiverse children or those with behavioral or mental health needs may require additional external support for themselves and their caregivers. Here’s how you can help your child make and keep friends — at any age.

Our earliest friendships

Childhood friendships are key for mental and physical health. Preschool friendships help children develop social and emotional skills, feel a sense of belonging, and decrease stress.

“Our earliest friendships give us practice for our adult relationships,” Luff says. “They help us learn what to expect from a good friend and set expectations for adult relationships.”

Toddlers — some of whom have spent more than half their lives in the pandemic — are not immune, but they appear to be less fazed. Many experts agree they likely won’t be permanently impacted. After all, even in quarantine, young children absorbed new experiences with their parents, siblings, and pets.

Elementary school friendships

The shift from pre-K to kindergarten may be more challenging. “Children in transition years like kindergarten were most likely to be impacted by the pandemic,” Luff says. “It was especially hard for them to make new friends during remote learning.”

It may take a couple of playdates before preschool and elementary-age children begin to feel comfortable with peers and friends. If your child continues to have difficulty connecting with old friends, or with making new ones, try to listen closely and adapt to their needs.

“Focus on helping the child try different strategies to figure out what works,” Luff says.

Middle school friendships

In middle school, friends start confiding in each other and trying to solve each other’s problems. Their friendships help them learn to express their feelings constructively. Some research also suggests that close friendships at this age can help children deter or manage bullies.

By the time a child turns 12, they’ll understand that trust and support are the bedrock of any quality friendship. In turn, they often become less threatened if their friends have other friendships and more empowered by their strongest bonds.

“Middle school is another transitionary period where children were likely impacted by the pandemic,” Luff says. “Caregivers can help their child try different strategies to figure out what will work with their friends. Those lessons can be carried into the teen years and adult relationships.”

“Validate how distressing losing a friend can be,” she adds. “Hear your child’s perspective and then help them decide if this relationship can be repaired or what strategies they could use to make new friends.”

High school friendships

Teenage friendships can be a source of great empowerment. They provide unconditional acceptance from their peers at an especially vulnerable time. Simultaneously, they’re beginning to figure out who they are beyond their family while trying to foster a sense of belonging among their peers.

Conversely, a lack of friends can lead to a sense of social isolation, which can be a precursor for mental health concerns. In a study of more than 4,000 teenagers, those without a close friend reported having depressive symptoms at a much higher rate than those who did.

As a parent, try to manage your own mental health and set a good example for self-care. Look for ways to spend time with your own friends — virtually or safely in-person.

Respect your teen’s individuality. Some teens are outgoing and have many friends, while others are content with one or two close friends. Every teenager is different.

When to seek support

If you sense your child is having a particularly tough time, look for signs that might indicate a deeper mental health concern. Talk to your family’s pediatrician if you notice they’re sad, withdrawn, struggling with daily activities, or having trouble focusing, eating, or sleeping.

“When children struggle to make friends, they are more susceptible to depression and other mental and physical health disorders,” Luff says. “Additionally, children with mental health challenges struggle to make friends, which can exacerbate their symptoms.”

If treatment is needed, it may be available through your pediatrician’s office. They may also recommend another mental health professional who can provide specialized treatment.

Many Boston Children’s Primary Care Alliance practices offer support for mental and behavioral health. Find a practice near you.