For Parents

Talking to Children about Disasters*


WHAT TO SAY TO YOUR CHILD:

It is important to explain things about the disaster in words that your child understands
Allow your child to tell you how they feel
Allow your child to tell you what they understand about the disaster
Let your child know that they are safe
Let your child know that you (and other adults in their lives) are there to LISTEN and to answer questions
Let your child know that their feelings about the disaster are normal
You CAN share your concerns about the disaster with your child
Children and adolescents should not watch the events on television alone
It is unwise to let children or adolescents view scenes of the disaster over and over again
Let your child know that you and they will find ways to cope with the disaster

WHAT YOUR CHILD MAY EXPERIENCE:

A child's age affects how the child will respond to the disaster
Many children will need to talk to parents, teachers, and guidance counselors, and most will be able to cope with what they have experienced
Some children will not want to talk a lot about the disaster
Parents should be alert to changes in a child's behavior:

Several weeks after the experience of the disaster, some children may develop what is called "Posttraumatic Stress Disorder" (PTSD). Children with PTSD can have repeated episodes when they re-live the traumatic event or respond to other events with excessive fear. Most children will not develop PTSD.

Parents who are concerned about their child should seek help

WHERE TO SEEK HELP:

Talk to your child's teacher or guidance counselor
Additional assistance is available through the school-based support team
Talk to your child's pediatrician/nurse practitioner/family doctor
Ask for a referral to a child psychiatrist or psychologist
Child and parent support groups will also be available

*Prepared by the Mount Sinai Hospital Divisions of General Pediatrics and Child & Adolescent Psychiatry, September 12, 2001.

Pointers for Teachers


This information sheet is to help inform teachers about the effects of the World Trade Center disaster on their students and to guide them in helping students cope positively. Teachers and schools are a community's major means of caring for its children. When disaster strikes a community, teachers become de facto emergency response workers whose role includes (a) helping children regain a sense of safety and (b) understand what has happened in their world. In addition, because teachers know the children in their care, they are well placed to notice behavioral/emotional changes and make a referral to insure that the child receives evaluation.

Typical Reactions after a Trauma

Younger children often become fearful of separating from parents. Sometimes, they cry, scream, cling, suck their thumb, have sleep problems. In general, children act younger than their age and become much needier. Children that are older (6-11) can become withdrawn or behaviorally disruptive. Problems with anger are frequent. Problems with attention and concentration may develop. Sometimes, children will describe physical aches and pains, such as stomach-aches. Sleep disturbances, including nightmare about the event, are usually good markers of difficulty adjusting. Adolescents tend to respond much like adults. They often report intrusive thoughts (thinking about the event over and over even when they don't want to). They avoid reminders and don't want to think/talk about what happened. Sleep disturbances, school avoidance, persistent sadness and withdrawal, discouragement about the future, are also signs of difficulty.

Helping a child or Youth

Children often react to disaster by feeling unsafe. This becomes expressed in behaviors typical of younger children. A purpose of such reactions is to draw caretakers closer and to ask for more attention and care. The very getting closer-the provision of more social support-is usually the best therapy. It is not usually useful to demand of the child that they "buck up" right away. The key intervention is to create a socially protective environment in which the child is reassured by the increased attention. However, reassurance does not mean license. It is important to flexibly adjust expectations while gently nudging the child back to increased functional capacity. However, it should be understood that this increased flexibility is a very real challenge. This is because while teachers are used to children occasionally needing more support, having most children needing more support can seem daunting, and because during disasters teachers are also emotionally strained. It can be very helpful to have additional resources in the schools to help.

When to refer a child

It is best to refer a child when he or she continues to need sustained additional attention (marked either by disruptive behavior or withdrawal) after most other kids have returned to normal function. Such a referral will permit the child to receive more sustained attention and should not be perceived as a mark of pathology on the child's part but rather as a need for more support to work through the impact of the event.

Classroom Activities to Help Children Express Feelings

It is important to remember that children vary widely in how they react to disastrous events. Some never have much difficulty with them, others have transient reactions that pass spontaneously. Concern should develop particularly when a child continues to have (a) behavioral disturbances (anger and aggression for example), (b) emotional difficulties (crying spells, severe withdrawal, increased fear), or functional impairment (difficulty with school, peers).

Providing a structured environment and activities to assist children to share experiences and clarify concerns can be very helpful in restoring a sense of safety. Such activities also permit teachers to observe the reactions of children providing an enriched database about each child's reaction to the disaster.

The activities below were drawn from several published resources for teachers and are presented to illustrate the types of activities that teachers may choose to use or improvise upon.

1. Making toys and materials that encourage play reenactment of children's experiences of a disaster can be helpful to them in integrating such experiences. These might include fire, rescue, and dump trucks, ambulances, bulldozers, or building blocks. Play with puppets can also help children describe feelings.

2. Physical activity can be a good way to relieve tension and anxiety for children as well as adults. Physical contact during times of stress can give them a sense of security. Games that include physical activity and contact may be helpful. Some examples for preschool, early elementary:

3. Having a child draw a picture about a disaster is a good way to initiate expression in some children. Talking about the picture later with a teacher or in a small group may allow them to vent their experiences and to discover that others share their fear (See #7 below).

4. A group mural or collage on topics like "what happened" followed by small group discussions may also be helpful.

5. Help or encourage children to develop skits about what happened in the disaster. Especially encourage them to include anything positive about the experience as well as those aspects that were frightening or disconcerting.

6. Students can draw, write, or talk about the thing they best remember, or respond to questions or topics such as:

It is extremely important to end the activity on a positive note by focusing on things that promote a sense of security, mastery, or preparedness. While this may be volunteered by students and underlined by the teacher. However, if it is not teachers should introduce such positive themes and elaborate them.

Positive disaster outcomes include:

Questions to promote expression/sharing

Prepared by Claude Chemtob, PhD - Visiting Professor -Mount Sinai Hospital and School of Medicine, Division of Child and Adolescent; September 2001.