Helping children overcome emotional problems in the wake of a disaster is a considerable task for parents, teachers, and mental health professionals. Most children have similar fears after a tragic occurrence: that the event will happen again, that someone they love will be hurt or die, and that they may be left alone. First and foremost, all children must have their basic needs met. They need food, clothing, shelter, and to feel safe with someone who cares about them. Assuming that these needs have been met, as well as any health issues addressed, there are actions adults can take to alleviate children’s anxiety.
Children’s reactions to a disaster depend upon what was experienced and upon their previous living situation. Children are especially vulnerable if they had a recent family disruption or their lives were chaotic. Having to flee from ones home and leaving all possessions behind are difficult enough, but having a home destroyed and fearing for ones life can be devastating.
When family members become anxious and frightened, a child's fear is magnified. When possible, adults need to deal with the situation in a way that will help children avoid a permanent sense of loss. Adults need to support each other so that they can be emotionally available for their children. When they cope well under extremely difficult conditions, there is a good chance the children will make a positive adjustment. Support for these children is necessary to avoid long-term emotional harm. If some of the following symptoms are extreme and/or continue for months, a child will most likely need professional help.
Birth to Age Six
Children who are too young to speak cannot describe their feelings, but they may remember sights, sounds, or odors from a disaster. They often react by being irritable. Preschool children are especially vulnerable to fears of being abandoned. These children believe that outcomes are reversible and they expect everything to return as it was before. Some common reactions for children in this age range are:
- Clinging, crying, whimpering, and/or screaming;
- Following a parent everywhere;
- Refusing to be left alone;
- Being fearful of darkness or animals;
- Having sleep disturbances or loss of appetite;
- Losing bladder or bowel control;
- Stuttering or other speech problems;
- Trembling or being unable to move;
- Exhibiting regressive behaviors such as bed-wetting and thumb-sucking;
- Refusing to go places that remind them of the place where the traumatic event occurred; and
- Recreating parts of the devastation in their play.
What can be done to help these children?
- Provide reassurance through your words and actions that you love them and will take care of them.
- Be available to touch, hug and give attention.
- Create a bedtime ritual.
- Accept their need to sleep near an adult.
- Continue family routines as much as possible.
- Allow them to engage in make-believe play related to the disaster.
- Listen to the children express their thoughts and feelings concerning the event. (Note: Reading the Kelly Bear Feelings book helps children verbalize their emotions.)
- Be understanding and sympathetic.
- Spend extra time together as a family.
These children understand that changes can be permanent. They may become preoccupied with the details of the disaster or exhibit fears that seem unrelated to it. Some common reactions of children ages seven to eleven are:
- Being withdrawn;
- Expressing irrational fears;
- Being irritable;
- Having angry outbursts;
- Having sleep disturbances such as nightmares, night terrors and bed-wetting;
- Being competitive with siblings;
- Isolating him or herself;
- Refusing to attend school;
- Being disoriented and/or easily confused;
- Exhibiting poor concentration and school performance;
- Losing interest in activities;
- Expressing physical complaints such as headaches, stomach aches or dizziness; and
- Being depressed, anxious, or emotionally numb.
What can be done to help these children?
- Be sympathetic, patient and accepting.
- Be non-judgmental if they exhibit regressive behaviors.
- Provide a routine and structure.
- Monitor television viewing that may be frightening to them.
- Relax expectations.
- Understand their need to be sad and cry without shame.
- Help them feel in control by encouraging them to make some decisions.
- Encourage them to discuss what happened, but do not insist that they discuss it. (Note: Instead of saying, “How do you feel?” say something like, ”What do you think other children your age are worrying about?” The latter questions is easier for children to answer.)
- Provide an opportunity for them to see their friends.
- Allow them to act out the disaster through their play.
- Help them think about what they can do to feel more comfortable.
- Help them identify triggers that may cause them distress, i.e. aromas, storms, specific places, etc.
- Explore things they can do or say to themselves to relieve their anxiety.
- Be honest and realistic when discussing the future but be as reassuring as possible.
- Discuss safety measures to be taken in case of a future disaster.
- Encourage them to participate in family recovery projects.
For these students it is necessary to provide opportunities for peers to share their reactions. They need to know that their fears are normal. Their reactions tend to resemble those of adults, yet they may also react in a childlike manner. The symptoms of possible problems for this age student include:
- Having intense emotions and being unwilling to discuss them with their family.
- Having appetite and sleep disturbances;
- Experiencing flashbacks or nightmares;
- Exhibiting physical problems such as rashes, digestion problems, asthma or weight gain or loss;
- Having psychosomatic symptoms such as headaches;
- Expressing fear of leaving home;
- Avoiding any reminders of the disaster;
- Feeling guilty for not doing more;
- Withdrawing and losing interest in school and/or peer interactions;
- Avoiding school and academic work;
- Having a decreased energy level;
- Feeling indifferent, agitated, hopeless and/or depressed;
- Having suicidal thoughts;
- Rebelling against rules;
- Feeling immortal and exhibiting risk taking behaviors;
- Using alcohol or other drugs; and
- Exhibiting delinquent behavior.
What can be done to help these students?
- Help them feel in control by having them make some decisions.
- Reassure them that they did all they could at the time.
- Facilitate a group of peers to discuss the disaster.
- Foster participation in social activities and/or athletics with peers.
- Provide extra attention and comforting.
- Provide a routine but be flexible.
- Relax expectations for a time.
- Encourage participation in rebuilding efforts.
- Seek professional help.
Additional Ways Teachers and School Personnel Can Assist These Students
- Take time to prepare yourself emotionally, especially if the disaster affected you personally.
- Be aware that any child who watched news coverage of the disaster can become a "secondary victim" and can suffer emotional and physical problems even if they live away from the disaster.
- Be sensitive to cultural differences among children.
- Let children know that it is normal to feel upset and fearful after being exposed to a tragedy.
- Provide an opportunity for children who want to talk about the event to express their thoughts and feelings.
- Respect the right of some children to avoid any discussion.
- Avoid repeated dialogue concerning the event that may be disturbing to some children.
- Answer their questions with honesty, yet be brief using words that children easily understand.
- Speak in hopeful terms.
- Reassure the students that the event is over and that adults will do everything possible to keep them safe.
- Provide peer buddies for these children.
- Provide an organized classroom that can serve as a safe haven.
- Understand that some of these children may be extremely angry, withdrawn or sad.
- Be aware of triggers that may cause distress such as certain aromas, activities, or storms that they may associate with the disaster.
- Realize that it will take time for the students to adjust.
- If deemed appropriate share stories of disasters that demonstrate resiliency and that have resulted in a return to a “new normal.”
- Offer opportunities for children to draw pictures of their choosing and perhaps pictures that represent their future hopes.
- A school counselor or team of mental health professionals may want to lead discussions with children in classrooms or in small groups. (Note: if the children are unresponsive, ask them to write down their feelings or questions anonymously, pass them to the front and then read and discuss them as a group.)
- School counselors may want to use drama, puppets, art, play, books, creative writing, photography, music, discussions or games to help these children learn ways to cope with their emotions and anxieties. Individual counseling may also be offered.
- Hold a meeting for parents to discuss the disaster, to share concerns about their children\0xD5s reactions and to explore ways school personal and parents can work together for benefit of the students.
- If feasible, add support staff during, before, and after school.
- When possible help connect families to community resources. Bring agencies into the school that can deal with needs related to housing, finances, and insurance.