Dealing with a loss

Understanding your feelings.

Helping Young Children Cope with Trauma

Disasters are upsetting to everyone involved. Children, older people, and/or people with disabilities are especially at risk. For a child, his or her view of the world as a safe and predictable place is temporarily lost. Children become afraid that the event will happen again and that they or their family will be injured or killed. The damage, injuries, and deaths that can result from an unexpected or uncontrollable event are difficult for most children to understand.

How a parent or other adult reacts to a child following any traumatic event can help children recover more quickly and more completely. This brochure contains general information to help you in this task.

Children's Reactions

Children's fear and anxiety are very real, even though to adults they may seem exaggerated. Children are afraid of what is strange. They fear being left alone. Following a disaster, they may begin acting younger than the age they are. Behaviors that were common at an earlier age, such as bedwetting, thumb sucking, clinging to parents or fear of strangers, may reappear. Older children who have shown some independence may want to spend more time with their families. Bedtime problems may appear. A child may begin to have night-mares; not want to sleep alone; and/or become afraid of the dark, falling asleep or remaining asleep.

Some children will show their fear by developing physical symptoms, such as stomachaches, headaches or feeling "sick." All children can experience thinking difficulties. They can become easily distracted, feel confused and disoriented and find it hard to concentrate. These reactions can be triggered by smells, objects or activities associated with the trauma. A child may be unaware of the triggers and of any of the behavioral changes that occur. They are not intentionally showing they are anxious or fearful.

Children of different ages react in different ways to trauma.

Birth to 2 years
Without the ability to speak, children cannot describe the event or their feelings. They can retain memories of particular sights, sounds, or smells. When they are older, these memories may emerge in their play. Babies may be more irritable, cry more often and need to be held and cuddled frequently. They will respond to the caring that is given to them by an adult.

Preschool and Kindergarten
In the face of an overwhelming event, very young children can feel helpless, powerless, and unable to protect themselves. When the safety of their world is threatened, they feel insecure and fearful. Children this age cannot understand the concept of permanent loss. They believe that consequences are reversible. They will repeatedly recreate parts of the disaster in their play. These are all normal reactions. Abandonment is a major childhood fear, so children need frequent reassurance they will be cared for and will not be left behind.

Activities for home or school: play acting, physical contact, puppets, art, stories, large muscle movement (throwing balls, etc.).

School age (7 to 11 years)
Children at this age have the ability to understand the permanence of loss from a trauma. They can become preoccupied with details of it and want to talk about it continually. They may not be able to concentrate in school and their grades drop. Since their thinking is more mature, their understanding of the disaster is more complete. This can result in a wide range of reactions: guilt, feelings of failure, and anger.

School age children can also slip back into earlier behaviors. As in younger children, sleep problems can appear. Their anxiety and fear may be seen in an increased number of physical complaints.

Activities for home or school: play acting, puppets, drawing and painting, sharing their experiences in groups, reading, creative writing or discussion.

Pre-adolescence and adolescence (12 to 18 years)
In this age group, children have a great need to appear knowledgeable and experienced to the world, especially to their family and friends. When they live through a traumatic event they need to feel their anxieties and fears are shared by their peers and are appropriate. Because they survived the trauma, they may feel immortal. This can lead to reckless behavior and taking dangerous risks. Their reactions are a mixture of earlier age group reactions and reactions that are more adult. Teenage years are a period of moving outward into the world. However, experiencing a trauma can create a feeling that the world is unsafe. Even teenagers may return to earlier ways of behaving. Overwhelmed by intense reactions, teens may be unable to discuss them with their family members.

Activities at school: general classroom activities, literature or reading, peer helpers, health class, art class, speech/drama, social studies/government, history.

How To Help Children

Routines
Children of all ages can benefit from the family keeping their usual routinesmeals, activities, and bedtimesas close to normal as possible. This allows a child to feel more secure and in control. As much as possible, children should stay with people with whom they feel most familiar.

Special Needs
Accept the special needs of children by allowing them to be more dependent on you for a period of time. Give more hugs if they need them; let them keep the light on at night or not sleep alone or return to having their favorite teddy bear or blanket; don't mind their clinging behavior.

Media Coverage
Following a disaster, everyone is eager to hear the latest news about what happened. However, disaster research has shown that unexpected messages or images on television were frightening, causing a reappearance of stress-related problems. In addition, anyone who watches the disaster coverage can become what is called a "secondary victim" and can suffer emotional and physical problems. It is best to not allow children to watch news coverage of the disaster.

Feelings and Reactions
Children express their feelings and reactions in different ways. Your acceptance of this will make a difference to how your child recovers from the trauma. This means accepting that some children will react by becoming withdrawn and unable to talk about the event, while others will feel intensely sad and angry at times and at other times will act as if the disaster never happened. Children are often confused about what has happened and about their feelings. However, don't be surprised if some children don't seem to be affected by what they have seen and heard. Not everyone has immediate reactions; some have delayed reactions that show up days, weeks, or even months later, and some may never have a reaction.

Talking about what happened

• Listen to and accept children's feelings.
• Give honest, simple, brief answers to their questions.
• Make sure they understand your answers and the meaning you intend.
• Use words or phrases that won't confuse a child or make the world more frightening.
• Create opportunities for children to talk with each other about what happened and how they are feeling.
• Give your child an honest explanation if you are feeling so upset you don't want to talk about what happened. You may want to take "time out" and ask a trusted family friend to help.
• If children keep asking the same question over and over again it is because they are trying to understand; trying to make sense out of the disruption and confusion in their world. Younger children will not understand that death is permanent, so their repeated inquiries are because they expect everything to return to normal.
• If the child feels guilty, ask him or her to explain what happened. Listen carefully to whether he or she attaches a sense of responsibility to some part of the description. Explain the facts of the situation and emphasize that no one, least of all the child, could have prevented it.
• Let the school help The child's teacher can be sensitive to changes in the child's behavior and will be able to respond in a helpful way.
• Even if you feel the world is an unsafe place, you can reassure your child by saying, "The event is over. Now we'll do everything possible to stay safe, and together we can help get things back to normal."
• Notice when children have questions and want to talk.
• Be especially loving and supportive; children need you at this time.

When To Seek Professional Help
Children are amazingly flexible, even though they can be deeply affected by trauma or losses. Sometimes a child can be helped by a counselor who can provide a safe place to talk about what happened and their feelings. Getting professional help is a good idea if a child shows any of the following changes for longer than three months following the trauma:

• Behavior or academic problems at school.
• Angry outbursts.
• Withdrawal from usual social activities or play with other children.
• Frequent nightmares or other sleep disturbances.
• Physical problems such as nausea, headaches, weight gain or loss.
• Intense anxiety or avoidance behavior that is triggered by reminders of the event.
• Depression or a sense of hopelessness about life or the future.
• Alcohol or drug use problems.
• Dangerous risk-taking behavior.
• Continued worry about the event as a primary focus in life.

Certain events may make a child more vulnerable to having difficulty. If a child has experienced a recent loss such as a divorce, a death of someone who was close, or a move to a new neighborhood, he or she may feel particularly overwhelmed by the trauma. A traumatic event can reactivate the emotions associated with previous traumas, which can be overpowering.

Seeing a counselor does not mean that a child is "mentally ill" or that you have failed to support him or her. Following a trauma, many adults and children have found that it is helpful to talk with a counselor who has specialized training in post-traumatic reactions and can help them understand and deal with how they are feeling.