Helping Children and Adolescents Cope with Disasters
Ten ways to help

By Glenda Thorne, Candy Lawson and Alice Thomas

Hurricane Katrina victimized children wide and far. Thousands of children are survivors of Hurricane Katrina, while millions of other children have observed terrifying sights via extensive television coverage. Media has shown pictures of families on rooftops begging to be rescued, and horrific pictures of suffering, death and catastrophic destruction. Reports abound about children who are still separated from their families - on television, on the internet, in magazines and in newspapers.

Then, less than a month later, Hurricane Rita reignited fear and prompted an epic evacuation of nearly three million people. Once again, homes were flooded and shattered, leaving families waiting to be rescued.

Parents, teachers and other caring adults can help children cope with hurricane disasters and other traumatic events. First, adults should understand that children and adolescents will react to trauma and stress in varying ways depending on their age and developmental levels, their preexisting temperament or disposition, their level of family, teacher and peer support, and their general resiliency or ability to bounce back.

Normal reactions to stress may be emotional, cognitive, physical, or interpersonal. Examples of emotional reactions include shock, fear, anger, grief, guilt, feelings of helplessness, hopelessness, numbness and/or emptiness, and a reduced ability to feel pleasure or love. Cognitive reactions to stress include disorientation, confusion, indecisiveness, worry, inattention, trouble concentrating, loss of memory, undesired memories, and self-blame. Physical reactions include fatigue, anxiety, irritability, trouble sleeping, bodily aches or pains, and changes in appetite. Distrust, heightened conflict, withdrawal, and feelings rejected or abandoned are examples of stress-related interpersonal reactions.

Adults can help children cope with disasters and other traumatic events.

1. Listen.
Listen and empathize when children express their concerns or fears. Create a safe and confidential atmosphere in which children can discuss their fears, concerns and anxieties. Acknowledge the frightening parts of the disaster. Avoid being indifferent or denying the seriousness of the situation to the child. Statements such as, “Don’t worry, everything will be okay” or “Just forget about it” do little to help and may communicate to the child that their feelings are not understood. In school, it is helpful for children know there is at least one person in whom they can confide their fears. This person may be their teacher, principal or guidance counselor.

2. Reassure.
Children need comforting and frequent reassurance that they are safe.

3. Recognize feelings that underlie behaviors.
Be aware of behaviors associated with stress or trauma and name the feelings that may be the cause of the behaviors. For example, if a child is acting aggressively, the adult might say, “It seems like you are really mad about losing all the things you liked to play with the most” or “When we see things like this happening, it can make us afraid that we will never be safe again”.

4. Help children to recognize and express their feelings in an acceptable way.
When children are engaging in behaviors that are not healthy or adaptive such as aggression, acting out or withdrawing, adults can both recognize the feelings that underlie these behaviors and also help children identify and label these feelings. For example, if a child is clinging to his parents, a parent could say something like, “It seems that you are afraid something might happen to me; is that what you are feeling?” The parent may suggest ways children might handle the fear more appropriately, such as talking about it, drawing pictures, or writing about it in a journal.

5. Provide consistency and routine to the greatest extent possible.
Although many families and schools directly affected by the disaster may not be able to return to routines that were in place prior to the hurricane, they can develop some consistency and routines in their day-to-day living. If more than one family is living in the same home, it is important to think ahead and identify possible times or situations that may be more chaotic, such as getting ready for school or work in the morning. Engaging in group problem solving on how to handle these stressful times gives everyone involved a voice in decision-making and increases their ownership of the solutions to the problems.

6. Involve children in actions that help others.
Involving children in actions that are helpful to others can give them some sense of control over what is happening. Activities may include collecting money, food, and/or clothing for those who are in need; performing a task such as helping others clean their homes or yards; or helping more with routine chores. At school, children might write poems or stories and compile them into a class book about the disaster. They could also draw pictures and illustrations for the book. They could visit nursing homes. There seems to be special bonding between the young and elderly that is very healthy and healing for both. They could donate clothing they have outgrown, or even some of their favorite clothes or toys to those who lost theirs.

7. Preview with children situations that may be difficult or stressful and give them ideas about what to do or say during these times.
Stressful or difficult events after a hurricane for children affected first hand may include attending funerals or memorial services, returning to school, attending a new school in a new location, living with friends or extended family members, living in shelters and living in new FEMA trailer parks in new locations. Be honest with children. Give them realistic information about what is happening or going to happen. For example, when children return to school after a natural disaster, other children and teachers may be ask them about their experiences. If children have gone through particularly difficult circumstances, parents may want to review simple statements or brief explanations their children might give their classmates.

8. Reduce demands.
Trauma and stress often cause reduced energy and fatigue, so children and adolescents may need reduced demands during these difficult times. For example, parents might tolerate more irritability or sibling rivalry than is usually tolerated from their children. Teachers might reduce the volume of classwork and homework assignments.

9. Adaptively handle adult stress.
Children pick up on their parents’ and teachers’ stress. Children need caregivers who are physically and emotionally available. Therefore, it is important that parents, teachers and other adults who experience trauma, especially trauma caused from large-scale natural disasters such as hurricanes, find effective ways to reduce their own stress, to understand the impact of grief, and to know when they need to seek professional help. Sharing experiences with family members, friends and other support networks is very important. Model for children: find joy in the simple things in life, take pleasure in fellowship with others, rely on your religious beliefs and spiritual strength, and count your blessings.

10. Be on the alert for behaviors that require professional help.
Parents and teachers of children who experienced Hurricane Katrina first hand should contact mental health personnel if the following behaviors present themselves:
o Long term denial and/or avoidance of the traumatic event; lack of recognized response to the trauma
o Extended periods of depression (loss of interest in activities, feelings of hopelessness and helplessness, inability to experience moments of joy, profound emptiness)
o Vague and generalized feelings of guilt and depression
o Persisting anxiety about the traumatic event
o Inability to respond to comfort and rejection of support
o Purposeful withdrawal from friends, loss of sociability
o Sleep or appetite problems, unusual loss or gain of weight
o Prolonged rather than transient physical complaints
o Acting younger for a prolonged period
o Destructive outbursts
o Inappropriate euphoria
o Accident-proneness
o Inappropriate/illegal behavior
o Decline in school performance or refusal to attend school
o Excessive grief
Item 10 adapted from Caring for Kids after Trauma and Death: A Guide for Parents and Professionals by the Institute for Trauma and Stress at the NYU Child Study Center (2002).

Online resources

Helping children and adolescents after a disaster:
 
American Academy of Child and Adolescent Psychiatry
 
New York University Child Study Center
 
Caring for Kids after Trauma and Death: A Guide for Parents and Professionals
 
National Association of School Psychologists
 
Connect for Kids
 
National Center for PTSD