Responding to Children’s Emotional Needs During Times of Crisis: Information for Parents

Pediatricians are often the first
responders for children and families suffering emotional and psychological
reactions to terrorism and other disasters. As such, pediatricians have a unique
opportunity to help parents and other caregivers communicate with children in
ways that allow them to better understand and recover from traumatic events such
as terrorist attacks or other disasters. Pediatricians also can help to
facilitate timely referral to mental health services, as appropriate, for these
children and their families.

Important tips for parents and other caregivers
include:

• Take care of yourself first. Children
  depend on the adults around them to be and feel safe and secure. If you
  are very anxious or angry, children are likely to be more affected by
  your emotional state than by your words. Find someone you trust to help
  with your personal concerns.

• Watch for unusual behavior that may
  suggest your child is having difficulty dealing with disturbing events.
  Stress-related symptoms to be aware of include depressed or irritable
  moods; sleep disturbances, including increased sleeping, difficulty
  falling asleep, nightmares or nighttime waking; changes in appetite,
  either increased or decreased; social withdrawal; obsessive play, such
  as repetitively acting out the traumatic event, which interferes with
  normal activities; and hyperactivity that was not previously
  present.

• Talk about the event with your child. To
  not talk about it makes the event even more threatening in your
  child’s mind. Silence suggests that what has occurred is too
  horrible to even speak of.

• Start by asking what your child has
  already heard about the events and what understanding he or she has
  reached. As your child explains, listen for misinformation,
  misconceptions, and underlying fears or concerns.

• Explain—as simply and directly as
  possible—the events that occurred. The amount of information that
  will be helpful to a child depends on his or her age. For example, older
  children generally want and will benefit from more detailed information
  than younger children. Because every child is different, take cues from
  your own child as to how much information to provide.

• Limit television viewing of terrorist
  events or other disasters, especially for younger children. When older
  children watch television, try to watch with them and use the
  opportunity to discuss what is being seen and how it makes you and your
  child feel.

• Encourage your child to ask questions,
  and answer those questions directly. Like adults, children are better
  able to cope with a crisis if they feel they understand it.
  Question-and-answer exchanges help to ensure ongoing support as your
  child begins to understand the crisis and the response to it.

• Don’t force the issue with your
  child. Instead, extend multiple invitations for discussion and then
  provide an increased physical and emotional presence as you wait for him
  or her to be ready to accept those invitations.

• Recognize that your child may appear
  disinterested. In the aftermath of a crisis, younger children may not
  know or understand what has happened or its implications. Older children
  and adolescents, who are used to turning to their peers for advice, may
  initially resist invitations from parents and other caregivers to
  discuss events and their personal reactions. Or, they may simply not
  feel ready to discuss their concerns.

• Reassure children of the steps that are
  being taken to keep them safe. Terrorist attacks and other disasters
  remind us that we are never com-pletely safe from harm. Now more than
  ever it is important to reassure children that, in reality, they should
  feel safe in their schools, homes, and communities.

• Consider sharing your feelings about the
  event or crisis with your child. This is an opportunity for you to role
  model how to cope and how to plan for the future. Before you reach out,
  however, be sure that you are able to express a positive or hopeful
  plan.

• Help your child to identify concrete
  actions he or she can take to help those affected by recent events.
  Rather than focus on what could have been done to prevent a terrorist
  attack or other disaster, concentrate on what can be done now to help
  those affected by the event.

• If you have concerns about your
  child’s behavior, contact your child’s pediatrician, other
  primary care provider, or a qualified mental health care specialist for
  assistance.

For additional information, please visit the
American Academy of Pediatrics’ Children, Terrorism & Disasters
Web site at http://www.aap.org/terrorism.