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
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
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
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
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
For additional information, please visit the
American Academy of Pediatrics’ Children, Terrorism & Disasters
Web site at