Robert J. Hilt, MD, FAAP, is an Associate Professor of Psychiatry at the University of Washington and Seattle Children’s Hospital. He is the co-chair of the Committee on Collaboration with Medical Professions with the American Academy of Child and Adolescent Psychiatry. Dr. Hilt has received board certifications in general pediatrics, adult psychiatry, and child and adolescent psychiatry.
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Disclosure: Dr. Hilt has no relevant financial relationships to disclose.
Q: After the recent bombings in Boston, a number of parents have asked me what they should tell their kids about a perplexing event like this. Is there any particular approach you would recommend?
A. Terrorism and major natural disasters are thankfully very rare events, but when they occur they capture our full national attention. Because we as adults want to learn what happened in these disastrous events in great detail, our media outlets set about supplying us with as much information and as many visual images as they can. Exposure to all of this information can have unintended negative consequences on children. For instance it became clear after the 9/11 attacks that young children could develop acute stress reactions and posttraumatic stress disorder simply from cumulative exposure to media coverage of the event, even though the attack itself did not impact anyone they knew personally.1 Video images of a disastrous event are particularly difficult for preschool-age children to process, as they may believe that each image they see represents a new event occurring.
The following are some general principles about how to help children after major disasters or terrorism events.
Take Control of Your Child’s Media Exposure
If you have preschool-age children, avoid video and radio coverage of the event in their presence. Also, minimize the amount of media exposure for older school-age children, but if viewed try to be present in order to interpret and discuss with them what they’ve seen. Adolescents need less active avoidance of media exposure because of a greater ability to regard events in perspective of what actually impacts their own lives, but they would similarly benefit from discussing any feelings the event raises with their parent.
Listen to Your Child and Answer His or Her Questions Honestly
While honestly responding to your child, use a sophistication level that they can understand and avoid giving them any more information than they need. Kids tend to over-personalize major events like this. What they really need to know is if they are safe and how the people in their lives are going to keep them safe. Even if your child doesn’t ask you this directly, find a way to offer reassurance about your family’s and your child’s own personal safety.
Maintain Business as Usual
Kids need to be active, they need to be engaged socially (such as with friends at school), and they need to have routines like regular mealtimes and bedtimes in their daily lives. Pulling them out of their usual activities or keeping them home from school sends the message that the world has been inexorably altered and is far less safe for them. Maintaining routines helps children to cope.
Take Care of Yourself
Events of this magnitude can be very frightening to us as adults. If you feel a sense of panic or pervasive fears, then your child is more likely to pick up on this message, undermining any attempt to offer your child reassurance. By taking care of your own distress, through talking to friends or using other supports, you are in a far better position to be helpful and reassuring to your child.
Ask for Help When Needed
Children experiencing distress for a few days after learning about terrorism events or disasters is not unusual and typically self-resolves if children receive their usual sources of support or through following the above suggestions. What is of more concern is when a child develops persisting distress for weeks or even months. Signs of an ongoing problem include behavioral regression (acting much younger), developing poor focus, falling grades, loss of appetite, recurring body aches, irritability, poor sleep, nightmares, social withdrawal, or a depressed mood. If a child develops persisting distress like this, it is generally a good idea to seek assistance from a mental health professional.
- Otto MW, Henin A, Hirshfeld-Becker DR, Pollack MH, Biederman J, Rosenbaum JF. Posttraumatic stress disorder symptoms following media exposure to tragic events: impact of 9/11 on children at risk for anxiety disorders. J Anxiety Disord. 2007;21(7):888–902 doi:10.1016/j.janxdis.2006.10.008 [CrossRef].