The following provides a list of possible reactions to tragedy by age:
Pre-school: Crying, thumb-sucking, loss of bowel/bladder control, fear of being left alone or of strangers, irritability, confusion and immobility.
Later Childhood: Headaches or other physical complaints, depression, fears about safety, confusion, inability to concentrate, poor performance, fighting, withdrawal from peers.
Preadolescent/Adolescent: Headaches or other physical complaints, depression, confusion, poor performance, aggressive behaviors, withdrawal/isolation, changes in peer groups or friends.
Adult: Psychosomatic problems like ulcers or heart trouble, withdrawal, suspicion, irritability, anger, loss of appetite, sleep problems, loss of interest in everyday activities, alcohol use.
Older Adults: Depression, withdrawal, apathy, agitation, anger, irritability, suspicion disorientation, confusion, memory loss, accelerated physical decline, increase in number of somatic complaints.
Helping kids through crises
Experts offer advice about how parents can aid their children in coping with Twin Towers catastrophe
By Victoria A. Caruso
In the wake of recent terrorist attacks on the World Trade Center and Pentagon, parents and children are struggling to understand the incomprehensible. Regardless of age, however, young people aren't as well equipped emotionally to cope with the enormity of this tragedy.
Talking with children about the events of Sept. 11 is critical, experts say. Clinicians from South Nassau Communities Hospital's Counseling Center in Baldwin are providing the following suggestions to help children through this national crisis:
Know your child
Every child reacts differently to stress. Parents must use their own judgment to determine how much their child can comprehend. Do not compare their reactions or feelings to other children, and understand that their response is not wrong, just different.
Many children will need reassurance that they are safe physically. Many children will immediately associate the tragedy with themselves, wanting answers to such questions as: "Did I do something wrong?"; "What will happen to me?"; or "How will this affect me?"
Acknowledge feelings.
Children must know they can express their feelings without fear of judgment. Reassure them that anger, guilt, sorrow and tears are normal responses to tragedy. Encourage them to talk about their feelings and let them know that it's OK if they don't understand why the terrorist attacks happened.
"Children are going to want to understand something they can't," said Gary Dunn, director of South Nassau's Counseling Center. "This is something that can't even be comprehended by adults."
Understanding death
Most children under age 9 do not clearly understand death. Many associate it with an illness or old age, while others know that people in dangerous lines work sometimes are killed.
"Kids whose fathers are in high-risk jobs deal with the danger of the job on a daily basis," said Thomas Demaria, Ph.D., administrative director of Behavioral Health Services at South Nassau. "There is not the expectation that a parent who is an accountant went to work but never made it home. They associate a solider with war, a police officer with crime, but have a hard time understanding why someone would attack a business building."
Explain to your child that death is neither something that they can "catch," nor something that they caused. Children often blame themselves for the death of a loved one, wondering if the death resulted from something they did or did not do.
Be straightforward
Use simple language and a direct approach with your child and provide honest, clear answers to their questions. Parents sometimes withhold information from children if they think it might be hurtful. Not informing children of crises usually forces them to reach their own conclusions, and their minds can then conjure dreadful ideas about what happened.
Children also react to a parent or loved one's behavior. You might think you are acting like nothing has changed, but children are intuitive and can detect when there is a problem.
"Most children know something is wrong because they pick up cues from their parents," said Ellen Voght, CSW, clinical coordinator of Child and Adolescent Services at South Nassau. "If a parent is acting scared, upset or not themselves, the child will get scared. They know something is going on, but how much they understand depends on the individual child."
Observe your child
What looks like bad behavior might be grief. Children may not have the verbal skills or emotional insight to express their feelings. Try to understand the message or emotion being expressed in their behavior. The older the children, the more capable they are of expressing themselves in words. Younger children simply have their feelings. What they do with their bodies typically speaks to their feelings. Movement and activity play a large role in their ability to communicate.
Tending to your needs
Parents are urged to care for their own needs. If your child is experiencing grief, chances are that you are too. If you do not mind your own needs, you will have limited patience and understanding to deal with the grief of others, especially children.
Don't impose biases
"The best approach is to sit your kids down and ask them what they know or what they think is going on," said Voght. "Stay away from ethnic-related comments," she said. "Use expressions such as 'bad people' or 'accident.'"
Be patient
Like adults, children experience different stages of grief, and the process of emotional healing will differ from person to person. A child might ask you to explain the same things many times.
Understand that younger children might not fully understand and might have a hard time coping. Explain to children they will experience highs and lows and understand they will experience short- and long-term feelings of sadness, anxiety and depression. Hugging them and telling them they are loved will enforce a positive outlook.
Maintain routines
Children do best with routines, especially at home and school. Structure and normalcy are necessary. "Kids are great with routines," said Voght. "When you change their routine, they know something is up."
Let them become involved
Enabling youngsters to become involved in humanitarian acts is socially constructive for children who, like adults, are searching for a way to make a difference and lend support. Let your child pick a charity or fund to send money to, or let them donate food or supplies to your local collection center.
