Supporting a Child After a Disaster

Supporting a Child After a Disaster

Having worked with children and families in the aftermath of America’s worst recent disasters and mass casualty events, David Schonfeld, MD can tell you children react in many different ways.

When classes finally resumed at one school following a shooting, Dr. Schonfeld said a classroom of students couldn’t remember how to use their rulers and had to be re-taught something they’d learned years earlier.

At another school, he said, long-sleeve shirts suddenly became popular with the girls in the weeks after a shooting there. They were wearing them to hide self-inflicted cuts they’d made trying to cope with their feelings.

Sometimes, Dr. Schonfeld says, children will show no obvious signs, yet they may be quietly struggling with profound anxiety. For others, a disaster can trigger symptoms that are a reaction to some previous trauma in their life.

Our Lady of the Lake Children’s Hospital invited Dr. Schonfeld to speak recently as South Louisiana continues to recover and heal from multiple shootings in the past two years and devastating flooding in 2016. Although daily routines may appear to have returned to normal, we know that many families continue to experience the effects of those traumas.

Helping and supporting children requires thoughtful observation, calmness and patience. What we should not do, however, is to think we can help children simply “get over it.”

“Trauma changes your life,” Dr. Schonfeld says. “You adjust and cope and move forward; the only way is through, not around it, or to go back.”

Dr. Schonfeld is a behavioral and development pediatrician who practices in Los Angeles. He serves as director of the National Center for School Crisis and Bereavement at the USC School of Social Work. He is a member of the American Academy of Pediatrics Disaster Preparedness Advisory Council and served as the commissioner of the National Commission on Children and Disasters.

He often consults following school crisis and pediatric bereavement in the aftermath of disasters, including Hurricane Katrina, and shootings at Sandy Hook Elementary and at a movie theater in Aurora, Colorado.

“We were all challenged in 2016; our entire community was affected,” said Shaun Kemmerly, MD, chief medical officer at Our Lady of the Lake Children's Hospital. “We thought we could all benefit from Dr. Schonfeld's expertise about the struggles we’ve gone through as a community.”

Symptoms to Watch For

Dr. Schonfeld says the first step to supporting children is recognizing if they are suffering the effects of trauma. Some of the most common symptoms include:

  • Sleep problems— These can be anything from difficulty falling asleep or waking up, to nightmares or fear of the dark.
  • Separation anxiety and school avoidance— Many who have been through trauma may be hesitant to separate from family or friends for fear something will happen while they’re not with them.
  • General anxiety— For example, after a hurricane a child may become anxious about stormy weather, or they may just become more fearful in general.
  • Difficulty concentrating or deteriorating academic performance— Teachers who may usually introduce three concepts in a lesson report having to cut back to just one so that children can absorb the new material.
  • Regression— Some children may behave like younger kids, become irritable or more self-centered. Often, complaints about routine things increase because there is less tolerance, which is part of the stress reaction.
  • Sadness and depression— Children who previously enjoyed certain activities and friends will withdraw from or avoid them, which can be a sign of trauma.
  • Onset of substance abuse— This is more for teens and adults, who sometimes turn to alcohol or drugs as a way to cope with trauma-induced stress.
  • Avoidance of places, things or activities that trigger traumatic feelings— Sometimes children avoid thinking or talking about trauma.
  • Negative alterations in mood— Children who’ve experienced trauma can feel they’re somehow responsible and experience extreme distress.
  • State of increased arousal— This can be expressed in self-destructive behavior, exaggerated startle response and an inability to concentrate.

Dr. Schonfeld points out that children do not have to be present or victims of an event to be affected by it. Merely being told about a death, injury, or act of violence can be traumatic to a child, and they may have dreams about it and “re-experience” the event.

How to Help and Support Your Children

Parents can help children to be more resilient to distress and trauma by teaching them to feel comfortable talking about when they feel distress.

“Adults tend to hide distress from their kids, ‘to be strong for them,’” he says. “But kids can’t learn coping mechanisms if they’re not taught them and see them. Adults need to feel comfortable sharing with children that we have distress, and how we cope with it.

For example, rather than merely suggesting that your children talk with their friends about things they’re anxious about, or suggesting that they write in a journal, share examples of when you felt stressed. Tell them how discussing it with your spouse or someone close helped you to feel better, or how writing about it in a journal made you feel less anxious. “We need to help them build a toolkit of coping and resilience skills,” Dr. Schonfeld says.

“We need to allow our kids to experience graduated amounts of distress without solving it for them,” he says.

“Have some faith in them that they can deal with it, and always be there if they can’t.”

Taking care of our children also means taking care of ourselves and not doing things that worsen stress. “If you’re watching TV after a disaster and you realize you’re not learning anything new, you should turn off the TV because it’s just not helping you anymore,” Dr. Schonfeld says. “Respect your child enough that they can do it, and show them that you believe in them; then be there.”