It has only been few days since the bombing at the Boston Marathon. For many it feels much longer. Parents are worried about the impact of this event on their kids (and themselves). We remember how long it took to recover from other tragedies. Fortunately, kids and families tend to be incredibly resilient. However, there may be a range of emotions and behaviors that parents could notice in the short run that would tip off a problem. Here are some things to look for and more if you see them, things you could do to fend off longer term problems.

What can parents do in general to fend off problems?

 Above all, we want to foster resilience for kids of all ages and for our family members. There are a few tips for parents:

  •  Remember that kids observe your behaviors and react to your feelings and actions.
  • Parents need to take care of themselves first.  It is much like the statement on airplanes, if the pressure drops, put the oxygen mask on yourself first, then help the child next to you. Parents are best able to help kids of any age if they have a means of processing the tragedy. The more you can obtain support from others, calm yourself down and present yourself in a supportive way, the better this is in allowing you to help your kids. This usually means having nurturing family members and/or a community to help you.
  • Kids need a few basic things:

  • Reassurance things are going to be OK
  • Assurance their daily needs will be met
  • Presence of caring adults who are paying attention to them
  • Hope for the present and future.

 Any way we can make these four key provisions known is really important.

How can parents and caregivers distinguish normal reactions to trauma from those that are worthy of concern and perhaps professional attention? Let’s look at kids in different age groups. Here are some tips for observation and guidelines for what you can do.

 Remember that a change in the short run may simply be a phase and can disappear with a brief response. So, don’t jump to conclusions that things are going to be terrible the first signs of problems.

Infants, Toddlers and Preschoolers

Very young children have a limited repertoire for expressing distress. They will not tell you what is going on, so you need to watch for signs of upset. Look for changes in behavior compared to their “baseline.”

 What can parents look for in this age group?

  • Increased anxiety when separated from parents and caregivers
  • Increased watching to see how parents are reacting
  • Emotional regression, such as more clinging or whiny behavior
  • Difficulty sleeping, fears of the dark, or some bed wetting
  • Irritability, including temper outbursts, increased sensitivity to loud sounds, such as thunder or airplanes
  • Picky eating
  • Regression to “old” behavior, such as thumb sucking, wanting to sleep with parents

 What can parents to do if they see this behavior?

  • Spend some additional time with your kids.  Provide more hugging, cuddling, and playing with them.  This will reassure parent and child.
  • Be more patient and reassuring, particularly with difficult regressive behavior
  • If your child wants to sleep in your bed, that’s OK, especially at times of great stress
  • TURN THE TV OFF! Limit exposure to news coverage of an attack. If you wish to watch or listen, do so when your children are not in the room.  They do not yet have the ability to put the frightening images they see in perspective.
  • Maintain normal routines and minimize unnecessary separations
  • For toddlers and preschoolers, ask if they have any worries.  Share your feelings to demonstrate that it is OK to talk about feelings (NOT the events with preschoolers).  Some kids may express their feelings by drawing, coloring or playing fantasy games, such as those with dolls’ houses or action figures.  Encourage this, and try to play along.  Such play may reveal their emotional struggles and simultaneously help them resolve the feelings they are struggling with

 School-Age Children

 Children ages 6-12 are more advanced intellectually.  They have a clear sense or right and wrong, but tend to be strictly rule oriented.  They have a simplistic view of “good guys” and “bad guys”.  They feel safest if things are clear-cut.  They also have a greater sense of empathy, and can appreciate the sadness or fear of others, even those they see on television. They have begun to understand the finality of death.  Despite these advances, they are not able to comprehend abstract concepts, such as justice, and they have a limited sense of causality.  They also are not able to distance themselves emotionally from events, and see things truly objectively.  They tend to “personalize” events, as if they happened or will happen to them or their families.  While they may be reassured by talking and understanding more than younger children, they may easily become overwhelmed and confused with complex events that are highly charged emotionally.

 What can parents look for in this age group?

  •  Anxiety around separation from family, sometimes not wanting to play with friends or go to school
  • Problems with sleep, fear of the dark, fear of burglars or harm coming to themselves or parents
  • Re-experiencing exposure to traumatic events through repetitive thinking, playing, talking about the event, or nightmares
  • Increase in physical complaints, such as stomach aches, head aches
  • Poor concentration at home or at school, occasional with decreased school performance
  • Thoughts about death and dying
  • Worrying, either about bad things happening, or seemingly trivial details of daily life
  • Irritable mood, crabby behavior, occasional temper outbursts

 What can parents do if they see this behavior?

  •  Remember that kids often work through their emotional issues with play instead of words.  Children use toys to replay scary they’ve seen or imagined.  This is normal behavior and can be rewarding for them (though it may be hard for you to watch!).
  • You should expect that school-age kids have seen images of the bombing or heard news reports. Televisions and computers are everywhere, and there may be discussions about the Marathon in school. Many of these experiences are terrifying! Ask them what they have seen or heard, and be prepared to provide reassurance, hope and instill a sense that they will be kept safe.
  • Let younger children know that even though they have seen the same pictures or images of the bombing, it only happened once and is OVER.
  • Remember that school-age kids may have no idea where Boston is. You should remind them where it is located in relation to your house.
  • Kids need to have perspective. You can assure them that the finish line of the Boston Marathon is a VERY IMPORTANT place, but their house or school is not the same as a national monument.
  • If your kids ask questions, this is great. You want them to talk and express their feelings. Be patient and try to answer them simply and honestly.
  • Encourage your child to express his or her feelings, worries and concerns, and respond in kind by sharing yours.  Allow feelings of anger, but try to re-direct misplaced feelings of hate.
  • Remind your children that there are many, many more good people in the world than there are bad people, and that the good people will try to take care of them and protect them.
  • Also remind them to LOOK FOR THE HELPERS. The wonderful quote by Mr. Rogers is very important for kids and adults alike. Not only are there many good people in the world, but we all can be helpers, and the more the better!
  • Let your children participate in efforts to make things better.  This makes them feel like THEY ARE THE HELPERS! This might include raising money and sending it for relief efforts, helping in community activities, or sending a note, card or drawing to victims of terrorism.
  • Help your children get back to “business as usual”. Keeping a normal schedule will reassure them. 
  • Provide comforting, shared activities, such as listening to music, playing games or telling stories.

 Teenagers

Teens are much more aware of the dangers in the world. They are grappling with issues of personal and societal dangers. They appreciate the risks involved in life, and many have lost pets, loved ones e.g. grandparents, or know of friends who have dealt with death. They themselves have taken risks or know of others who have; they know about “near misses.” They may be fearful of what is going to happen to the world, their life and their future.

 Situations such as the Marathon bombing raise fears about the uncertainties in life. After such tragedies as 9/11, the Newtown Shooting or the Aurora Cinema Shooting many teens felt a sense of foreshadowing, fearfulness about manmade as well as natural disasters.

 The aim of working with teenagers is to see how they are reacting at home, school and with peers, and watch for any clear changes in behavior.

 What can parents look for in their teens?

  •  Watch for changes in sleep, appetite, and normal routines
  • Some teens may be much more anxious and fearful of even basic activities like going to school, watching the news or even their favorite TV show
  • Watch for increased irritability, crabbiness, refusal to help in ways they typically did not act before
  • Some teens will isolate themselves from friends and family
  • Be on the lookout for dramatic “personality change,” such as a talkative kid who is now very quiet, or a calm teen who is really jumpy and anxious.

 What can parents do if they see behavioral changes in their teens?

  •  It is very useful to watch the news with them, and ask them their opinions and reactions to what you are viewing. Ask them questions. Ask them how such things can happen in the world, what will make the world a safer place, how they would change things. Get them to open up.
  • Remember YOU may be putting together the Marathon Bombing with 9/11, the Newtown or Aurora shootings and your teens may not. Do not assume that THEY are seeing the world in negative terms. But also remember that you remember all these events, some of your teenagers may not. Try not to put all the negative events in their lives on the table as this will be overwhelming. Teens need hope for a positive future!
  • Most of all teenagers want to be heard and understood. At the same time, they may be wary of sharing their inner fears to parents, unless there is a long history of talking together. It is very helpful to share your own personal concerns with them. Teens are eager to hear about your life experiences, losses, near misses and frightening times. Adolescents love to hear about parents’ lives and their own struggles. If you had experienced dangerous or frightening situations, share them with your teenagers.

College-age Youth:

 College students are more advanced than teenagers intellectually. Their experience involves an increased ability and interest in grappling with the important issues in their lives and in the world. In addition, they have often met with more “near miss”experiences than teenagers. They have probably known of relatives, or sadly even friends who have died. They are concerned about their place in life, their future role in the workplace, and what the world will be like for themselves and their futurefamily.

Many will identify with the loss of the graduate student in the Bombing and intensely appreciate the fragility of life. At the same time, they may be desperately trying to

understand why anyone would do such a thing – considering political, personal, and emotional motives. Many will be actively talking with each other, and certainly processing the events socially and in the classroom. They will try to put together the historical terrorist attacks in the United States and around the world.

Remember, college kids today lived through 9/11 when they were early school-age kids. Further, they will be actively seeking information about the event by increased use of digital and social media.

 While over half of psychiatric disorders begin in childhood and adolescence, the onset of emotional problems peaks in college, particularly mood disorders. This may add to vulnerability. Though this age group may be better equipped to deal with the bombing intellectually, college students still feel quite insecure and will need considerable guidance and attention in order to understand an event that is baffling to the most stable adult. And since they are often away from family in the school setting, they may have less of a protective environment than younger kids. College students often look and feel very much like adults, but truth be told, they still need their parents to provide guidance and reassurance. And since they are struggling with their own issues of identity, they may be more open to discuss and consider profiling and labeling than younger kids.

  • College kids want to express their ideas, feelings and worries about current events. Ask open ended questions about the bombings and see what they come up with. Then enter into conversation about what could cause events like this to occur and how they may be prevented.
  • Talk with them about their sense of safety and role in the world. How do they feel about their future? Are they worried that the world will be a dangerous place? How might they want to help change things? College age kids usually are idealistic, and need to feel that they may be able to make a difference in the world.
  • Ask what kind of a person might do such a thing? If you find that the response is a rapid jump to labeling or profiling, ask more details about how he or she came to such a conclusion. Wonder with the student about the ways people turn out the way they do; ask about how he or she would feel being labeled in black and white terms. All this would help them consider the dangers of jumping to conclusions. Certainly they would not want to be abruptly labeled negatively themselves!
  • If your conversations uncover significant emotional issues, such as depression, social isolation, excessive anxiety, lack of interest in the future, or use of substances, perhaps discussing the possibility of talking with a professional to get further guidance.

Remember that most kids and parents will gradually recover from the shock we experienced following the Marathon bombing. If your child continues to show many of the behaviors mentioned above, it may be a good idea to take her or him to your pediatrician, school guidance counselor, or seek a child psychologist or psychiatrist for advice.

Derived from previous posting on CommonHealth: Reality and Reform www.commonhealth.wbur.org

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