Early Life Stress Expert Discusses How to Talk to Kids about Hurricane...

Early Life Stress Expert Discusses How to Talk to Kids about Hurricane Katrina; Victor Carrion, MD, Director of the Early Life Stress Research Program at Lucile Packard Children’s Hospital



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Stanford, CA–(HISPANIC PR WIRE – BUSINESS WIRE)–September 19, 2005–Shielding kids from the media can be a difficult task these days. TVs are blaring and newspapers are plastered with photos of the aftermath of Hurricane Katrina. Is it appropriate to try to limit children’s exposure to these images and stories? How can we answer their questions about the fate of people caught in the storm and subsequent flooding? Child psychiatrist Victor Carrion, MD, is director of the Early Life Stress Research Program at Lucile Packard Children’s Hospital, a program that studies the impact of abuse and trauma on the developing brain. Here he provides insight about how to best reassure and inform your child as the storm recovery continues.

Q: Should children be allowed to watch media coverage of the storm and its aftermath?

A: I believe that it’s part of a parent’s job to limit the amount of media exposure kids get, tailoring it to both the chronological and developmental age of the child. Younger kids obviously should have little or no exposure, and parents may want to restrict exposure in some manner even in adolescents. In general I would not have them watch the news or read the papers during events like the hurricane unless it’s necessary for some reason, like a school project or report.

This is because one of the risk factors for developing post traumatic stress disorder is proximity to the event. People at the epicenter of an earthquake exhibit more traumatic symptoms than others who were further away. More and more, though, the media brings events like this right into our homes, making that proximity available to everyone. Parents should also be aware that their child may still hear about the event at school or from friends, and be prepared to answer their questions.

Q: What if, despite a parent’s efforts, a child has seen disturbing footage or photos? What types of concerns might they have? How can parents best address those concerns?

A: Children with concerns will ask questions about what they’ve seen and heard, and parents need to answer these questions simply and directly. Allow the child to be in control of the conversation; don’t offer additional information unless asked. Also, it is important to be aware of the emotional response that the child may have to these answers. It is natural for children of all ages to be concerned about their own safety when they hear of bad things happening to others.

Preschoolers are usually most concerned that they will be left alone, separated from their parents or caregivers. School-aged children may become more clingy, and may feel helpless or out of control. They may not want to go to school, or may complain of headaches or stomachaches. Adolescents may become more withdrawn, claiming that they would have had no problem evacuating or escaping the flood.

These are normal responses; parents shouldn’t expect their children to be brave. They also shouldn’t force them to discuss specific events. It’s more important to talk to the child about how the images or news reports has made him or her feel. During this talk, the parent should emphasize that the child is in a safe place and would be protected if anything like that happened here. Focus on a few positive messages: many people were rescued, people are getting their lives back together, and the water is being drained from the city.

Remind the children that it’s the parents’ job to worry about these issues, not the kids’.

Q: But in the case of this hurricane, many of the things that children most fear, being separated from their parents, being left alone, losing all their belongings, actually did happen. How can parents reassuringly say things that may not be true?

A: Parents are people too, and they have their own reactions to what has happened and is happening. Many may be feeling very helpless.

However, it’s important for parents to know what their own fears are, and to try to put them aside when they talk to their children. Saying things like “I will always keep you safe” is just part of the job of parenting. Children need to know that their parents are in control.

They shouldn’t have to worry that the parents need support from the children, or that the parents are too worried to take care of them.

Q: In addition to speaking reassuringly about the tragedy, are there any concrete actions a parent can take to help a child feel safer?

A: Depending on the age of the child and how aware he or she is about the disaster, it might be helpful to actively involve them in the relief effort. For example, a child could start a lemonade stand or hold a garage sale, donating the proceeds to hurricane victims. If a child has relatives in the affected area it may be helpful to encourage them to write letters to these family members. These types of activities can restore a feeling of control to the child.

If a child remains very concerned about his or her safety it may help to remind him or her of existing family emergency plans such as fire or earthquake drills. Practicing familiar plans and discussing family meeting points may reassure the child if it’s done calmly and matter-of-factly. The parent could point to such plans as proof of the parent’s commitment and ability to keep the child safe. Such discussions and practices may loose some of their reassuring quality, though, if presented in a fearful way.

Q: Say you have an older adolescent familiar with the scope of events over the past weeks. Some of the images and stories bring up tough ethical questions. For example, why couldn’t or didn’t some people evacuate before the storm, and when does looting go from stealing to a survival tactic? Should parents discuss these issues with their children?

A: Parents shouldn’t be afraid of these types of discussions.

Children are very concrete; they see things as good and bad, black and white. As we grow older we begin to realize that most issues are actually shades of grey. This may be a valuable opportunity to take your child aside and point out that “good” and “bad” are difficult words. Some people didn’t evacuate because they didn’t have the means to do so; others decided to stay because their home and belongings are very important to them, or for a variety of other personally legitimate reasons. Many of the people taking things from stores needed the supplies to stay alive; some did not. It’s a good time to talk to children about circumstances and context. But talk to them at their level, and don’t expect too much.

Q: Obviously some children will be more affected by this tragedy than others. How can a parent tell if a child is overreacting and may need special help?

A: We know that certain populations of children, such as those who have suffered through previous traumatic events, those who struggle with anxiety in their daily lives and those who are particularly vulnerable to stress for a variety of reasons, are going to be more sensitive to troubling images and news reports. Parents need to be even more protective and reassuring with these kids. They need to be watched very carefully to be sure that their normal responses to the hurricane don’t become incapacitating.

Signals that a child might need professional help dealing with their feelings about the hurricane include any type of atypical behavior that interferes with the child’s normal functioning. For example, maybe the child is not performing up to the same academic level as before, or is avoiding spending time with friends or becomes significantly more withdrawn. They may have nightmares or repeated intrusive thoughts about the disaster. If this type of response continues for more than a month, or significantly interferes with a child’s normal functioning, it may be time to seek expert help.

About Lucile Packard Children’s Hospital

Ranked as one of the nation’s top ten pediatric hospitals by U.S. News and World Report, Lucile Packard Children’s Hospital at Stanford is a 264-bed hospital devoted to the care of children and expectant mothers. Providing pediatric and obstetric medical and surgical services and associated with Stanford School of Medicine, Packard Children’s offers patients locally, regionally and nationally the full range of health-care programs and services — from preventive and routine care to the diagnosis and treatment of serious illness and injury. For more information, visit http://www.lpch.org.

Early Life Stress Expert Discusses How to Talk to Kids about Hurricane Katrina; Victor Carrion, MD, Director of the Early Life Stress Research Program at Lucile Packard Children’s Hospital