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PDLSPDLS©©: Psychosocial : Psychosocial Issues of Children and Issues of Children and Families in DisastersFamilies in Disasters
Learning ObjectivesLearning Objectives
Review normal psychosocial issues in children.Review normal psychosocial issues in children.
Review reactions of children and adolescents to Review reactions of children and adolescents to disasters.disasters.
Focus on how the healthcare provider may prepare, Focus on how the healthcare provider may prepare, assess, and treat children and families in disasters.assess, and treat children and families in disasters.
Prepare the healthcare provider to assess and address Prepare the healthcare provider to assess and address community needs.community needs.
Address specific problems and provide recommendations Address specific problems and provide recommendations for disaster assistance in the psychosocial sphere.for disaster assistance in the psychosocial sphere.
It is impossible to separate the effects of It is impossible to separate the effects of disasters on children and their families disasters on children and their families and the two should be considered as a and the two should be considered as a unit.unit.
Case ReportCase Report
A theater filled with children in 1953 was hit by a tornado. A A theater filled with children in 1953 was hit by a tornado. A total of 169 children ranging in ages 2 to 15 were involved.total of 169 children ranging in ages 2 to 15 were involved.
The children were evaluated with respect to emotional The children were evaluated with respect to emotional disturbances: disturbances:
NoneNone 113113MildMild 3232SevereSevere 2424
A startling total of 30% of the children involved in this A startling total of 30% of the children involved in this catastrophe had mild to severe emotional disturbances catastrophe had mild to severe emotional disturbances following the incident.following the incident.
The following events are of the greatest The following events are of the greatest significance with respect to children significance with respect to children and their families in a disaster.and their families in a disaster.
1.1. Death or physical injury to a family member.Death or physical injury to a family member.
2.2. A loss of home or possessions.A loss of home or possessions.
3.3. Relocation (school changes).Relocation (school changes).
4.4. Job loss.Job loss.
5.5. Parental disorganization or dysfunction. Parental disorganization or dysfunction.
Factors Affecting ResponsesFactors Affecting Responses
Perceived or actual life threat.Perceived or actual life threat.
Duration of life disruption.Duration of life disruption.
Familial and personal property loss.Familial and personal property loss.
Parental reactions and extent of family disruption.Parental reactions and extent of family disruption.
Child’s predisaster state.Child’s predisaster state.
Probability of recurrence.Probability of recurrence.
Preexisting Risk FactorsPreexisting Risk Factors
Previous physical and/or psychosocial pathology Previous physical and/or psychosocial pathology in a child or family member.in a child or family member.
Dysfunctional families secondary to alcohol or Dysfunctional families secondary to alcohol or drug abuse.drug abuse.
Children with developmental or physical Children with developmental or physical disabilities.disabilities.
Newborns who are in the early stages of bonding.Newborns who are in the early stages of bonding.
Cultural, Religious and Ethnic Cultural, Religious and Ethnic ConsiderationsConsiderations
Outreach by leaders of different cultural groups is Outreach by leaders of different cultural groups is essential in all phases.essential in all phases.
Information regarding available services should be Information regarding available services should be provided in all languages appropriate to the provided in all languages appropriate to the community.community.
Distribution of such information should be through Distribution of such information should be through church and community groups.church and community groups.
Religion (churches, synagogues and clergy) becomes Religion (churches, synagogues and clergy) becomes extremely active in the recovery of the community extremely active in the recovery of the community during and after a disaster.during and after a disaster.
Early Vs. Late Effects Early Vs. Late Effects of Disaster in Children of Disaster in Children and Adolescentsand Adolescents
The Three StagesThe Three Stages
First StageFirst Stage
Time Time During and immediately after a disasterDuring and immediately after a disaster
ReactionReaction Disbelief, denial, anxiety, relief, grief, altruismDisbelief, denial, anxiety, relief, grief, altruism
Second StageSecond Stage
TimeTime A few days to several weeks after disasterA few days to several weeks after disaster
ReactionReaction Clinging, appetite, changes, regressive Clinging, appetite, changes, regressive
symptoms, somatic complaints, sleep symptoms, somatic complaints, sleep disturbances, apathy, depression, anger, and disturbances, apathy, depression, anger, and hostile delinquent actshostile delinquent acts
Third StageThird Stage
TimeTime Months laterMonths later
ReactionReaction ReconstructionReconstruction
Somatic SymptomsSomatic Symptoms
These include headaches, abdominal pain, and These include headaches, abdominal pain, and chest pain and are commonly observed in children chest pain and are commonly observed in children and adolescents.and adolescents.
Reassurance by the healthcare worker can be of Reassurance by the healthcare worker can be of help after evaluation.help after evaluation.
Counseling and mental health intervention may be Counseling and mental health intervention may be necessarynecessary for the victims as well as the for the victims as well as the Healthcare workersHealthcare workers..
Regressive BehaviorRegressive Behavior
Separation anxiety symptoms which include enuresis, Separation anxiety symptoms which include enuresis, encopresis, thumb-sucking, loss of acquired speech, encopresis, thumb-sucking, loss of acquired speech, whining, and fear of darkness are commonly seen in children whining, and fear of darkness are commonly seen in children or toddlers. These are short-lived behaviors following a or toddlers. These are short-lived behaviors following a disaster.disaster.
The Healthcare worker should be reassured of this so that The Healthcare worker should be reassured of this so that punishment and shame are avoided.punishment and shame are avoided.
In older children and adolescents, regression takes the form In older children and adolescents, regression takes the form of competing for parental attention and a decline in of competing for parental attention and a decline in previously responsible behaviors. Extreme dependency and previously responsible behaviors. Extreme dependency and transient confusion can occur.transient confusion can occur.
Regressive Behavior (continued)Regressive Behavior (continued)
Parents should be reassured that this behavior is common Parents should be reassured that this behavior is common and short-lived. If the above symptoms persist more than a and short-lived. If the above symptoms persist more than a few weeks family and child counseling is advised.few weeks family and child counseling is advised.
The return of stability in the routine of the home as well as The return of stability in the routine of the home as well as the passage of time rectify the problem.the passage of time rectify the problem.
Aggressive/Defiant BehaviorAggressive/Defiant Behavior
Toddlers and preschoolers may exhibit hostile Toddlers and preschoolers may exhibit hostile behaviors such as hitting and biting.behaviors such as hitting and biting.
School age children may get involved in peer fights.School age children may get involved in peer fights.
Adolescence may become delinquent or rebellious.Adolescence may become delinquent or rebellious.
Aggressive/Defiant Behavior Aggressive/Defiant Behavior (continued)(continued)
Recommendations Recommendations
For the younger child, limit setting may be of help.For the younger child, limit setting may be of help.
With adolescents, involving them in the rebuilding With adolescents, involving them in the rebuilding of the community or helping with younger children of the community or helping with younger children or elderly may aid recovery.or elderly may aid recovery.
Repetitious BehaviorRepetitious Behavior
Most commonly seen in toddlers and preschoolers Most commonly seen in toddlers and preschoolers after disaster.after disaster.
These children will reenact crucial details of the These children will reenact crucial details of the disaster.disaster.
Other repetitive behaviors are recurrent nightmares Other repetitive behaviors are recurrent nightmares and frequent flashbacks.and frequent flashbacks.
The Healthcare worker should allow the child or The Healthcare worker should allow the child or preschooler to reenact the events as these are preschooler to reenact the events as these are therapeutic and can help in recovery.therapeutic and can help in recovery.
AnxietyAnxiety
Anxiety occurs in all age groups.Anxiety occurs in all age groups.
The Healthcare worker should not dismiss or The Healthcare worker should not dismiss or minimize the expression of anxiety.minimize the expression of anxiety.
One should discuss with the child or adolescent One should discuss with the child or adolescent their fears and anxieties.their fears and anxieties.
Family counseling can be a benefit. Family counseling can be a benefit.
DepressionDepression
A sense of sadness which is not the same as depression is A sense of sadness which is not the same as depression is common after disaster.common after disaster.
Sadness is to be expected. If depression is present and Sadness is to be expected. If depression is present and persistent psychiatric intervention is warranted.persistent psychiatric intervention is warranted.
This may be manifested by adolescents with suicidal This may be manifested by adolescents with suicidal thoughts and teenagers expressing helplessness, thoughts and teenagers expressing helplessness, hopelessness and suicidal ideation.hopelessness and suicidal ideation.
The Healthcare worker should alert parents to signs of The Healthcare worker should alert parents to signs of depression such as decreased appetite, sleep disturbance, depression such as decreased appetite, sleep disturbance, constant sadness and irritability.constant sadness and irritability.
GuiltGuilt Children and teenagers may feel guilty for surviving or having their Children and teenagers may feel guilty for surviving or having their
families and homes intact.families and homes intact.
They feel helpless.They feel helpless.
Young children may experience “magical thinking” in that they feel Young children may experience “magical thinking” in that they feel they are responsible for the disaster because of something “bad” they they are responsible for the disaster because of something “bad” they did.did.
If Litigation is involved, the trauma may persist resulting in If Litigation is involved, the trauma may persist resulting in disillusionment.disillusionment.
The Healthcare worker can be of assistance by reassuring the The Healthcare worker can be of assistance by reassuring the children and adolescents that they were not at fault.children and adolescents that they were not at fault.
Assignment of blame is counter productive to rebuilding lives, families Assignment of blame is counter productive to rebuilding lives, families and communities.and communities.
Posttraumatic Stress DisorderPosttraumatic Stress Disorder
Posttraumatic stress disorder (PTSD) has been Posttraumatic stress disorder (PTSD) has been a term used in children and adults following a term used in children and adults following traumatic events and disasters.traumatic events and disasters.
Few children develop the full disorder and they Few children develop the full disorder and they may have a delayed onset.may have a delayed onset.
This includes anxiety, depression and conduct This includes anxiety, depression and conduct disorders.disorders.
Some children display the symptoms only Some children display the symptoms only during the immediate post disaster period. during the immediate post disaster period.
The diagnosis of PTSD has the following The diagnosis of PTSD has the following criteria in three major categories persisting criteria in three major categories persisting for more than one month.for more than one month.
Reexperiencing of the event through play or Reexperiencing of the event through play or trauma specific nightmares.trauma specific nightmares.
Routine avoidance of the reminders of the event Routine avoidance of the reminders of the event or a general lack of responsiveness.or a general lack of responsiveness.
Increased sleep disturbances, irritability and poor Increased sleep disturbances, irritability and poor concentration.concentration.
The Five Primary Responses of The Five Primary Responses of Children and Adolescents to DisastersChildren and Adolescents to Disasters
1.1. Increased dependency on parents or guardians.Increased dependency on parents or guardians.
2.2. NightmaresNightmares
3.3. Regression in developmental achievements.Regression in developmental achievements.
4.4. Specific fears about reminders of the disaster Specific fears about reminders of the disaster (e.g., a toy airplane if the child was in an airplane (e.g., a toy airplane if the child was in an airplane crash).crash).
5.5. Demonstration of the disaster via post-traumatic Demonstration of the disaster via post-traumatic play and reenactments.play and reenactments.
Specific Responses of Toddlers and Specific Responses of Toddlers and Preschoolers to DisastersPreschoolers to Disasters
Reaction reflects that of parentsReaction reflects that of parents
Regressive behaviorsRegressive behaviors
Decreased appetiteDecreased appetite
Vomiting, constipation, diarrheaVomiting, constipation, diarrhea
Sleep disorders (insomnia, nightmares)Sleep disorders (insomnia, nightmares)
Tics, stuttering, mutenessTics, stuttering, muteness
Specific Responses of Toddlers and Specific Responses of Toddlers and Preschoolers to Disasters (continued)Preschoolers to Disasters (continued)
ClingingClinging
Reenactment via playReenactment via play
Exaggerated startle response Exaggerated startle response
IrritabilityIrritability
Posttraumatic stress disorderPosttraumatic stress disorder
Specific Responses of School Age Specific Responses of School Age Children to DisastersChildren to Disasters
Most marked reactionMost marked reaction
Fear, anxietyFear, anxiety
Increased hostility with siblingsIncreased hostility with siblings
Somatic complaintsSomatic complaints
Sleep disordersSleep disorders
School problemsSchool problems
Specific Responses of School Age Specific Responses of School Age Children to Disasters (continued)Children to Disasters (continued)
Social withdrawalSocial withdrawal
Reenactment via playReenactment via play
ApathyApathy
Posttraumatic stress disorderPosttraumatic stress disorder
Decreased interest in peers, hobbies, schoolDecreased interest in peers, hobbies, school
Specific Responses of Preadolescents Specific Responses of Preadolescents to Disastersto Disasters
Increased hostility with sibsIncreased hostility with sibs
Somatic complaintsSomatic complaints
Eating disordersEating disorders
Sleep disordersSleep disorders
Decreased interest in peers, hobbies, schoolDecreased interest in peers, hobbies, school
Specific Responses of Preadolescents Specific Responses of Preadolescents to Disasters (continued)to Disasters (continued)
RebellionRebellion
Refusal to do choresRefusal to do chores
Interpersonal difficultiesInterpersonal difficulties
Post-traumatic stress disorderPost-traumatic stress disorder
Specific Responses of Adolescents to Specific Responses of Adolescents to DisastersDisasters
Decreased interest in social activities, peers, Decreased interest in social activities, peers, hobbies, schoolhobbies, school
Anhedonia (inability to experience pleasure)Anhedonia (inability to experience pleasure)
Decline in responsible behaviorsDecline in responsible behaviors
Rebellion, behavior problemsRebellion, behavior problems
Somatic complaintsSomatic complaints
Sleep disordersSleep disorders
Specific Responses of Adolescents to Specific Responses of Adolescents to Disasters (continued)Disasters (continued)
Eating disordersEating disorders
Change in physical activityChange in physical activity
ConfusionConfusion
Lack of concentrationLack of concentration
Risk-taking behaviorsRisk-taking behaviors
Differences by genderDifferences by gender
Responses vary by gender. Boys take Responses vary by gender. Boys take longer to recover and exhibit aggressive, longer to recover and exhibit aggressive, antisocial and violent behaviors.antisocial and violent behaviors.
Girls are more distressed, have more verbal Girls are more distressed, have more verbal emotions, ask more questions and have emotions, ask more questions and have more frequent thoughts concerning the more frequent thoughts concerning the disaster.disaster.
Disruption of Normal PatternsDisruption of Normal Patterns
The cardinal effect of disaster and children in adolescents The cardinal effect of disaster and children in adolescents is a disruption of their lives.is a disruption of their lives.
Disruption leads to a loss of reliability, cohesion, and Disruption leads to a loss of reliability, cohesion, and predictability.predictability.
Toddlers respond with increased dependency.Toddlers respond with increased dependency.
School-age children show evidence of trauma with talk School-age children show evidence of trauma with talk and play about trauma and hostility to peers and family.and play about trauma and hostility to peers and family.
Adolescents may also withdraw and have decreased Adolescents may also withdraw and have decreased interest and experience fatigue, hypertension, hostility and interest and experience fatigue, hypertension, hostility and loss of objectivity.loss of objectivity.
Disruption of normal patterns Disruption of normal patterns (continued)(continued)
Treatment/RecommendationsTreatment/Recommendations Parents, teachers, and Healthcare workers should create Parents, teachers, and Healthcare workers should create
and maintain a predictable schedule for children.and maintain a predictable schedule for children.
Night lights, stuffed animals, and reassurance are helpful.Night lights, stuffed animals, and reassurance are helpful.
Compassion is helpful but punishment is not.Compassion is helpful but punishment is not.
Consultation with psychiatrist or psychiatric social worker Consultation with psychiatrist or psychiatric social worker may be a benefit.may be a benefit.
Re-enactmentRe-enactment
PlayPlay
HomeHome
DrawingsDrawings
NightmaresNightmares
Guided play/imagery to take control of scenario and make a happy ending.
Psychological IssuesPsychological Issues
PDLS will review general concepts, not age-specific PDLS will review general concepts, not age-specific detailsdetails
The psychological impact of disasters on children as The psychological impact of disasters on children as victimsvictims
Focus on what to expect and how to helpFocus on what to expect and how to help
General PrinciplesGeneral Principles
Children are at a high risk of experiencing Children are at a high risk of experiencing psychological consequences before, during, and psychological consequences before, during, and after a disasterafter a disaster
Many factors that affect thisMany factors that affect this≈There is some controversy about theseThere is some controversy about these
What to Expect?What to Expect?
Everyone is affected by a disaster in some wayEveryone is affected by a disaster in some way
Expected ChangesExpected Changes
Anxiety, Fears, and Worries about safety of self and Anxiety, Fears, and Worries about safety of self and othersothers
Worries about re-occurrence or consequences such Worries about re-occurrence or consequences such as waras war
Hyperactivity, decreased concentration, withdrawal, Hyperactivity, decreased concentration, withdrawal, outbursts, absenteeismoutbursts, absenteeism
Increased body complaintsIncreased body complaints≈Headache, Stomach-ache, PainsHeadache, Stomach-ache, Pains
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Expected ChangesExpected Changes
Changes in school performanceChanges in school performance
Recreating Event through talk, playRecreating Event through talk, play
Increased sensitivity to soundsIncreased sensitivity to sounds≈Sirens, thunder, aircraftSirens, thunder, aircraft
Questions about death and injuryQuestions about death and injury
Changes in sleepChanges in sleep
Denial of impactDenial of impact
Hateful or angry statementsHateful or angry statements
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Specific Symptoms: Specific Symptoms: AggressionAggression
Seen across all age groupsSeen across all age groups
Verbal and/or physical outbursts towards siblings, Verbal and/or physical outbursts towards siblings, adultsadults
Specific Symptoms: Specific Symptoms: Regressive BehaviorRegressive Behavior
Seen across all age groupsSeen across all age groups
Crying, clinginess, helplessnessCrying, clinginess, helplessness
Regression of toileting habitsRegression of toileting habits≈BedwettingBedwetting
≈Diaper dependenceDiaper dependence
Specific Symptoms: Specific Symptoms: Post-traumatic stressPost-traumatic stress
Post-traumatic stress symptoms includePost-traumatic stress symptoms include::≈NightmaresNightmares≈FlashbacksFlashbacks≈Emotional detachment or numbnessEmotional detachment or numbness≈InsomniaInsomnia≈HypervigilanceHypervigilance≈IrritabilityIrritability≈Memory LossMemory Loss
Common Symptoms: Common Symptoms: Post-traumatic stressPost-traumatic stress
The best studied psychological effectThe best studied psychological effect
Factors affecting development of PTSD:Factors affecting development of PTSD:≈Age (older > younger)Age (older > younger)
≈Gender (females > males)Gender (females > males)
≈Race (black > white)Race (black > white)
≈Parental coping skills and capabilitiesParental coping skills and capabilities
≈Child’s perception of risk (media role?)Child’s perception of risk (media role?)
≈Duration of and distance to the dangerDuration of and distance to the danger
ExamplesExamples
Buffalo Creek Dam Collapse (1972)Buffalo Creek Dam Collapse (1972)
179 children screened 2 years after179 children screened 2 years after
37% given “probable diagnosis” PTSD37% given “probable diagnosis” PTSD
ExamplesExamples
Flooding in Bangladesh (1993)Flooding in Bangladesh (1993)
162 children screened 2 years later162 children screened 2 years later
Aggressive behavior went from 0% to 10%Aggressive behavior went from 0% to 10%
34% new onset of enuresis in previously toilet-34% new onset of enuresis in previously toilet-trained childrentrained children
ExamplesExamples
Wildfires in AustraliaWildfires in Australia
808 children screened808 children screened≈2, 4, 26 months after surviving2, 4, 26 months after surviving
≈PrevalencePrevalence of post-disaster PTSD did not change of post-disaster PTSD did not change
Prevalence is % present in population testedPrevalence is % present in population tested
≈Predicting factorsPredicting factors
Mother’s response to disaster more predictive Mother’s response to disaster more predictive compared to patient’s direct exposurecompared to patient’s direct exposure
ExamplesExamples
Reactions studied in preschoolers exposed to a Reactions studied in preschoolers exposed to a severe hurricanesevere hurricane≈After 14 months, when compared to unexposed childrenAfter 14 months, when compared to unexposed children
Higher levels of anxiety and withdrawalHigher levels of anxiety and withdrawal
Other behavioral issues resolved slowly over 6 Other behavioral issues resolved slowly over 6 months post-disastermonths post-disaster
Again, mother’s response predictive of resilience in Again, mother’s response predictive of resilience in childchild
ExamplesExamples
9/11 terrorist attacks9/11 terrorist attacks≈National sample 3-5 days after attacksNational sample 3-5 days after attacks
≈35% parents reported one child or more with anxiety-35% parents reported one child or more with anxiety-related symptomsrelated symptoms
≈Half of children worried about their safetyHalf of children worried about their safety
Factors:Factors:– Parental response
– Amount of media viewed on the attacks
Suicide?Suicide?
Development of PTSD symptoms a link to suicidal Development of PTSD symptoms a link to suicidal behaviorbehavior
In cross-population study of multiple federally In cross-population study of multiple federally declared disasters:declared disasters:≈25% increase in suicide in age group 10-29 years old25% increase in suicide in age group 10-29 years old
≈Hurricanes, floods, and earthquakes highest riskHurricanes, floods, and earthquakes highest risk
≈Data suggest young men at highest riskData suggest young men at highest risk
How to HelpHow to Help
Understand the high rates at which these Understand the high rates at which these psychiatric disorders appear in children after psychiatric disorders appear in children after disasterdisaster
Understand the time frameUnderstand the time frame≈Many behavioral problems will resolve over weeks to Many behavioral problems will resolve over weeks to
monthsmonths
≈Anxiety/PTSD symptoms may persist over yearsAnxiety/PTSD symptoms may persist over years
PlanningPlanning
Incorporate Incorporate Psychologic First AidPsychologic First Aid information and information and providers in your planning at all levelsproviders in your planning at all levels
Utilize the expertise and advice of mental health Utilize the expertise and advice of mental health professionals before, during, and afterprofessionals before, during, and after≈Preparation and pre-positioning resourcesPreparation and pre-positioning resources≈Expertise in screening, therapyExpertise in screening, therapy
OverviewOverview
Children need to be viewed as an integral part of Children need to be viewed as an integral part of the population, not a “special circumstance” to be the population, not a “special circumstance” to be dealt with separatelydealt with separately≈What happens to adults happens to childrenWhat happens to adults happens to children
Planning, Response, and Recovery must Planning, Response, and Recovery must acknowledge this principle to be effectiveacknowledge this principle to be effective
InfluencesInfluences
It is established that outside factors greatly affect a It is established that outside factors greatly affect a child’s post-disaster psychiatric recovery, child’s post-disaster psychiatric recovery, especially:especially:≈How parents (especially mother) reacts in the post-How parents (especially mother) reacts in the post-
disaster environmentdisaster environment
≈MediaMedia
InfluencesInfluences
Exploring the parent-child relationship a little bit Exploring the parent-child relationship a little bit more:more:≈Child AbuseChild Abuse
≈Substance AbuseSubstance Abuse
In general, parental stress and a lack of social In general, parental stress and a lack of social services are linked to an increase in child abuse services are linked to an increase in child abuse reportsreports≈Is this true after a disaster too?Is this true after a disaster too?
ExamplesExamples
Loma Prieta Earthquke (1989)Loma Prieta Earthquke (1989)
Hurricane Hugo (1989)Hurricane Hugo (1989)
Hurricane Andrew (1992)Hurricane Andrew (1992)
Data suggest that child abuse rates increased in the Data suggest that child abuse rates increased in the 3 and 6 month period after these disasters3 and 6 month period after these disasters
ExamplesExamples
Hurricane Floyd (1999) in North CarolinaHurricane Floyd (1999) in North Carolina≈Inflicted traumatic brain injury increased in the 6 months Inflicted traumatic brain injury increased in the 6 months
following the hurricane in the most affected countiesfollowing the hurricane in the most affected counties
≈After 6 months rates of inflicted injury returned to baselineAfter 6 months rates of inflicted injury returned to baseline
≈Accidental injury rates remained the sameAccidental injury rates remained the same
ExamplesExamples
A 2001 café fire in the Netherlands wounded 250 A 2001 café fire in the Netherlands wounded 250 adolescents, and killed 14adolescents, and killed 14
Compared to a control group:Compared to a control group:
≈Increased rates of anxiety, depression, and alcohol useIncreased rates of anxiety, depression, and alcohol use
≈Marijuana, Ecstasy, and sedative use did not increaseMarijuana, Ecstasy, and sedative use did not increase
ExpectationsExpectations
Disasters are stressful events to all members of the Disasters are stressful events to all members of the communitycommunity≈Anticipate problems such as:Anticipate problems such as:
Increased child abuseIncreased child abuse
Increased substance abuseIncreased substance abuse
Media and SocietyMedia and Society
What has been the role of media in recent What has been the role of media in recent disasters?disasters?≈Hurricane KatrinaHurricane Katrina≈Indian Ocean TsunamiIndian Ocean Tsunami≈9/11 Terrorist Attacks9/11 Terrorist Attacks
How did children respond to this information, based How did children respond to this information, based on what we have already discussed?on what we have already discussed?
Media and SocietyMedia and Society
Many children feared for their own safety, and that Many children feared for their own safety, and that of their parentsof their parents
Media viewing of disturbing images may Media viewing of disturbing images may exacerbate anxiety, aggression, regression, PTSDexacerbate anxiety, aggression, regression, PTSD
What is the responsibility of the media?What is the responsibility of the media?
What is the responsibility of parents?What is the responsibility of parents?
SuggestionsSuggestions
Acknowledge that children do not benefit from the Acknowledge that children do not benefit from the repeated viewing of frightening imagesrepeated viewing of frightening images
Photo: National Geographic Channel
SchoolSchool
The re-establishment of routine may prevent the The re-establishment of routine may prevent the worsening of symptoms in children and speed the worsening of symptoms in children and speed the recoveryrecovery
The ability to recover after a disaster and return to The ability to recover after a disaster and return to normal is termed normal is termed resiliencyresiliency
SchoolSchool
School provides much of what is taken away during School provides much of what is taken away during a disaster and may be an important part of a disaster and may be an important part of resiliencyresiliency≈OrderOrder≈RulesRules≈ConsistencyConsistency≈FriendsFriends≈Role Models and TeachersRole Models and Teachers
Coping Techniques at Home and Coping Techniques at Home and SchoolSchool
Reinforce the idea of safety and security through Reinforce the idea of safety and security through self-realizationself-realization
Maintain a routine scheduleMaintain a routine schedule
Listen to children’s discussions of the eventsListen to children’s discussions of the events
Discuss how media may be affecting their feelingsDiscuss how media may be affecting their feelings
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Coping Techniques at Home and Coping Techniques at Home and SchoolSchool
Validate feelings of anger but discuss how Validate feelings of anger but discuss how developing hatred towards groups of people does developing hatred towards groups of people does not helpnot help
Encourage children to talk about how they have Encourage children to talk about how they have been affected, and explain how these reactions are been affected, and explain how these reactions are normalnormal
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