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The Informed Parent

More Help For Anxious Worriers

by Peter W. Welty, M.D., F.A.A.P.
Published on Nov. 19, 2001

A distressed mother came into the office last week concerned about her three children, ages 4, 9, and 18 years. They, along with the rest of the world, saw the terrible events of September 11, and her children had not been the same since. The younger ones were crying a lot, afraid to be alone without her, and all three of them were worried and concerned. She needed to know how to help them, and herself, to get past these awful events and move on.

There are so many parents wondering how to talk to their children about the events of September 11. All of us, children included, witnessed the film of the airliners crashing into the World Trade Center. The anxiety continues with the current anthrax events.

Because there has been no other terrorist attack on the United States, with the exception of the Oklahoma City bombing, there is little empirical research to help us answer our questions on how to help our children. Information from related events are our best defense.

There is a wide range of emotional responses that children and adults display in response to a disaster. More severe reactions tend to be correlated with a higher degree of exposure to the event, such as a direct life threat, witnessing the event, physical injury, etc. Also close proximity to the event, history of prior traumas, female gender, parental emotional problems and poor parental response to the event tend to bring out severe reactions.

Children can display a wide range of emotions, depending on their age.

Younger children’s responses to trauma tend to include:

  1. helplessness and passivity
  2. overall fear and anxiety
  3. increased startle response
  4. sleep disturbances and nightmares
  5. separation fears and clinging behaviors
  6. an inability to understand death as permanent

Older school-age children:

  1. may feel responsible and guilty
  2. may display repetitive play and retelling
  3. may have sleep disturbances and nightmares
  4. display aggressive play
  5. may pay close attention to parents’ anxieties
  6. may show increased worry about others and be fearful in general
  7. display behavior that regresses to the behavior of a younger child
  8. may show loss of interest in usual activities
  9. may not have a clear understanding of the event or of death
  10. may show magical explanations to fill in their gaps of understanding
  11. may perform more poorly in school

Older adolescents:

  1. may also show a decline in school performance
  2. rebel at home and at school
  3. may show risky, acting-out behaviors
  4. may take efforts to distance themselves from feeling afraid and confused
  5. may also have sleep disturbances and nightmares

Parents can go a long way to help their children cope with the terrible events of September 11, and our ongoing anthrax concerns.

  1. Create a safe environment for your family. Children take comfort in routine and familiar environments.
  2. Provide reassurance and emotional supports. Tell them they are safe and that you will be with them.
  3. Be honest with your children about what has happened. But be sure to gear your explanation to their developmental level. Tell your child that the United States is responding to the attacks. Tell them how the police, firemen, armed services and governments from other countries are all joining in to keep us safe.
  4. Be aware that children will often take on the fears and responses of the adults around them. If you are overly anxious and fearful, or angry and revengeful, chances are your children are, too. Be sure to look at your own feelings and carefully remember that your children will model their responses to yours.
  5. Try to place the attacks in perspective. Watching the same film over and over tends to make the event real and new, each and every time it is shown. Try to tell your children that the world is generally a safe place.
  6. Try to maintain a comforting environment for your child. Listen to your child’s fears and concerns regarding the event, but try to put them in perspective.
  7. Set a limit to aggressive and violent play.
  8. Allow some behavior regression, which is common during this stressful time. Reassure your children that strong feelings are normal after a trauma, and will fade with time.

Most children who are emotionally affected by the terrorist bombings will display some of the symptoms we discussed. They will likely recover with time, in a few weeks. If your child has severe, prolonged responses of depression or anxiety, you may want to seek the assistance of a mental health counselor who has experience in dealing with trauma in children.

Information in this article is from the National Center for PTSD’s web site, which provides valuable information on the mental health identification and treatment of trauma-related issues.

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