Related topics: •  Helping Kids Cope With Terrorist Acts

Editor's note: The following article was originally published in October 2001 as parents around the country struggled to explain the events of 9/11 to their children. The catastrophic violence children might have previously encountered on the big screen at movie theaters was suddenly appearing on their living room TV screens -- only this time it was real. Because we continue to live in tumultuous times, we have decided to leave this article as it was originally published. The advice it gives to parents remains valid.

Over and over on the television screen, the plane smashes like a missile into the tower of the World Trade Center, igniting a fireball and sending great plumes of smoke into the Manhattan sky. By now, in the wake of the worst terrorist attack ever on American soil, the whole country is grappling with that image -- and that includes our children.

Many kids have seen something like this in the movies, but this time it's real. How do we talk to them about what happened in New York City and the Pentagon? How do we describe terrorism to our children and at the same time assure them that they will be okay? How do we explain the unexplainable?

Child psychiatrists and other experts agree that the best response depends on the child's age. Smaller children's greatest need is for reassurance that they and their parents will be safe. Older children also need reassurance, but will most likely demand a more in-depth conversation with you about the world and the existence of terrorism.

"A little child is afraid that the bomb is going to fall on his [house] and kill his mommy," says Pennsylvania child psychiatrist Elizabeth Berger, MD, a member of the American Academy of Child and Adolescent Psychiatry. "An older child who thinks abstractly, especially a preteen or teenager, says, 'How can this happen? What does it mean for our world?'"

While it may be tempting to shield our children completely from such horrendous events, it's probably not a good idea, psychologists say. During times of crisis, children are particularly sensitive to what their parents are feeling, and will most definitely sense the sadness, anger, anxiety, and distress that you're experiencing. The key is to find a balance between being as honest with our children as their age allows, while letting them know they are loved and protected.

Younger children will realize that something terrible has happened and should be reassured that they are safe, say many experts, including members of the National Association of School Psychologists. Try to keep up the family routine as much as possible, reading bedtime stories or whatever comfortable routines your child is used to.

Small children will most likely experience fears of abandonment and anxiety that harm may come to them or to their parents, says Berger. "A good way to reassure small children is to say, 'Yes, sometimes terrible things happen in the world and this is one of those times. But I'm safe, I'm here, and you're safe.'"

Experts generally agree that you shouldn't go into detail about the events with your children unless they specifically ask. Rachel Biale, a clinical social worker in Northern California, says smaller children simply need to know that they are safe in their own homes and at school.

"If your children are under 8 years old, I'd shield them as much as possible. Don't expose them to repeated footage of buildings collapsing and people falling and explosions -- it's just too terrifying for young children," says Biale, the director of community education at the Osher Marin Jewish Community Center in San Rafael. "Children 3 to 5 years old need to be comforted and to know they're safe in their homes and at preschool. You could start out by saying a terrible thing has happened very far away. You might tell them that some very mean people have hurt a lot of people and crushed some buildings. I wouldn't get more specific unless they ask. If they do ask whether people have been killed, I'd tell them yes, and that's why mommy and daddy and many other people are very sad and upset."

"Children may ask a lot of questions, including some that have no satisfying answer, such as how somebody could do that," Biale adds. "You could tell them that some people don't agree with our country and what it stands for, and they did this to hurt us and to scare us. But even though we are very sad, the people who did this won't get their way." If they ask whether the United States has ever done something wrong, she says, it's best to be honest and tell them yes.

Biale says that very young children may act out the air attack by building block towers and knocking them over again and again. It's healthy to let a child "play it out," she says: "Adults deal with this kind of tragedy by talking about it incessantly and watching television, and this is how a young child deals with it. You only need to stop a child if he is hurting another child or an animal."

You can also tell your child that you feel very angry about the air attacks, Biale adds. "But it's important to let them know that even when we are angry, that is not a reason to hurt other people."

According to the National Association of School Psychologists, adults should act calm, controlled, and reassuring; remind children that trustworthy people such as fire fighters and police officers are involved; and let them know that it's okay to feel upset. You should also find out what resources your school has to help children cope.

Older children are likely to ask the harder questions: Why would anyone want to do this to us? How do we know they won't keep attacking? What can we do to make the world a better place?

Despite the shock and grief we may be feeling in the aftermath of an attack, these events also present an opportunity to listen to our preteens' and adolescents' ideas about the world, and to talk to them about ways we can make the world a better place.

"Young people -- bless them -- have the capacity for altruism and for wanting to solve the world's problems," says Berger. "This is a sad but important opportunity to do some serious reflection on the misery, not just in New York and Washington, but in all the other cities around the world where innocent people lose their lives."

Adolescents and preteens will respond best if they're able to get involved in an activity related to the tragedy, experts say. You or school officials might encourage them to write letters to high-school students in New York City, or to donate his allowance or recent earnings to the Red Cross. (Younger children may want to send get-well cards to the mayors or people in the hospitals in those cities.)

Biale also cautions that parents should be careful to talk with children about their anger and how to deal with it. "When something terrible happens, we often want to find someone to blame and be mad at," Biale says. "We still don't know, but if it turns out -- as early news reports suggest -- that this was done by Muslim fundamentalists, it's really important not to direct that anger at all Muslims or all people of Arab descent."

But older children will also need reassurance and to spend time with their parents, experts say. Just because they're old enough to tackle the bigger questions, doesn't mean they might not need some old-fashioned nurturing from their parents. "A 17-year-old might need a hug this minute and a discussion of world politics the next minute," Berger says. The important thing is to spend extra time with your children during these next few weeks, listen to them carefully, and be open to talking with them at every opportunity.

Lynn Cohen, a marriage and family therapist in Vacaville, California, compares the aftermath of this tragedy to that following the school massacre in Columbine, Colorado. "At that time, there was a great need to let children talk about their feelings," she says. "Likewise now, let them vent and express their emotions. They need to get them out in the open and not hold in their fears or anxiety. Then try to do something calming with them before they go to bed at night."

Experts disagree on whether or how much TV news coverage of the air attack children should be allowed to watch.

If your children are curious about the news, and old enough to know the difference between events being reported on television and those happening in your own living room, they should be allowed to watch the news, says Berger. "I think it backfires if a parent tries to cover the eyes and ears of a child who wants to pursue information that is clearly available to the public," Berger says.

"It's certainly true that being glued to CNN somehow helps adults," Berger continues. "But I think parents have to watch out not to create 'CNN orphans,' meaning the child feels that he has to compete with a disaster."

Lynn Ponton, MD, a child psychiatrist in San Francisco, recommends that parents allow younger children to watch a few minutes of news, then spend some time discussing the events with them and paying close attention to how they're reacting.

"Media viewing is complicated," Ponton says. "You want to allow them to watch some news coverage so that they can process [the tragedy], but the images can also be very traumatizing to children." Too much exposure to the violent images, Ponton says, runs the risk of either desensitizing children to the violence, or contributing to hyperactivity and anxiety.

Following a disaster, people may develop post-traumatic stress disorder (PTSD), psychological damage that can result from experiencing, witnessing, or participating in an overwhelmingly traumatic event. Children with this disorder have repeated episodes in which they re-experience the trauma in nightmares and flashbacks, or relive it through repetitive play. Though symptoms can occur soon after the event, the disorder often surfaces several months, or even years, later.

Professional advice or treatment for children affected by a disaster -- especially those who have witnessed destruction, injury, or death -- can help prevent or minimize PTSD. Parents who are concerned about their children can ask their pediatrician or family doctor to refer them to a child and adolescent psychiatrist or counselor.

According to the American Academy of Child and Adolescent Psychiatry, parents should be alert to these changes in a child's behavior:

•Refusal to return to school and "clinging" behavior, including shadowing the mother or father around the house

•Persistent fears related to the catastrophe (like fears about being permanently separated from parents)

•Sleep disturbances such as nightmares, screaming during sleep, and bedwetting, which persist more than several days after the event

•Irritability and loss of concentration

•Being jumpy or easily startled

•Behavior problems like misbehaving in school or at home in ways that are not typical of the child's normal behavior

•Physical complaints, like stomachaches, headaches, or dizziness, for which a physical cause cannot be found

•Withdrawal from family and friends, sadness, listlessness, decreased activity, and preoccupation with the events of the disaster

If you have a very young child, you may find that she or he is showing anxiety about the attack on the United States in other ways, says Berger. For him, the stress won't be about a hijacked airplane but about "a burglar in the attic, or a strange animal," she says. "He may become all keyed up and angry at his little sister... A child may show distress, fright, anger, and anxiety that may not seem directly related."

Above all else, it's important to help your child to feel included and loved. "What frightens children terribly is to feel that something awful is happening, and no one will tell them what it is," says Berger. "It's a child's worst terror to feel that he's all alone. In most circumstances, children do well with the truth if they are given the emotional support from people they love."

-- Paige Bierma is a health and medical writer who has contributed to Hippocrates, Safety + Health magazine, and Vibe. She won the Investigative Reporters and Editors' top award for her 1995 expose on the abuse of teenagers in wilderness therapy camps.

References

First published September 12, 2001
Last updated February 26, 2008
Copyright © 2001 Consumer Health Interactive

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