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Tips for Talking With and Helping Children and Youth
Cope After a Disaster or Traumatic Event
A GUIDE FOR PARENTS, CAREGIVERS, AND TEACHERS

    “Adult support and reassurance is the key to helping children through a traumatic time”


Children and youth can face emotional strains                 PRESCHOOL CHILDREN, 0–5 YEARS OLD
after a traumatic event such as a car crash
or violence.1 Disasters also may leave them                   Very young children may go back to thumb
with long-lasting harmful effects.2 When                      sucking or wetting the bed at night after a
children experience a trauma, watch it on TV,                 trauma. They may fear strangers, darkness,
or overhear others discussing it, they can feel               or monsters. It is fairly common for preschool
scared, confused, or anxious. Young people                    children to become clingy with a parent,
react to trauma differently than adults. Some                 caregiver, or teacher or to want to stay in a place
may react right away; others may show signs                   where they feel safe. They may express the
that they are having a difficult time much later.             trauma repeatedly in their play or tell exaggerated
As such, adults do not always know when a                     stories about what happened. Some children’s
child needs help coping. This tip sheet will help             eating and sleeping habits may change. They
parents, caregivers, and teachers learn some                  also may have aches and pains that cannot be
common reactions, respond in a helpful way,                   explained. Other symptoms to watch for are
and know when to seek support.                                aggressive or withdrawn behavior, hyperactivity,
                                                              speech difficulties, and disobedience.

Possible Reactions to a Disaster                               nfants and Toddlers, 0–2 years old, cannot
                                                                I
                                                                understand that a trauma is happening, but
or Traumatic Event                                              they know when their caregiver is upset. They
                                                                may start to show the same emotions as
Many of the reactions noted below are normal
                                                                their caregivers, or they may act differently,
when children and youth are handling the stress
                                                                like crying for no reason or withdrawing from
right after an event. If any of these behaviors
                                                                people and not playing with their toys.
lasts for more than 2 to 4 weeks, or if they
suddenly appear later on, these children may                    hildren, 3–5 years old, can understand
                                                                C
need more help coping. Information about                        the effects of trauma. They may have trouble
where to find help is in the Helpful Resources                  adjusting to change and loss. They may
section of this tip sheet.                                      depend on the adults around them to help
                                                                them feel better.

1            Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov
TIPS FOR TALKING WITH AND HELPING CHILDREN AND YOUTH COPE AFTER A DISASTER OR TRAUMATIC EVENT
A GUIDE FOR PARENTS, CAREGIVERS, AND TEACHERS



EARLY CHILDHOOD TO ADOLESCENCE,                                 ƒƒ  arents, teachers, and other caregivers can help
                                                                   P
6–19 YEARS OLD                                                     children express their emotions through conversation,
                                                                   writing, drawing, and singing. Most children want to
Children and youth in these age ranges may                         talk about a trauma, so let them. Accept their feelings
have some of the same reactions to trauma as                       and tell them it is ok to feel sad, upset, or stressed.
younger children. Often younger children want
                                                                   Crying is often a way to relieve stress and grief. Pay
much more attention from parents or caregivers.
They may stop doing their school work or                           attention and be a good listener.
chores at home. Some youth may feel helpless                    ƒƒ  sk your teen and youth you are caring for what
                                                                   A
and guilty because they cannot take on adult                       they know about the event. What are they hearing in
roles as their family or the community responds
                                                                   school or seeing on TV? Try to watch news coverage
to a trauma or disaster.
                                                                   on TV or the Internet with them. And, limit access
 Children, 6–10 years old, may fear going to                    so they have time away from reminders about the
    school and stop spending time with friends.                    trauma. Don’t let talking about the trauma take over
    They may have trouble paying attention and                     the family or classroom discussion for long periods of
    do poorly in school overall. Some may become                   time. Allow them to ask questions.
    aggressive for no clear reason. Or they may
    act younger than their age by asking to be fed              ƒƒ  dults can help children and youth see the good that
                                                                   A
    or dressed by their parent or caregiver.                       can come out of a trauma. Heroic actions, families
  outh and Adolescents, 11–19 years old,
  Y                                                                and friends who help, and support from people in
  go through a lot of physical and emotional                       the community are examples. Children may better
  changes because of their developmental                           cope with a trauma or disaster by helping others.
  stage. So, it may be even harder for them                        They can write caring letters to those who have
  to cope with trauma. Older teens may deny                        been hurt or have lost their homes; they can send
  their reactions to themselves and their                          thank you notes to people who helped. Encourage
  caregivers. They may respond with a routine                      these kinds of activities.
  “I’m ok” or even silence when they are upset.
  Or, they may complain about physical aches                    ƒƒ f human violence or error caused an event, be
                                                                   I
  or pains because they cannot identify what is                    careful not to blame a cultural, racial, or ethnic group,
  really bothering them emotionally. Some may                      or persons with psychiatric disabilities. This may
  start arguments at home and/or at school,                        be a good opportunity to talk with children about
  resisting any structure or authority. They also                  discrimination and diversity. Let children know that
  may engage in risky behaviors such as using
                                                                   they are not to blame when bad things happen.
  alcohol or drugs.
                                                                ƒƒ t’s ok for children and youth to see adults sad
                                                                   I
                                                                   or crying, but try not to show intense emotions.
How Parents, Caregivers, and Teachers                              Screaming and hitting or kicking furniture or walls
Can Support Children’s Recovery                                    can be scary for children. Violence can further
The good news is that children and youth are                       frighten children or lead to more trauma.3
usually quite resilient. Most of the time they get              ƒƒ  dults can show children and youth how to take care of
                                                                   A
back to feeling ok soon after a trauma. With
                                                                   themselves. If you are in good physical and emotional
the right support from the adults around them,
                                                                   health, you are more likely to be readily available to
they can thrive and recover. The most important
ways to help are to make sure children feel                        support the children you care about. Model self-care,
connected, cared about, and loved.                                 set routines, eat healthy meals, get enough sleep,
                                                                   exercise, and take deep breaths to handle stress.

2            Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov
TIPS FOR TALKING WITH AND HELPING CHILDREN AND YOUTH COPE AFTER A DISASTER OR TRAUMATIC EVENT
A GUIDE FOR PARENTS, CAREGIVERS, AND TEACHERS



Tips for Talking With Children and
Youth of Different Age Groups After
a Disaster or Traumatic Event
PRESCHOOL CHILDREN, 0–5 YEARS OLD
Give these very young children a lot of cuddling
and verbal support.
ƒƒ  ake a deep breath before holding or picking
   T
   them up and focus on them, not the trauma.
ƒƒ  et down to their eye level and speak in a
   G
   calm, gentle voice using words they can
   understand.
ƒƒ  ell them that you still care for them and will
   T
   continue to take care of them so they feel safe.

EARLY CHILDHOOD TO ADOLESCENCE,
6–19 YEARS OLD
Nurture children and youth in this age group:
ƒƒ  sk your child or the children in your care what
   A                                                          ƒƒ  ncourage children to participate in
                                                                 E
   worries them and what might help them cope.                   recreational activities so they can move
                                                                 around and play with others.
ƒƒ  ffer comfort with gentle words, a hug when
   O
   appropriate, or just being present with them.              ƒƒ  ddress your own trauma in a healthy way.
                                                                 A
                                                                 Avoid hitting, isolating, abandoning, or
ƒƒ  pend more time with the children than
   S
                                                                 making fun of children.
   usual, even for a short while. Returning to
   school activities and getting back to routines             ƒƒ  et children know that you care about them-
                                                                 L
   at home is important too.                                     spend time doing something special; make
                                                                 sure to check on them in a nonintrusive way.
ƒƒ  xcuse traumatized children from chores for
   E
   a day or two. After that, make sure they have              A NOTE OF CAUTION! Be careful not to pressure children to
   age-appropriate tasks and can participate in               talk about a trauma or join in expressive activities. While most
   a way that makes them feel useful.                         children will easily talk about what happened, some may
                                                              become frightened. Some may even get traumatized again by
ƒƒ  upport children spending time with friends
   S                                                          talking about it, listening to others talk about it, or looking at
   or having quiet time to write or create art.               drawings of the event. Allow children to remove themselves
                                                              from these activities, and monitor them for signs of distress.




3            Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov
TIPS FOR TALKING WITH AND HELPING CHILDREN AND YOUTH COPE AFTER A DISASTER OR TRAUMATIC EVENT
A GUIDE FOR PARENTS, CAREGIVERS, AND TEACHERS



                                                                          When Children, Youth and Parents,
    Helpful Resources                                                     Caregivers, or Teachers Need
    Substance Abuse and Mental Health Services
    Administration’s Disaster Technical Assistance                        More Help
    Center (SAMHSA DTAC)                                                  In some instances, a child and their family may
    Toll Free: 1-800-308-3515
                                                                          have trouble getting past a trauma. Parents or
    Web Site: http://www.samhsa.gov/dtac
                                                                          caregivers may be afraid to leave a child alone.
    Treatment Locators                                                    Teachers may see that a student is upset or
    Mental Health Services Locator
                                                                          seems different. It may be helpful for everyone
    Toll-Free: 1–800–789–2647 (English and Español);                      to work together. Consider talking with a mental
    TDD: 1–866–889–2647                                                   health professional to help identify the areas of
    Web Site: http://store.samhsa.gov/mhlocator                           difficulty. Together, everyone can decide how
                                                                          to help and learn from each other. If a child
    Substance Abuse Treatment Facility Locator
                                                                          has lost a loved one, consider working with
    Toll-Free: 1–800–662–HELP (1–800–662–4357)
    (24/7 English and Español); TDD: 1–866–487–4889
                                                                          someone who knows how to support children
    Web Site: http://www.findtreatment.samhsa.gov                         who are grieving.4 Find a caring professional in
                                                                          the Helpful Resources section of this tip sheet.
    Hotlines
    Disaster Distress Helpline                                            1
                                                                              N
                                                                               ational Center for Statistics and Analysis. (n.d.). Traffic safety facts,
    Toll-Free: 1-800-985-5990 Text ‘TalkWithUs’ to 66746                      2003 data: Children. (DOT HS 809 762). Washington, DC: National
    Web Site: http://www.disasterdistress.samhsa.gov                          Highway Traffic Safety Administration. From http://www-nrd.nhtsa.dot.
                                                                              gov/Pubs/809762.pdf (accessed April 20, 2012).
    Child Welfare Information Gateway
    Toll-Free: 1–800–4–A–CHILD (1–800–422–4453)
                                                                          2,4
                                                                                N
                                                                                 ational Commission on Children and Disasters. (2010). National
    Web Site: http://www.childwelfare.gov/responding/how.cfm                    Commission on Children and Disasters: 2010 report to the President
                                                                                and Congress. AHRQ Publication No. 10-MO37. Rockville, MD:
                                                                                Agency for Healthcare Research and Quality. From http://archive.
    Resources Addressing Children’s Needs                                       ahrq.gov/prep/nccdreport/nccdreport.pdf (accessed April 20, 2012).
    Administration for Children and Families                              3
                                                                              C
                                                                               hildren’s Bureau. (2010). Child maltreatment 2009. Washington,
    Web Site: http://www.acf.hhs.gov/                                         DC: Administration on Children, Youth and Families; Administration
                                                                              for Children and Families; U.S. Department of Health and Human
                                                                              Services. From http://www.acf.hhs.gov/programs/cb/stats_research/
    Additional Behavioral Health Resources                                    index.htm#can (accessed April 20, 2012).
    These behavioral health resources can be accessed
    by Clicking through to the SAMHSA website and then
    clicking on the related link.
    National Suicide Prevention Lifeline
    Toll-Free: 1–800–273–TALK (1–800–273–8255);
    TTY: 1–800–799–4TTY (1–800–799–4889)
    Web Site: http://www.samhsa.gov
    National Child Traumatic Stress Network
    Web Site: http://www.samhsa.gov/traumaJustice/


                                                               ∙



                                                                          HHS Publication No. (SMA) 12-4732
                                                                          (Revision of KEN-01-0091/KEN-01-0093; Revised 04/2007)


4               Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov

                                                                   2012

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Tips for talking with and helping children traumatic event

  • 1. ∙ Tips for Talking With and Helping Children and Youth Cope After a Disaster or Traumatic Event A GUIDE FOR PARENTS, CAREGIVERS, AND TEACHERS “Adult support and reassurance is the key to helping children through a traumatic time” Children and youth can face emotional strains PRESCHOOL CHILDREN, 0–5 YEARS OLD after a traumatic event such as a car crash or violence.1 Disasters also may leave them Very young children may go back to thumb with long-lasting harmful effects.2 When sucking or wetting the bed at night after a children experience a trauma, watch it on TV, trauma. They may fear strangers, darkness, or overhear others discussing it, they can feel or monsters. It is fairly common for preschool scared, confused, or anxious. Young people children to become clingy with a parent, react to trauma differently than adults. Some caregiver, or teacher or to want to stay in a place may react right away; others may show signs where they feel safe. They may express the that they are having a difficult time much later. trauma repeatedly in their play or tell exaggerated As such, adults do not always know when a stories about what happened. Some children’s child needs help coping. This tip sheet will help eating and sleeping habits may change. They parents, caregivers, and teachers learn some also may have aches and pains that cannot be common reactions, respond in a helpful way, explained. Other symptoms to watch for are and know when to seek support. aggressive or withdrawn behavior, hyperactivity, speech difficulties, and disobedience. Possible Reactions to a Disaster  nfants and Toddlers, 0–2 years old, cannot I understand that a trauma is happening, but or Traumatic Event they know when their caregiver is upset. They may start to show the same emotions as Many of the reactions noted below are normal their caregivers, or they may act differently, when children and youth are handling the stress like crying for no reason or withdrawing from right after an event. If any of these behaviors people and not playing with their toys. lasts for more than 2 to 4 weeks, or if they suddenly appear later on, these children may  hildren, 3–5 years old, can understand C need more help coping. Information about the effects of trauma. They may have trouble where to find help is in the Helpful Resources adjusting to change and loss. They may section of this tip sheet. depend on the adults around them to help them feel better. 1 Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov
  • 2. TIPS FOR TALKING WITH AND HELPING CHILDREN AND YOUTH COPE AFTER A DISASTER OR TRAUMATIC EVENT A GUIDE FOR PARENTS, CAREGIVERS, AND TEACHERS EARLY CHILDHOOD TO ADOLESCENCE, ƒƒ arents, teachers, and other caregivers can help P 6–19 YEARS OLD children express their emotions through conversation, writing, drawing, and singing. Most children want to Children and youth in these age ranges may talk about a trauma, so let them. Accept their feelings have some of the same reactions to trauma as and tell them it is ok to feel sad, upset, or stressed. younger children. Often younger children want Crying is often a way to relieve stress and grief. Pay much more attention from parents or caregivers. They may stop doing their school work or attention and be a good listener. chores at home. Some youth may feel helpless ƒƒ sk your teen and youth you are caring for what A and guilty because they cannot take on adult they know about the event. What are they hearing in roles as their family or the community responds school or seeing on TV? Try to watch news coverage to a trauma or disaster. on TV or the Internet with them. And, limit access  Children, 6–10 years old, may fear going to so they have time away from reminders about the school and stop spending time with friends. trauma. Don’t let talking about the trauma take over They may have trouble paying attention and the family or classroom discussion for long periods of do poorly in school overall. Some may become time. Allow them to ask questions. aggressive for no clear reason. Or they may act younger than their age by asking to be fed ƒƒ dults can help children and youth see the good that A or dressed by their parent or caregiver. can come out of a trauma. Heroic actions, families  outh and Adolescents, 11–19 years old, Y and friends who help, and support from people in go through a lot of physical and emotional the community are examples. Children may better changes because of their developmental cope with a trauma or disaster by helping others. stage. So, it may be even harder for them They can write caring letters to those who have to cope with trauma. Older teens may deny been hurt or have lost their homes; they can send their reactions to themselves and their thank you notes to people who helped. Encourage caregivers. They may respond with a routine these kinds of activities. “I’m ok” or even silence when they are upset. Or, they may complain about physical aches ƒƒ f human violence or error caused an event, be I or pains because they cannot identify what is careful not to blame a cultural, racial, or ethnic group, really bothering them emotionally. Some may or persons with psychiatric disabilities. This may start arguments at home and/or at school, be a good opportunity to talk with children about resisting any structure or authority. They also discrimination and diversity. Let children know that may engage in risky behaviors such as using they are not to blame when bad things happen. alcohol or drugs. ƒƒ t’s ok for children and youth to see adults sad I or crying, but try not to show intense emotions. How Parents, Caregivers, and Teachers Screaming and hitting or kicking furniture or walls Can Support Children’s Recovery can be scary for children. Violence can further The good news is that children and youth are frighten children or lead to more trauma.3 usually quite resilient. Most of the time they get ƒƒ dults can show children and youth how to take care of A back to feeling ok soon after a trauma. With themselves. If you are in good physical and emotional the right support from the adults around them, health, you are more likely to be readily available to they can thrive and recover. The most important ways to help are to make sure children feel support the children you care about. Model self-care, connected, cared about, and loved. set routines, eat healthy meals, get enough sleep, exercise, and take deep breaths to handle stress. 2 Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov
  • 3. TIPS FOR TALKING WITH AND HELPING CHILDREN AND YOUTH COPE AFTER A DISASTER OR TRAUMATIC EVENT A GUIDE FOR PARENTS, CAREGIVERS, AND TEACHERS Tips for Talking With Children and Youth of Different Age Groups After a Disaster or Traumatic Event PRESCHOOL CHILDREN, 0–5 YEARS OLD Give these very young children a lot of cuddling and verbal support. ƒƒ ake a deep breath before holding or picking T them up and focus on them, not the trauma. ƒƒ et down to their eye level and speak in a G calm, gentle voice using words they can understand. ƒƒ ell them that you still care for them and will T continue to take care of them so they feel safe. EARLY CHILDHOOD TO ADOLESCENCE, 6–19 YEARS OLD Nurture children and youth in this age group: ƒƒ sk your child or the children in your care what A ƒƒ ncourage children to participate in E worries them and what might help them cope. recreational activities so they can move around and play with others. ƒƒ ffer comfort with gentle words, a hug when O appropriate, or just being present with them. ƒƒ ddress your own trauma in a healthy way. A Avoid hitting, isolating, abandoning, or ƒƒ pend more time with the children than S making fun of children. usual, even for a short while. Returning to school activities and getting back to routines ƒƒ et children know that you care about them- L at home is important too. spend time doing something special; make sure to check on them in a nonintrusive way. ƒƒ xcuse traumatized children from chores for E a day or two. After that, make sure they have A NOTE OF CAUTION! Be careful not to pressure children to age-appropriate tasks and can participate in talk about a trauma or join in expressive activities. While most a way that makes them feel useful. children will easily talk about what happened, some may become frightened. Some may even get traumatized again by ƒƒ upport children spending time with friends S talking about it, listening to others talk about it, or looking at or having quiet time to write or create art. drawings of the event. Allow children to remove themselves from these activities, and monitor them for signs of distress. 3 Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov
  • 4. TIPS FOR TALKING WITH AND HELPING CHILDREN AND YOUTH COPE AFTER A DISASTER OR TRAUMATIC EVENT A GUIDE FOR PARENTS, CAREGIVERS, AND TEACHERS When Children, Youth and Parents, Helpful Resources Caregivers, or Teachers Need Substance Abuse and Mental Health Services Administration’s Disaster Technical Assistance More Help Center (SAMHSA DTAC) In some instances, a child and their family may Toll Free: 1-800-308-3515 have trouble getting past a trauma. Parents or Web Site: http://www.samhsa.gov/dtac caregivers may be afraid to leave a child alone. Treatment Locators Teachers may see that a student is upset or Mental Health Services Locator seems different. It may be helpful for everyone Toll-Free: 1–800–789–2647 (English and Español); to work together. Consider talking with a mental TDD: 1–866–889–2647 health professional to help identify the areas of Web Site: http://store.samhsa.gov/mhlocator difficulty. Together, everyone can decide how to help and learn from each other. If a child Substance Abuse Treatment Facility Locator has lost a loved one, consider working with Toll-Free: 1–800–662–HELP (1–800–662–4357) (24/7 English and Español); TDD: 1–866–487–4889 someone who knows how to support children Web Site: http://www.findtreatment.samhsa.gov who are grieving.4 Find a caring professional in the Helpful Resources section of this tip sheet. Hotlines Disaster Distress Helpline 1 N ational Center for Statistics and Analysis. (n.d.). Traffic safety facts, Toll-Free: 1-800-985-5990 Text ‘TalkWithUs’ to 66746 2003 data: Children. (DOT HS 809 762). Washington, DC: National Web Site: http://www.disasterdistress.samhsa.gov Highway Traffic Safety Administration. From http://www-nrd.nhtsa.dot. gov/Pubs/809762.pdf (accessed April 20, 2012). Child Welfare Information Gateway Toll-Free: 1–800–4–A–CHILD (1–800–422–4453) 2,4 N ational Commission on Children and Disasters. (2010). National Web Site: http://www.childwelfare.gov/responding/how.cfm Commission on Children and Disasters: 2010 report to the President and Congress. AHRQ Publication No. 10-MO37. Rockville, MD: Agency for Healthcare Research and Quality. From http://archive. Resources Addressing Children’s Needs ahrq.gov/prep/nccdreport/nccdreport.pdf (accessed April 20, 2012). Administration for Children and Families 3 C hildren’s Bureau. (2010). Child maltreatment 2009. Washington, Web Site: http://www.acf.hhs.gov/ DC: Administration on Children, Youth and Families; Administration for Children and Families; U.S. Department of Health and Human Services. From http://www.acf.hhs.gov/programs/cb/stats_research/ Additional Behavioral Health Resources index.htm#can (accessed April 20, 2012). These behavioral health resources can be accessed by Clicking through to the SAMHSA website and then clicking on the related link. National Suicide Prevention Lifeline Toll-Free: 1–800–273–TALK (1–800–273–8255); TTY: 1–800–799–4TTY (1–800–799–4889) Web Site: http://www.samhsa.gov National Child Traumatic Stress Network Web Site: http://www.samhsa.gov/traumaJustice/ ∙ HHS Publication No. (SMA) 12-4732 (Revision of KEN-01-0091/KEN-01-0093; Revised 04/2007) 4 Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov 2012