People all across the country were deeply shaken by the recent tragic bridge collapse in Minneapolis. Continuing media coverage has included dramatic pictures of submerged and partially submerged cars and other wreckage. These images and the stories of the dead and missing family members are disturbing to adults, but they can be devastating to children who are struggling to understand what has happened.
The National Association of Pedia-tric Nurse Practitioners (NAPNAP), an organization dedicated to the physical and mental health of children and teens, has advice for adults who are trying to help children understand and cope in the wake of the Minnesota disaster. On its web site at www.napnap.org, the association has posted information from its Keep Your Child/Yourself Safe and Secure (KySS) initiative that includes suggestions for helping children, teens and their families cope with disasters and traumatic events.
"NAPNAP extends its sincere condolences to all those who lost family and loved ones in the tragic collapse of the bridge in Minnesota," said NAPNAP President Carolyn Jaramillo de Montoya, MSN, CPNP. "It is difficult for adults to understand such loss and even more difficult for children. NAPNAP has studied this issue at length and I hope that the resources that we have posted on our web site will help children and families who are struggling with this and other tragedies."
Among the KySS recommendations:
1. Be honest and give age and developmentally appropriate explana-tions about the disaster or traumatic event.
For young children, in particular, only provide answers to questions they are asking and do not overwhelm them with too much detail. Use language that young children can understand. Do not expose young children to visual images that are terrifying in the newspapers or television.
It may be easier for young children to express how they are feeling by asking them to talk about how their stuffed animals or dolls are feeling or thinking.
2. Help children and teens to express how they are feeling about what they have seen or heard. Younger children may want to make a drawing about how they are feeling, while older school-age children and teens can benefit from writing about how they feel.
Ask children and teens, "What is the scariest or worst thing about this event for you?" If your child is unable to express their feelings don’t force them to, but let them know you are there to listen when they are ready.
3. Reassure children that they did nothing wrong to cause what happened. Toddlers and preschool children especially feel guilty when something tragic happens.
4. Tell children and teens that what they are feeling (e.g., anger, anxiety, and helplessness) is normal and that others feel the same way. Let your children know about your own feelings as it will allow them to feel OK about their own fears.
5. Alleviate some of their anxiety by reassuring children that we will get through this together and will be stronger as a result of what we have been through. Emphasize that everything is now under control and that adults will be there to help them through this and that they are not alone.
6. Help children and teens to release their tension by encouraging daily physical exercise and activities.
7. Keep as much as possible to regular routines and continue to provide structure to children’s schedules.
8. Recognize that a tragic event could elevate psychological or physical symptoms (e.g., headaches, abdominal pain or chest pain) in children and teens that are already depressed or anxious.
Remember that young children who are depressed typically have different symptoms (e.g., restlessness, excessive motor activity) than older school-age children or teens who are depressed (e.g., sad or withdrawn affect; difficulty sleeping or eating; talking about feeling hopeless).
Anger can be a sign of anxiety in children and teens.
Children, even teens, who are stressed typically regress (e.g., revert to doing things that they did when they were younger, such as sucking their thumbs, bedwetting, or acting dependent upon their parents). This is a healthy temporary coping strategy. If you child has any ongoing signs or symptoms of depression, persistent anxiety, recurrent pain, persistent behavioral changes, or if they have difficulty maintaining their routine schedules make sure they are seen by a health care or mental health professional.
9. Use this opportunity as a time to work with children on their coping skills.
10. Hug your child!
NAPNAP President-Elect Linda Lindeke, an Associate Professor at the University of Minnesota School of Nursing, is currently working to develop an online module for pediatric emergency preparedness. The module, part of Minnesota Emergency Readiness Education and Training from the University of Minnesota, will be completed at the end of August.
"Children are vulnerable in many natural disasters as well as in accidental or violent events, like school shootings," said Lindeke. "Children can be intentional or unintentional targets. Even if not in harm’s way, children can be emotionally affected by exposure to media de scri ptions of disasters. Pediatric Nurse Practitioners (PNPs), parents and the community must anticipate children’s unique needs in all kinds of emergency situations."
