NEW YORK — Some children worried about their relatives who were displaced and in dire straits. Others had relatives who died. Many were acting out in school. Some had nightmares. Some were looking for explanations. And nearly all of them were worried, scared and confused.
In the wake of Hurricane Sandy, these symptoms in children coping with trauma are all too familiar.
But the group of children that I'm referring to dates back to 2010, when I coordinated a middle school mental health program in Crown Heights, Brooklyn with a large population of Haitian students — all of whom were reeling from the catastrophic earthquake.
The takeaway: for children, trauma knows no bounds.
Although as a city, we are beginning to return to a semblance of normalcy, we are not out of the woods just yet. This is particularly true when it comes to children, who feel trauma deeply, even if they don't have the tools to express their feelings.
The most traumatized children will likely be found where the damage and flooding from Sandy were the most severe. However, this doesn’t mean you have to live in the Rockaways, Breezy Point, or parts of Staten Island to feel the pain.
The following are suggestions in helping children through this difficult time:
It’s important as parents and caregivers that we identify and address our own feelings before we try to help others. This is especially true for parents of small children (under 4), as they take their emotional cues from the adults closest to them.
If you are feeling emotionally overwhelmed, your children will sense it. If you withdraw, they will know. The best thing you can do for them is to do your best to sort through your own feelings, as overwhelming as they seem, as you help them with their own.
Explain what happened
How you go about explaining Sandy will depend on the child’s age. Older children and adolescents can handle details, but small children can't. Be honest, and make sure to let them know that they are safe. Do not share any more details than are necessary for their understanding, while using age-appropriate language. Be patient, it may take more than one sitting in order to accomplish this.
Address Their Feelings and Beliefs
Often, children walk away from traumatic events with negative beliefs about their own responsibility for the tragedy. Tell them you love them, and that no part of Sandy, or any other traumatic event, was their fault. This will help them form realistic beliefs about the storm. In addition, explain that you (and/or the family) will take care of them. But don't promise more than you can deliver. If they need to stay with a relative or a friend for a time, be honest with them about this. Additionally, let the child know it’s OK for them to feel upset, and that any feelings they have are OK, and that you are there for them, however they may feel.
Recognize Their Reactions to the Storm
According to the National Institute of Mental Health (NIMH), there are many different reactions to watch out for. Small children (under the age of 6) can react to a disaster in a number of ways — including showing fearful facial expressions; clinging to a parent or caregiver; crying or screaming; or returning to behaviors common to being younger, such as thumb sucking, bedwetting and being afraid of the dark. Keep in mind, young children’s reactions are strongly influenced by their parents' reactions to Sandy.
Older children (6-11) may react by isolating themselves; becoming quiet around friends, family, and teachers; having nightmares or other sleep problems; exhibiting disruptive behavior in school and/or at home; refusing to attend school; having trouble with concentration; or performing poorly in school. Having good communication with your child’s school in helping you to monitor your child with these behaviors becomes crucial.
Adolescents (12-18) may have flashbacks to the night of the storm (or any previous traumatic event in their lives, regardless of the type); may use alcohol and/or drugs; may display anti-social or avoidant behavior; or may experience nightmares or other sleep problems.
Knowing When it’s Time to See a Professional
Predicting how long these reactions will last is a difficult prospect. Sometimes, having enough loving support will get a child through a trauma. However, if the symptoms seem to be interrupting their daily life, or are becoming overwhelming to them or to you, it's time to seek professional help. There are some red flags to watch for. If a child has had a previous trauma in their life, this new trauma can awaken those memories. If a child is in a safe environment and after a month they are still having difficulty adjusting, or developing new symptoms, it is also a sign to seek help.
Where to Get Help
There are many ways to help a child after a disaster. Some kids react well to a group setting, while others connect better one-on-one. A good place to start your search for a mental health professional is by speaking to your pediatrician. Your child’s doctor should have recommendations for therapists within your insurance network. If the child is school-aged, check with their school’s guidance counselor or school-based support team. Or, try using Psychology Today’s “Find a Therapist” database (full disclosure: as a private practice therapist, I pay to be listed in their database).
Here are some other resources to help with your children:
A few years ago, Sesame Street aired an episode where a hurricane comes through. On their website they feature this episode and offer activities and a special “Hurricane Kit” for children and parents. Check it out.
Also, take a look at the a non-profit educational and research organization Mentor Research Institute's hurricane, storm and flood coloring book with tips on how to help children cope with storms. I think it’s excellent, and has good tips at the end for adults.
Remember, it may take some time before you know how your child is faring, but as long as you offer them a safe, supportive place to express their feelings, you'll be in a better position to handle their fears and concerns.
Morris Cohen is a Clinical Social Worker, Licensed by the State of New York, and maintains a private psychotherapy and consultation practice in Midtown Manhattan. You can visit his website at morriscohenlcsw.com.