Helping Children Cope

Responding to Stressful Events: Helping Children Cope

Natural or human-caused disasters, terrorist attacks or acts of war are upsetting for children, even if they only witness them on television or see their impact on the adults they care about. We need to remember that it is normal for kids to feel depressed, horrified, worried, sad, nervous, and frightened in the face of such events.

Parents, older siblings, family members, teachers and adults in general need to pay attention to children's feelings and reactions.

It is important to know that:

• You can help kids cope with their reactions.
• These reactions are usually brief and soon disappear.
• How you handle the situation will strongly affect how your child will handle it.
• You are better prepared to help if you pay attention to your own feelings and reactions and take positive steps to care for yourself.
• One of the most important steps you can take to help children is to reassure them that they are safe, that you will protect them from danger, and that you will continue to help them when they feel afraid.

(For some hints on how to do this, check out another brochure in this series, "Taking Care of Ourselves, Our Families and Our Communities")

The following information will help you understand some common reactions of children following a stressful event.

For The Young Child (1-6)

Young children are not as verbal as older children. They express themselves through conversations with adults and each other, selftalk, play, songs and drawings. Take time to listen to and observe the child. These activities are a window into their thoughts and feelings.

Here are some other ways they can show you how they feel:

• Crying
• Whining
• Bedwetting
• Thumb sucking
• Wanting to be held
• Clinging to caregivers
• Stomach aches
• Headaches
• Isolating themselves from others
• Staring into space/no emotion
• Eating problems
• Nightmares
• Sleeping problems
• Crankiness
• Tantrums
• Being stubborn
• Fear of the dark
• Being more agitated

How you can help

Do not be alarmed. These reactions are some of the ways children express their feelings after a traumatic event or comfort themselves when they are upset. They are important and common signs. They tell you that the child needs help.

Do not overreact. If you punish or nag the child, his/her behaviours may last longer and she/he will not get the help they need.

Spend extra time paying attention to the child. Help them feel understood and loved. Let your children know that you are not upset with their bed wetting, thumb sucking or nail biting. Reassure them that you know that it is only happening because they are upset and that they are safe.

Catch them being good. Praise for good behaviour brings positive results.

Children who cling need to be reassured. Leave them when you must, but reassure them that you will be back.

Comfort and hold them. Children need physical closeness, holding, comforting, and reassurance. This helps them feel safe and secure. Protect children from further anxiety and fears. Very young children need to be protected from frightening scenes on TV because they are not old enough to understand the events. Be there to explain any fearful situations they may encounter.

Spend more family time together. Children need their parents, family members or familiar adults around them during and after a stressful or traumatic event. If family members are not available, time and reassurance from other adults are very important.

Maintain familiar routines. Mealtimes, visits with playmates and regular bedtime hours are comforting for the child. Familiar routines reinforce the child's sense of security.

Create an environment in which children feel safe enough to ask questions. Young children do not need detailed information about the events but they need to talk about their feelings. Let children know that they can ask questions. Ask them what they have seen, what they have heard and how they feel about it. Answer their questions honestly, but make sure the information is suitable to their age level. Remember also that they are listening when you talk to others about the events. Reassure them that people are doing everything they can to make them safe.

Kids have short attention spans. Talk to them for short periods of time, but do it often. Check in with them to see how they are doing.

Tell children how you feel. Let them know it is okay to have feelings of fear, sadness or anger, and that there are healthy ways of expressing and coping with these feelings. This helps them feel less alone, and more free to talk about their own feelings. They are more secure knowing you can handle what is happening.

Problems at Bedtime

Problems encountered at bedtime are the ones most often mentioned by parents, during and following stressful events. Children may:

• Refuse to go to their room by themselves to sleep.
• Wake up scared, crying, or trembling from a renewed fear.
• Once awake, insist on sleeping with parents or other family members or have someone remain near them.
• Be frightened by darkness, "monsters" or animals.

How you can help

Spendmore time with children when they are awake. This will help them feel more secure at night.

Encourage children to exercise and participate in active games which will reduce their anxiety and drain their surplus energy. Physical activities during the day will promote better sleep.

Establish a comforting routine at bedtime. a bath, quiet games, storytelling, singing lullabies, and taking a favourite toy or article to bed can add to a child's sense of security, comfort, and well-being.

Take the time to listen. Bedtime often provides a special quiet time when children can ask questions, share anxieties and can be reassured.

If a child wakes up frightened

• Go and reassure the child immediately. As you enter the room, don't turn on the lights or talk loudly.
• Acknowledge their fear. If they "have had a scary dream" allow them to talk about the dream without interrupting.
• Do not deny their fear by saying,"There's nothing to be afraid of." Instead be open, understanding, and help the child talk about it. This may help sort out reality from fantasy.
• Reassure the child that others are nearby, that he or she is safe. You may want to stay with the child until he or she goes back to sleep.

Older Children (7-11)

Older children may also show signs of being upset after a stressful event. At this age, the fears and anxieties expressed show that the child is aware of possible danger to themselves, their family and friends. Real or imaginary fears that seem unrelated to the events may also appear.

Here are some common reactions they may have:

• Afraid of being injured or separated from parents, family members or others
• Fear that similar events may occur
• Fear of noises or of the dark
• Rivalries and quarrels among brothers, sisters or friends
• Headaches
• Sleeping problems such as nightmares
• Eating problems and stomach aches
• Anger and irritability
• Nervousness
• Crying
• Withdrawal
• A return to earlier behaviours such as bed wetting, thumb sucking, and clinging

How to help

Take children's fears seriously. Do not force a child to be brave. Respect their feelings and try to understand them. A child who is scared is really scared. Do not show anger or ridicule. Avoid saying something like: "It's silly to be scared". Telling children that it's OK to be scared is comforting to them. Reassure them they are safe.

Listen to children and ask them what they have to say about their fears, their feelings, their thoughts on what has happened. Check in with them regularly. This will help them to better understand the situation and deal with their emotions. They will be able to express fears that may be unfounded, giving you the opportunity to explore their fears and reassure them. If possible, include the whole family in the discussion.

Try to explain the events as well as you can. Children, like adults, are more frightened when they do not understand what is happening around them. Adults must do their best to keep the children informed about what has happened and what may happen. Acknowledge what's frightening about it. If you don't know the answers to their questions, it's OK to say that there are some things about the situation that you don't know or understand.

Reassurance. Children usually need reassurance about their personal safety. They need to know that people are doing all they can to make our country and our world safe.

Parents, family members and adults as role models. It is important to let kids know what you think and feel. It helps them feel less alone if they know that their feelings are similar to yours. It is important, however, not to overwhelm them. If you are too upset, it is better to share your reactions with another adult.

When To Seek Help

Children are amazingly flexible and resilient, and parents are capable of helping their children overcome their fears and feelings of anxiety about stressful events. However, getting additional help is a good idea if a child continues to show significant changes in his or her behaviour, for example:

• Unusual and inappropriate behaviour at home, at school or in the community
• Increased learning problems and difficulty paying attention
• Frequent angry outbursts
• Not taking part in usual social activities or play with other children
• Staring blankly for long periods of time
• Frequent nightmares or other sleep problems
• Physical problems such as nausea, headaches
• Changes in appetite, weight gain or loss
• Feeling overly anxious or afraid
• Feeling sad or depressed
• Recurring talk about death that is more detailed or goes on for longer than is true for other children her/his age under the circumstances

One stressful event can make another more difficult to deal with. Children who have experienced the death of someone close, a divorce or a recent move may have more difficulty coping. This is true for adults as well.

Following a seriously stressful event, some adults and children have found it helpful to talk with a health professional such as a psychologist, a social worker, physician, nurse or psychiatrist who can help them understand and deal with how they are feeling.

Helping Yourself So You Can Help a Child Cope

Remember, you have strength, knowledge and experience that can help your family, other children and your community cope with the stresses triggered by tragic or violent events. It is important to take care of yourself in order to be able to help others. For additional self-help suggestions, see the other brochures in this series:

• Responding to Stressful Events : Helping Teens Cope
• Responding to Stressful Events : Self-Care for Caregivers
• Responding to Stressful Events : Taking Care of Ourselves, Our Families and Our Communities

Acknowledgments

This document was revised by the Mental Health Support Network of Canada, a network of professional and voluntary associations concerned about mental health and the stress arising from extreme stressors.

Much of the information in this document was developed following the September 11, 2001 terrorist attacks on the United States using information put together by Health Canada with input from the Canadian Medical Association, Canadian Psychological Association, Canadian Psychiatric Association and the Canadian Public Health Association.

Mental Health Support Network of Canada, Members:

• Canadian Association of Occupational Therapists
• Canadian Association of Social Workers
• Canadian Healthcare Association
• Canadian Medical Association
• Canadian Mental Health Association
• Canadian Nurses Association
• Canadian Paediatric Society
• Canadian Pharmacists Association
• Canadian Psychiatric Association
• Canadian Psychological Association
• Canadian Public Health Association
• Canadian Red Cross
• College of Family Physicians of Canada
• Public Health Agency of Canada

Coping Resources in Your Community

Please use this space to list the names and telephone numbers of key resources and programs in your community (including friends and family you can call to talk things over).

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This pamphlet has been published by the Public Health Agency of Canada, Ottawa, Ontario K1A 0K9.

It can be reproduced freely for non-profit educational purposes or as part of a public awareness initiative, provided that full acknowledgment of the source is made. For more information about the psychosocial dimension of emergency preparedness, see the Personal Services manual at: http://www.phac-aspc.gc.ca/emergency-urgence/index-eng.php