How to Help Your Child Cope with Disastershock

How to Identify When Your Child is Stressed

What is stress? It is a reaction of mind and body to particular unsettling experiences. Many stress feelings and reactions are shared in common by people of all ages. Children's stress responses in the event of a disaster may be obvious or subtle. Special attention is required to identify and meet the needs of children.

The most common reaction by children to a disaster is fear and anxiety. A child is fearful of a reoccurrence of the disaster. Another common fear is that the child or a family member might suffer injury in a reoccurrence. Another fear is that the child may be afraid of being separated from the family and left alone. At a time like this it is important for the family to remain together. If your child is unduly stressed by family members being in different places, which is normal in everyday life, the child will be more reassured if you let the child know where you are going to be, whether it is at work or at the grocery store. Another step to alleviate a child's anxiety is to rehearse what the family members might do in the event that there is another disaster. What are some safety precautions the family will take at home? Identify a plan if the disaster occurs when the child is at school. Who will pick your child up?

After a disaster, parents are stressed too. The parents' fears and anxieties are passed on to the children. An adult has more experience in coping with such stress, whereas children often do not. Therefore, it is important for the parent to recognize the emotional needs of the child. Your child may be scared and frightened. This anxiety often does not disappear by itself. You need to acknowledge with the child that the fear and anxiety are very real. You need to understand what the specific fears are. The only way to find this out is to talk to your child. Listen to what your child's specific fears are. Talk to your child about his or her feelings. Find out what your child thinks has happened. Your child may have been inundated with television and radio reports, which may have blown the crisis out of proportion. You need to sit down and talk about the facts of the disaster. Continue to listen to the child because he or she will express either directly or indirectly fears associated with the disaster. The most important responses to a child that you can make are to listen, to encourage the child to communicate and to continually reassure the child verbally as well as with extra hugs and attention.

More specific reactions to a disaster have been identified that children of all ages might experience. Immediately following a disaster, sleep disturbance and night terrors are common. Other children may experience a loss of interest in school. This reaction may range from fear of separation, to the anxiety that the school is not safe, to a lethargic response to school activities and peer interaction. Another common response seen in children of all ages is regressive behavior. A child might revert to prior behaviors exhibited at an earlier developmental stage because it might seem more safe and protected. The present situation is unsettling so the escape to a previous secure state is reassuring. These responses are common but such behaviors should not persist for a long period of time following the disaster.

Children of different age groups have specific stress reactions to a disaster. A child who is 5 experiences different vulnerabilities than does a child of 14. For the purpose of this book, the age groups will be divided into Preschool (ages 1 - 5); Early Childhood (ages 5 - 11); Preadolescent (ages 11 - 14); and Adolescent (ages 14 - 18). The table to your right summarizes the most common stress responses for the different age groups.

Children in the Preschool age group (ages 1 - 5) are particularly vulnerable to the disruption of their safe and secure environment. Their development has not reached a level of conceptualization that permits them to understand a disaster. Preschoolers lack the verbal skills to communicate their fears and anxieties. As a result, a Preschooler's stress is best identified by exhibited behaviors. These behaviors may be indirect so special attention to the child's needs is important. Typical regressive responses which are considered normal are thumbsucking and bedwetting. A 5 year old who stopped sucking his thumb at age 3 may spontaneously begin this behavior again. This is normal but should not continue indefinitely. Another response is a fear of the dark and nightmares. This is particularly heightened immediately following the disaster. It is also tied in with the Preschooler's fear of being alone and this fear increases at nighttime. The Preschooler might exhibit a behavioral response such as clinging to the parents.

A disaster increases the child's separation anxiety. Another stress symptom is speech difficulties. Language is a relatively new developmental milestone and may suffer in ways such as stuttering, stammering and difficulty in expressing in a fully coherent manner. A Preschooler's loss of appetite is another stress signal. Loss of bladder or bowel control, particularly in the older Preschooler, will often indicate stress. The overriding anxiety among Preschoolers is fear of abandonment and fear of being alone.

The Early Childhood (ages 5-11) group's stress responses are more generally indicated by regressive behavior. Behaviors such as excessive whining and clinging to the parent are common. This group may have an increase in separation anxiety from the parent which is more typical behavior of a Preschool child. The 5 to 11 year old may begin to experience a fear of the dark and nightmares. The nightmares may be connected to past events of the disaster as well as fear of future occurrences. Many stress behaviors are exhibited at school. This child may want to avoid school and even if encouraged to attend school may lose interest and have relatively poor concentration in school. These symptoms should also be brought to the attention of the teacher so the parent and teacher together can effectively address the child's stress. Other behavioral signs range from an increased aggressiveness to a withdrawal from friends and family. In order to determine these stress signals, the parent must try to recall what the child's normal behavior patterns were prior to the disaster. In this way the deviation from the norm can be assessed because each child's so-called "normal" behavior is different. What might be observed as a stress signal for one child is not necessarily true for the next child.

The stress reactions in the Preadolescent (ages 11-14) include behavioral differences as well as physical responses. Physical symptoms that signal stress are complaints of headaches, stomach aches, vague aches and pains, and psychosomatic complaints. The Preadolescent may have difficulty sleeping and wake up with nightmares. Another physical symptom might be loss of appetite. In a Preadolescent child, the physical symptoms may be coupled with school problems. The child may complain of a headache in the morning and stay away from school. This could also be symptomatic of loss of interest in school and withdrawal from peers, which is also a normal stress reaction. Other children will express stress signals in a more aggressive way. These behaviors include increased rebellion at home and refusal to participate in family activities. Reactions to peers are particularly significant with the preadolescent and range from withdrawal to aggressive behavior with friends. It is important to help the preadolescent by affirming that the physical and behavior responses are normal and shared by other people, particularly his or her peers.

Preschool Children (ages 1-5)	Early Childhood (ages 5-11)	Preadolescence (ages 11-14)	Adolescence (ages 14-18)
Thumbsucking Bedwetting Fear of the dark and or night terrors Increased clinging Expressive language difficulties Loss of appetite Loss of bladder and bowel control	Whining Clinging Separation anxiety Fear of the dark and or nightmares Avoidance of school Poor concentration Increased aggressiveness Withdrawal of peers	Appetite difficulties Headaches and or stomach aches Psychosomatic complaints Sleep difficulties and or nightmares Loss of interest in school Loss of interest in peers Increased rebellion at home Aggressive behavior	Headaches and or stomach aches Psychosomatic complaints Appetite disturbance Decrease in energy level Irresponsible behavior Increased dependance on parent Withdrawal from peer group School problems

The Adolescent (ages 14-18) stress responses also include physical and behavioral signals but this age group's stress is increased because they are caught in the middle (between being viewed as children who need to be attended to and as adults who can cope on their own). The Adolescent is not an adult but an older child who has special needs, as do the other age groups.

Physical responses include headaches, stomach aches, and possible psychosomatic complaints, such as rashes. Appetite and sleep disturbances are also common. Another symptom might be a decrease in energy level where the once energetic and enthusiastic Adolescent becomes apathetic and disinterested in previously satisfying activities. Behavioral stress responses often show up in the Adolescent's interaction with peers because peers are central to this developmental stage. If the child's school is temporarily or even permanently closed due to disaster damage, this can have a profound stress effect that must be identified and directly addressed. Other behavioral stress responses might be irresponsible behavior - a "nothing can affect me" attitude, or dependent behavior at the other end of the spectrum where the Adolescent becomes less independent and tends to cling more to the family. It is most important to listen and talk to the Adolescent and try to reconnect the child with his or her peer group.

The most important way to determine the child's stress reactions in any age group is to listen to the child's fears and anxieties. Although these fears may seem childish or insignificant to an adult they are very real to the child. If your child is one who is shy about communicating then you may have to initiate the discussion. Parents' love, hugs, and extra attention are important ways to help children to cope with a stressful situation. A disaster is not a situation where we can say it's permanently over. We must live with the possibility of another disaster, as well as continue to live with the ramifications of the original disaster, whether it is the closing of a school, rebuilding of a home or disruption of traffic patterns. Remember that the effects don't disappear immediately.

It is important to note that the majority of children will cope and overcome the fears and anxieties of a disaster. But some children continue to suffer. If the physical or behavioral stress symptoms do not diminish after a few weeks or if the symptoms become worse, it is time to seek professional help. A mental health professional can assist you and your child in coping with stress reactions.