Children in Disaster

Mental Health Curriculum

Curriculum Materials• Build resilience in children and

families

• Understand the risk factors

• Comprehend the effects of terrorism on children

• Know the normal signs of stress in children developmentally

Providing Coping Skills

“What matters apparently, is not how individuals actually cope but rather how they perceive their capacities to cope and control outcomes.”Psychiatry Interpersonal and Biological Processes, “ 60,000 Disaster victims Speak: Part II. Summary and Implications of Disaster Mental Health Research” Fran H. Norris, PhD, Matthew J. Friedman, MD, PhD, and Patricia J. Watson, PhD, Vol. 65, #3, Fall 2002, p. 238-239.

BUILDING RESILIENCE

Resilience: “the ability to adaptwell to adversity,trauma, tragedy,

threats, or evensignificant sources of stress.”

Teaching Children & Teens to Adapt Well

1.Connections2.Helping Others3.Daily Routine4.Take a break5.Self-careAPA Help Center: Get the Facts: Psychology in Daily Life, A Guide for Parents and Teachers.

Teaching Children & Teens to Adapt Well, continued

6. Goal reaching7. A positive self-

view8. A hopeful outlook9. Self-discovery10.Change is

inevitable

APA Help Center: Get the Facts: Psychology in Daily Life, A Guide for Parents and Teachers, 12-11-2003.

The Effects KNOW THE ODDS!

• Did the disaster affect the child directly?

• How close was the child to the disaster scene?

• How are the child’s parents or other caregivers coping?

The Effects

• What gender is the child?

• Does the child have pre-existing risk factors?

• If the whole family was affected, are they accepting help?

Special Considerations

• Evacuation

• Child/parent reunification

• Shelter in place

• Isolation or quarantine

• Decontamination

• Dispensation site: – Vaccination /treatment

Developmentally Appropriate Outreach

• Children are not little adults.

• Delayed reactions

• Routine

• Referrals

UNDERREPORTING

• Parents and teachers underreport children’s internal experiences after a trauma.

• Encourage parents/ teachers to provide support by reflecting on the

–Experience

–Reminders

–Reactions

The Media

• Encourage families and schools to protect children/teens from contact with the media

• Discuss with parents the

impact that repeated

images of the event

have on children.

Responses to DisasterBehavioral

Emotional

Cognitive

Physiological

Remember that the reactions that you see within each of these categories are normal and temporary in the aftermath of a disaster.

Toddlers and Preschoolers Reaction reflects parents

Regresses developmentally

Changes in eating or sleeping patterns

Fears

Clingy behaviors/ separation anxiety

Exaggerated startle response

Ages five to eleven

Withdrawal Separation anxietiesNeeds more attention Decline in school performance Difficulty concentrating Somatic complaints – stomach aches

Heightened aggression/ temper outbursts

Ages twelve to fourteen

Sleep Disturbances -& other physical complaints

Appetite disturbance

Competes for attention

Deserts responsibilities

Withdraws- loss of interest

Resists authority

Turns to friends

Experiments with alcohol/drugs

Confusion/poor concentration

Feel guilt and helplessness

Minimize reactions

More risk-taking behavior

Separation anxieties

Overwhelmed by emotions, but unable to discuss with family.

Helping Children with Special Needs 3

–Visual

–Hearing

–Physical Limitations

–Severe Emotional

Disturbance

–Behavior disorders

Helping Children with Special Needs 2

–Autism

–Cognitive Limitations

–Learning Disabilities

Helping Children with Special Needs 1

• Triggers

– Special words– Images– Sounds

• Cues– Physical warning signs

National Association of School Psychologists: www.nasponline.org/NEAT/specpop_general.html

Helping Families with Injured Children

• Higher Risk for emotional problems

• Emotional Support

• Negotiating the system

Unattended Children

Definition

Higher emotional risks later

Safety

Anxiety

Abandonment

Reassurance Terrorism Events

• Kinds of events:– Terrorism Chemical Biological Radiological

Incendiary Nuclear (CBRIN)

• Terrorism is an unusual event• Regain sense of safety• Desensitization

Cultural Sensitivity

• Disability

• Language

• Ethnicity

• Norms and Values

Help for the Caregivers

When Do We Become Concerned?

Continuing problems

Signs to watch for

Stress or traumatic stress?

Mental Health Diagnosis

Warnings Signs – Longer Range

–Refusal to return to school–Clinging behavior–Persistent fears –Sleep disturbances–Loss of concentration–IrritabilityAmerican Academy of Child & Adolescent Psychiatry, “Helping Children After A Disaster,”, January 26, 2004.

www.aacap.org/publications/factsfam/disaster.htm

Warnings Signs – Longer Range

–Behavior problems–Physical complaints–Withdrawal from family & friends

–ListlessnessAmerican Academy of Child & Adolescent Psychiatry, “Helping Children

After A Disaster,”, January 26, 2004. www.aacap.org/publications/factsfam/disaster.htm

Supportive Activities

Group discussions

Puppet plays

Constructive writing

Community

involvement

Preparing Children for “Special” Events

Information– Age-dependent

– Accurate

– Appropriate

– Timely

Involvement– Age-dependent

– Promotes healing

– Respect child’s wishes

– Culturally appropriate

Preparing Children for “Special” Events

Hospitalization of family members

• Appropriate visitation

• Keep child involved in hospitalized family member’s life.

Reporting Requirements

• Report to your supervisor if you suspect:

–Child Neglect

–Child Abuse

–Domestic Violence

–Substance Abuse

Impact of Disaster

Positive actions with families can:

Reduce child abuse and neglectReduce domestic violencePromote understanding in differences in recovery time for peopleHelp families make positive changes in their living circumstancesIncrease recoveryHelp families understand that their reactions are normal.

Contact Information

Jenny WileyAssistant Coordinator, Disaster ReadinessDepartment of Mental Health1706 E. ElmJefferson City, MO 65102

573-751-4730Email: jenny.wiley@dmh.mo.gov