|
Natural disasters can be especially traumatic
for children and youth. Experiencing a dangerous
or violent flood, storm, wildfire, or earthquake
is frightening even for adults, and the devastation
to the familiar environment (i.e., home and
community) can be long lasting and distressing.
Often an entire community is impacted, further
undermining a child’s sense of security
and normalcy. These factors present a variety
of unique issues and coping challenges, including
issues associated with specific types of natural
disasters, the need to relocate when home and/or
community have been destroyed, the role of the
family in lessening or exacerbating the trauma,
emotional reactions, and coping techniques.
Children look to the significant
adults in their lives for guidance on how to
manage their reactions after the immediate threat
is over. Schools can help play an important
role in this process by providing a stable,
familiar environment. Through the support of
caring adults school personnel can help children
return to normal activities and routines (to
the extent possible), and provide an opportunity
to transform a frightening event into a learning
experience.
Immediate response efforts
should emphasize teaching effective coping strategies,
fostering supportive relationships, and helping
children understand the disaster event. Collaboration
between the school crisis response team and
an assortment of community, state, and federal
organizations and agencies is necessary to respond
to the many needs of children, families, and
communities following a natural disaster. Healing
in the aftermath of a natural disaster takes
time; however, advanced preparation and immediate
response will facilitate subsequent coping and
healing.
Issues Associated
with Specific Disasters
Hurricanes.
Usually hurricanes are predicted days to weeks
in advance, giving communities time to prepare.
These predictions give families time to gather
supplies and prepare. At the same time, however,
these activities may generate fear and anxiety.
Although communities can be made aware of potential
danger, there is always uncertainty about the
exact location of where the hurricane will impact.
When a hurricane strikes, victims experience
intense thunder, rain, lightning, and wind.
Consequently, startle reactions to sounds may
be acute in the months that follow. Among a
few children subsequent storms may trigger panic
reactions. Immediate reactions to hurricanes
can include emotional and physical exhaustion.
In some instances children may experience survivor
guilt (e.g., that they were not harmed, while
others were killed or injured). Research indicates
that greater symptomatology in children is associated
with more frightening experiences during the
storm and with greater levels of damage to their
homes.
Earthquakes.
Aftershocks differentiate earthquakes from other
natural disasters. Since there is no clearly
defined endpoint, the disruptions caused by
continued tremors may increase psychological
distress. Unlike other natural disasters (e.g.,
hurricanes and certain types of floods), earthquakes
occur with virtually no warning. This fact limits
the ability of disaster victims to make the
psychological adjustments that can facilitate
coping. This relative lack of predictability
also significantly lessens feelings of controllability.
While one can climb to higher ground during
a flood, or install storm shutters before a
hurricane, there is usually no advance warning
or immediate preparation with earthquakes. Survivors
may have to cope with reminders of the destruction
(e.g., sounds of explosions, and the rumbling
of aftershocks; smells of toxic fumes and smoke;
and tastes of soot, rubber, and smoke).
Tornadoes.
Like earthquakes, tornadoes can bring mass destruction
in a matter of minutes, and individuals typically
have little time to prepare. Confusion and frustration
often follow. Similar to a hurricane, people
experience sensations during tornadoes that
may generate coping challenges. It can be difficult
to cope with the sights and smells of destruction.
Given the capricious nature of tornadoes, survivor
guilt has been observed to be an especially
common coping challenge. For instance, some
children may express guilt that they still have
a house to live in while their friend next door
does not. In addition, a study following a tornado
that caused considerable damage and loss of
life revealed significant associations between
children’s disturbances and having been
in the impact zone, been injured, and having
experienced the death of relatives.
Floods.
These events are one of the most common natural
disasters. Flash floods are the most dangerous
as they occur without warning; move at intense
speeds; and can tear out trees, destroy roads
and bridges, and wreck buildings. In cases of
dam failure the water can be especially destructive.
Research has reported that many children who
survive a destructive flood experience psychological
distress. The two most significant predictors
of impairment are the degree of disaster exposure
and perceptions of family reactions. Sensations
that may generate coping challenges include
desolation of the landscape, the smell of sludge
and sodden property, coldness and wetness, and
vast amounts of mud. Most floods do not recede
overnight, and many residents have to wait days
or weeks before they can begin the cleanup.
Wildfires.
Unlike other natural disasters such as earthquakes,
there is often some warning of an advancing
wildfire. However, depending upon the wind and
terrain the direction and spread of a wildfire
can change abruptly. The amount of warning can
vary from one neighborhood to the next. While
some people may have hours (or even days) to
evacuate, others will have only a few minutes
to gather their belongings and leave their homes.
Even if evacuation is not ultimately necessary,
preparing for the possibility can be frightening
for children, particularly if they are seeing
images of homes burning nearby on television.
Reactions immediately following
a wildfire may include emotional and physical
exhaustion. In some instances children may experience
survivor guilt (e.g., that their home was left
unharmed, while others were completely destroyed).
In general it might be expected that greater
symptomatology in children will be associated
with more frightening experiences during the
wildfire and with greater levels of damage to
their community and homes. The sights, sounds,
and smells of a wildfire often generate fear
and anxiety. Consequently, similar sensations
(e.g., the smell of smoke) may generate distress
among children in the months that follow. Given
the scale of most wildfires, individuals living
outside the ravages of the fires may still feel
exposed to the danger from drifting clouds of
smoke, flames on the horizon, and television
reports. Some children may also react to follow-up
news coverage, and even weather reports that
talk about dry fire conditions after the fact.
It is important to acknowledge
that although a given natural disaster may last
for only a short period, survivors can be involved
with the disaster aftermath for months or even
years. In attempts to reconstruct their lives
following such a natural disaster, families
are often required to deal with multiple people
and agencies (e.g., insurance adjustors, contractors,
electricians, roofers, the Red Cross, the Federal
Emergency Management Agency (FEMA), and the
Salvation Army).
Possible Reactions
of Children and Youth to Natural Disasters
Most children will be able
to cope over time with the help of parents and
other caring adults. However, some children
may be at risk of more extreme reactions. The
severity of children’s reactions will
depend on their specific risk factors. These
include exposure to the actual event, personal
injury or loss of a loved one, dislocation from
their home or community, level of parental support,
the level of physical destruction, and pre-existing
risks, such as a previous traumatic experience
or mental illness. Symptoms may differ depending
on age but can include:
• Preschoolers—thumb
sucking, bedwetting, clinging to parents, sleep
disturbances, loss of appetite, fear of the
dark, regression in behavior, and withdrawal
from friends and routines.
• Elementary
School Children—irritability,
aggressiveness, clinginess, nightmares, school
avoidance, poor concentration, and withdrawal
from activities and friends.
• Adolescents—sleeping
and eating disturbances, agitation, increase
in conflicts, physical complaints, delinquent
behavior, and poor concentration.
A minority of children may
be at risk of post-traumatic stress disorder
(PTSD). Symptoms can include those listed above,
exhibited over an extended period of time. Other
symptoms may include re-experiencing the disaster
during play and/or dreams; anticipating or feeling
that the disaster is happening again; avoiding
reminders of the disaster; general numbness
to emotional topics; and increased arousal symptoms
such as inability to concentrate and startle
reactions. Although rare, some adolescents may
also be at increased risk of suicide if they
suffer from serious mental health problems like
PTSD or depression. Students who exhibit these
symptoms should be referred for appropriate
mental health evaluation and intervention.
Immediately Following
a Natural Disaster: Information for School Crisis
Teams
Identify children and youth
who are high risk and plan interventions. Risk
factors are outlined in the above section on
children’s reactions. Interventions may
include individual counseling, small group counseling,
or family therapy. From group crisis interventions,
and by maintaining close contact with teachers
and parents, the school crisis response team
can determine which students need supportive
crisis intervention and counseling services.
A mechanism also needs to be in place for self-referral
and parental-referral of students.
Support teachers
and other school staff. Provide
staff members with information on the symptoms
of children’s stress reactions and guidance
on how to handle class discussions and answer
children’s question. As indicated, offer
to help conduct a group discussion. Reinforce
that teachers should pay attention to their
own needs and not feel compelled to do anything
they are not comfortable doing. Suggest that
administrators provide time for staff to share
their feelings and reactions on a voluntary
basis as well as help staff develop support
groups. In addition, teachers who had property
damage or personal injury to themselves or family
members will need leave time to attend to their
needs.
Engage in post-disaster
activities that facilitate healing.
La Greca and colleagues have developed a manual
for professionals working with elementary school
children following a natural disaster. Activities
in this manual emphasize three key components
supported by the empirical literature: (a) exposure
to discussion of disaster-related events, (b)
promotion of positive coping and problem-solving
skills, and (c) strengthening of children’s
friendship and peer support. Specifically:
• Encourage
children to talk about disaster-related events.
Children need an opportunity to discuss their
experiences in a safe, accepting environment.
Provide activities that enable children to discuss
their experiences. These may include a range
of methods (both verbal and nonverbal) and incorporate
varying projects (e.g., drawing, stories, audio
and video recording). Again provide teachers
specific suggestions or offer to help with an
activity.
• Promote
positive coping and problem-solving skills.
Activities should teach children how to apply
problem-solving skills to disaster-related stressors.
Children should be encouraged to develop realistic
and positive methods of coping that increase
their ability to manage their anxiety and to
identify which strategies fit with each situation.
• Strengthen
children’s friendship and peer support.
Children with strong emotional support from
others are better able to cope with adversity.
Children’s relationships with peers can
provide suggestions for how to cope with difficulties
and can help decrease isolation. In many disaster
situations, friendships may be disrupted because
of family relocations. In some cases parents
may be less available to provide support to
their children because of their own distress
and their feelings of being overwhelmed. It
is important for children to develop supportive
relationships with their teachers and classmates.
Activities may include asking children to work
cooperatively in small groups in order to enhance
peer support.
Emphasize children’s
resiliency. Focus on their competencies
in terms of their daily life and in other difficult
times. Help children identify what they have
done in the past that helped them cope when
they were frightened or upset. Tell students
about other communities that have experienced
natural disasters and recovered (e.g., Miami,
FL and Charleston, SC).
Support all members
of the crisis response team. All
crisis response team members need an opportunity
to process the crisis response. Providing crisis
intervention is emotionally draining. This is
likely to include teachers and other school
staff if they have been serving as crisis caregivers
for students.
Secure additional
mental health support. Although
more than enough caregivers are often willing
to provide support during the immediate aftermath
of a natural disaster, long-term services may
be lacking. School psychologists and other school
mental health professionals can help provide
and coordinate mental health services, but it
is important to connect with community resources
in order to provide such long-term assistance.
Ideally these relationships would be established
in advance.
Important Influences
on Coping Following a Natural Disaster
Relocation.
The frequent need for disaster survivors to
relocate creates unique crisis problems. For
example, it may contribute to the social, environmental,
and psychological stress experienced by disaster
survivors. Research suggests that relocation
is associated with higher levels of ecological
stress, crowding, isolation, and social disruption.
Parent’s
Reactions and Family Support.
Parents’ adjustment is an important factor
in children’s adjustment, and the adjustment
of the child in turn contributes to the overall
adjustment of the family. Altered family functions,
separation from parents after natural disaster,
and ongoing maternal preoccupation with the
trauma are more predictive of trauma symptomatology
in children than is the level of exposure. Thus,
parents’ reactions and family support
following a natural disaster are important considerations
in helping children’s cope.
Emotional Reactivity.
Preliminary findings suggest that children who
tend to be anxious are those most likely to
develop post-trauma symptomatology following
a natural disaster. Research suggests that children
who had a preexisting anxiety disorder prior
to a natural disaster are at greater risk of
developing PTSD symptoms.
Coping Style.
It is important to examine children’s
coping following a natural disaster because
coping responses appear to influence the process
of adapting to traumatic events. Research suggests
that the use of blame and anger as a way of
coping may create more distress for children
following disasters.
Long-Term Effects
Research suggests that long
term difficulties following a natural disaster
(e.g., PTSD), are most likely to be seem among
children who experienced any of the following:
• Had threats to their
physical safety.
• Thought they might die during the disaster.
• Report that they were very upset during
the disaster.
• Lost their belongings or house as a
result of the disaster.
• Had to relocate in the aftermath.
• Attended schools following the disaster
that had multiple schedule changes, double sessions
or a lot of disruptions.
Consequently, crisis response team members need
to identify students who experience these risk
factors and closely monitor their status. These
students may require long-term coping assistance.
References
Asarnow, J., Glynn, S., Pynoos,
R. S., Nahum, J., Gunthrie, D., Cantwell, D.
P., & Franklin, B. (1999). When the earth
stops shaking: Earthquake sequelae among children
diagnosed for pre-earthquake psychopathology.
Journal of the American Academy of Child and
Adolescent Psychiatry, 38, 1016-1023.
Bolton, D., O’Ryan,
D., Udwin, O., Boyle, S., & Yule, W. (2000).
The long-term psychological effects of a disaster
experienced in adolescence: II: General psychopathology.
Journal of Child Psychology and Psychiatry and
Allied Disciplines, 41, 513-523.
Brock, S. E., Lazarus, P.
J., & Jimerson, S. R. (Eds.), Best practices
in school crisis prevention and intervention.
Bethesda, MD: National Association of School
Psychologists.
Feinberg, T. (1999). The midwest
floods of 1993: Observations of a natural disaster.
In A.S. Canter & S.A. Carroll (Eds.), Crisis
prevention & response: A collection of NASP
resources (pp. 223-239). Bethesda, MD: National
Association of School Psychologists.
Green, B. L., Korol, M., Grace,
M. C., & Vary, M. G. (1991). Children and
disaster: Age, gender and parental effects on
PTSD symptoms. Journal of the American Academy
of Child and Adolescent Psychiatry, 30, 945-951.
Goenjian, A .K., Molina, L.,
Steinberg, A. M., & Fairbanks, L. A. (2001).
Post traumatic stress and depressive reactions
among adolescents after Hurricane Mitch. American
Journal of Psychiatry, 158, 788-794.
Jones, R. T., Fray, R., Cunningham,
J. D., & Kaiser, L. (2001). The psychological
effects of hurricane Andrew on ethnic minority
and Caucasian children and adolescents: A case
study. Cultural Diversity and Ethnic Minority
Psychology, 7, 103-108.
La Greca, A .M., Vernberg,
E. M. Silverman, W. K., Vogel, A. L.,& Prinstein,
M. J. (1994). Helping children prepare for and
cope with natural disasters: A manual for professionals
working with elementary age children. Department
of Psychology, University of Miami.
Lazarus, P. J., & Jimerson,
S. R., Brock, S. E. (2002). Natural disasters.
In S. E. Brock, P. J. Lazarus, & S. R. Jimerson
(Eds.), Best practices in school crisis prevention
and intervention (pp. 435-450). Bethesda, MD:
National Association of School Psychologists.
Lazarus, P. J., & Gillespie,
B. (1996). Critical actions in the aftermath
of natural disasters. The School Administrator,
53(2), 35-36.
Lonigan, C. J., Shannon, M.
P., Finch, A. J. Jr., & Daugherty, T. K.
(1991). Children’s reaction to a natural
disaster: Symptoms severity and degree of exposure.
Advances in Behavioral Research and Therapy,
13, 135-154.
National Institute of Mental
Health. (2000). Helping children and adolescents
cope with disasters: Fact sheet [On-line]. Available:
http://www.nimh.nih.gov.
Prinstein, M. J., La Greca,
A. M., Vernberg, E. M., & Silverman, W.
K. (1996). Children’s coping assistance:
How parents, teachers, and friends help children
cope after a natural disaster. Journal of Clinical
Child Psychology, 25, 463-475.
Young, M. A. (1997). The community
crisis response team training manual (2nd ed.).
Washington, DC: National Organization for Victim
Assistance.
Zenere, F. J., & Lazarus,
P.J. (1999). Winds of terror. Children’s
responses to hurricane and tornado disasters.
In A. S. Canter & S. A. Carroll (Eds.),
Crisis prevention and response: A collection
of NASP resources (pp. 223-229). Bethesda, MD:
National Association of School Psychologists.
Adapted from Lazarus, P. J.,
& Jimerson, S. R., Brock, S. E. (2002).
Natural disasters. In S. E. Brock, P. J. Lazarus,
& S. R. Jimerson (Eds.), Best Practices
in School Crisis Prevention and Intervention
(pp. 435-450). Bethesda, MD: National Association
of School Psychologists.
For further information on
helping children cope with crises, visit www.nasponline.org.
|