Tips for coping with distress in young children after the earthquake

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HealthSciencesCentre ChildandFamilyPsychologyProgramme WaimairiBldg,DovedaleCampus,UniversityofCanterbury PrivateBag4800,Christchurch8020,NewZealand DrKarynFrance,Coordinator MichaelTarren Sweeney,Seniorlecturer SuziHall,Clinicaleducator. Tips for coping with distress in young children after the earthquake If you are a parent of young children in Christchurch you may be feeling anxious, helpless and not sure how to manage your young children s questions and signs of distress. But there is much that you can do! Parents are the most powerful agents for change in their children. In most cases warm parenting accompanied by some sensible strategies to support your distressed child is all that will be needed. Over time your and your child s stress will decrease. Here are some tips that researchers studying children s stress while coping with disasters have found to help: How normal is children s distress to a natural disaster? It is likely that most young children in Canterbury have been frightened or distressed to some extent by their experience of the earthquake, as indeed have many older children and adults. Beyond Saturday s earthquake, the large number of after-shocks has increased young children s distress and fears. Their experience of the present earthquake is different to that of many other natural disasters, because of its prolonged nature. So parents should feel reassured that there is nothing abnormal about their young children feeling unusually distressed or frightened, especially while these after-shocks are continuing. Parents should also feel reassured that most young children will rebound well from these distressing experiences, once the after-shocks have passed. What are some signs that young children might be distressed or feeling frightened by the earthquake and after-shocks? You may have noticed that your child: Is more fearful or anxious than usual. They might say that they are frightened, or they might show signs of fearfulness, such as being overly vigilant of after-shocks. They may have specific fears about the earthquake, such as becoming frightened when they enter their home, or when they go outside their home.

They may say they are frightened of future after-shocks, or you might notice that they are unusually tense after they have passed. They might say they are frightened that they or other people in their families will be hurt or even die from the after-shocks. Is clingier than usual, seems less independent, or shows more anxiety when separated from you or other family members. Is more tearful than usual, or seems sad May be having nightmares about the earthquake, or they may just be having more nightmares than usual Is more frightened of the dark or of going to bed alone. Is wetting the bed or soiling more than usual. Is more irritable, defiant, or naughtier than usual, or is having more tantrums (this will especially be the case if their sleep has been disturbed by after-shocks or nightmares). Seems to have less concentration than usual, or they may seem confused or disoriented e.g. asking questions about things that they previously would have understood. You should not feel alarmed if your young child is showing some or more of these signs of distress, anxiety or fatigue. These are normal experiences for young children experiencing a major natural disaster. Below we provide some advice on how you can help your children manage or reduce these emotional responses to stress, based on research evidence. Equally, you should not feel concerned if your child is not distressed or behaving differently to usual. Some children are less distressed than others by events such as earthquakes, and this is just as normal a response as feeling distressed. What can you do? 1) Comfort your children when they are distressed and during an aftershock. Let them express their feelings and talk about what they experienced. 2). Make a plan together for "next time" and remind them how well they are coping. Give examples of how they have done as you asked, made sensible decisions, been brave etc. Dr Brett McDermott, who has much experience with children coping with emergencies, has suggested a game for young children to help with planning, with understanding and with relieving stress. The game is

based on musical chairs where the music is the earthquake, the child dances to the safe place (e.g. under a table, in a doorway), practices breathing deeply through the scared feeling, practices remembering this will stop and tells the earthquake to go back to sleep!. The child then shakes off the earthquake afterwards. 3) Talk to children about what is happening and give them information that they can understand the earth under the ground has shifted, it's coming to a new place, and settling itself down. This might take a wee while but we are coping well. Be matter of fact and stick to the facts; explain that some buildings have been damaged but most are OK or can be fixed. Explain how the engineers, electricians and drain-layers are checking everything and fixing it up; emphasise that this time will end. 4) Talk about your feelings in a balanced way. Parents are distressed at the moment. Children can see this, and it is helpful to acknowledge it. Remind children at the same time that they are safe and this time will end. Ensure children are not exposed to continual distress on the part of their parents or other adults. Make sure they mainly see adults coping and being optimistic. 5) Emphasise some positive aspects of the experiences such as community support and people s generosity. For example, you might show children photos of the university students helping with the recovery, which can be found here: http://www.facebook.com/album.php?aid=23895&id=149784338378481 6) Continue familiar routines to let children know that life is going on, even if they are somewhere else or some things have changed. If they are away from home, parents can continue their routines as much as possible: family dinner, favourite TV show, bed-time routines and the like. Once school, early childhood education, work etc has resumed this too is an important part of a familiar routine. If families or children are staying with other people, creating some family space will be of benefit. Use it for regular, positive time together and to complete family routines as much as possible. 7) Prepare children to go back to school or early childhood centre. Your young children may be worried about leaving you. Assure your children that you will be safe and will be there after school. Also reassure them that the school is now safe and has a plan to deal with aftershocks. Find out what this is. If your children are very apprehensive accompany them

to school on the first day. A play-date with school friends prior to returning is a good idea too. 8) Watch media reports with children and protect them from too much exposure to them. After 9/11 some very young children thought that many, many towers had come down because they saw images from so many angles and repeated so often. They need to understand that the images are on tape and not still happening. Similarly listening to adults talk. We relieve stress by sharing our shock and experiences with others. Remember to check young children s understandings of our conversations and give a balanced view. How can you tell whether your children may need more help? While most children get through such experiences when parents use the ideas outlined above, a small number of children may have reactions that persist. Following the bushfires in Australia about 3 to 5% of children had ongoing symptoms 2 to 4 months after the fires. Sometimes fears, intense physical reactions, upsetting images or thoughts, disturbed sleep and nightmares can result when children are reminded in some way of the experience that has been frightening for them. When this occurs the child is often on high alert and may be jumpy in response to noises or movement. It may be hard for them to concentrate and they may seem distracted. Some children may become withdrawn and try to avoid a place, situation or person that reminds them of their experience. Theseresponsesarequitenormalimmediatelyfollowinga verydistressingevent,butcanindicatethatfurthersupportandassistance wouldbehelpfuliftheypersistforamonthormoreaftertheevent.. If you notice your child, after 2-4 months continues to seem on edge, is very anxious a lot of the time, shows any of the behaviours noted above and appears to be getting worse over time rather than better it may be helpful to seek professional input. There are well researched treatments for children and adults that are effective in helping them deal with stressful experiences. This tipsheet was prepared by: Dr Karyn France (senior lecturer) Dr Michael Tarren-Sweeney (senior lecturer) and Ms Suzi Hall (Clinical Educator) from the Child and Family Psychology Programme University of Canterbury,

Dr Martin Dorahy, Senior Lecturer, Clinical Psychology Programme, University of Canterbury Associate Professor Karen Salmon, Director, Clinical Psychology training programme, School of Psychology, Victoria University of Wellington Associate Professor Brett McDermott, Associate Professor in Child Psychiatry at the University of Queensland, Director of Beyondblue: the Australian National Depression Institute. Dr McDermott worked with the Australian Centre for Posttraumatic Mental Health following the Victorian bushfires to develop community and clinician resources around child and adolescent stress responses. Dr Vanessa Cobham, Lecturer, University of Queensland, Mater Child & Youth Mental Health Service, worked with the Australian Centre for Posttraumatic Mental Health following the Victorian bushfires to develop community and clinician resources around child and adolescent stress responses.