WISCONSIN UNITED
for MENTAL HEALTH

A crisis can be: War, terrorism, bombing Flood, fire, earthquake, tornado Domestic violence, sexual assault, abuse Change in family structure Sudden or chronic illness, death, epidemics Viewing violence on television or in real life Homelessness, lack of food or other necessities

News reports regarding disasters and violence are common. Have you thought about how exposure to such crises affect children? Did you know that children not directly exposed to a crisis can suffer from symptoms of posttraumatic stress disorder? Some of this anxiety results from media coverage of traumatic events. It is important for parents, teachers, and caregivers to know what reactions children might exhibit after exposure to a crisis.

It is normal to have a some sort of reaction to a crisis. Distress in children often occurs as a change in behavior or behavior regression. Reactions in children vary greatly and may occur immediately or days to weeks after the event. If symptoms occur for longer than one month, contact your health care provider.

Parents, teachers and caregivers should be observant and aware of what children have seen and heard; encourage children to spend time with trusted adults and to express themselves; limit television exposure to traumatic events; promote self-esteem, efficacy and empowerment in the children in their lives.

Typical reactions to a crisis for children and youth

Preschool (1-5 years)
Increase or return to behaviors such as thumb-sucking or bed wetting
Clinging to parents, fear of strangers or being left alone
Aches and pains, such as stomachaches
Regression in toileting habits
Loss or increase of appetite
Fear of the dark, night terrors
Speech difficulties, confusion
Ways to Help
Encourage expression through play reenactment
Give frequent attention
Provide verbal reassurance and physical comforting
Keep routines as much as possible
Encourage expression regarding loss of pets or toys

School Age (5-11 years)
Play and drawings may show anger or sadness
Change in school performance
Fears for safety of self and others
Irritability, whining, aggressive behaviors
Night terrors, nightmares, fear of dark
Headaches or other physical conditions
Depression, withdrawal from peers
Competition with siblings for parental attention
Ways to Help
Patience and tolerance
Play sessions with adults and peers
Discussions with adults and peers
Relaxed expectations temporarily at home and school
Opportunities for structure but not demanding chores or responsibilities at home
Rehearsal of safety measures to be taken in the case of future disasters

Preadolescence (11-14 years)
Sleep disturbance
Appetite disturbance
Rebellion in the home
Refusal to do chores
School problems, such as fighting, loss of interest
Physical complaints, such as headache, vague pains, skin eruptions, bowel problems
Loss of interest in peer social activities

Adolescence (14-18 years)
Appetite and sleep disturbances
Headaches and other physical complaints
Confusion or poor concentration, indifference
Agitation or decrease in energy level
Withdrawal and isolation, depression
Irresponsible and/or delinquent behavior
Aggressive behaviors
Decline in struggling with parental control
Ways to Help
Encourage participation in community activities
Encourage resumption of social activities, athletics, clubs, etc.
Encourage discussion of experience with others
Temporarily reduce expectations for level of school and general performance
Encourage but do not insist upon discussion of fears within the family setting

Content from presentations by
Joy Grotsky, RN, MS
Family Health Clinician
WI Division of Public Health
Bureau of Family and Community Health
Maternal Child Health Program