By: David Schonfeld, MD, FAAP
After any disaster or crisis, families struggle with what they should say to children and how to help them cope.
The American Academy of Pediatrics (AAP) encourages parents, teachers, child care providers and others who work closely with children to filter information about the event and present it in a way that their child can understand, adjust to and handle in a healthy way.
Where to start
No matter what age or developmental stage your child is, you can start by asking what they've already heard. Most children will have heard something, no matter how old they are. After you ask them what they've heard, ask what questions they have and how they feel about what's happened.
Older children, teens, and young adults might ask more questions. They may ask for and benefit more from additional information. But no matter what age your child is, it's best to keep the dialogue straightforward and direct.
Avoiding graphic details & exposure to media
In general, it is best to share basic information with children, not graphic details, or unnecessary details about tragic circumstances. Children and adults alike want to be able to understand enough so they know what's going on. Graphic information and images should be avoided.
Keep young children away from repetitive graphic images and sounds that may appear on television, radio, social media, the internet, etc.
With older children, if they will be viewing news coverage, consider recording it ahead of time. That allows you to preview it and evaluate its contents before you sit down with them to watch it. Then, as you watch it with them, you can stop, pause and have a discussion when you need to.
Children will generally follow good advice, but you have to give them some latitude to make decisions about what they're ready for. Most children will have access to the news and graphic images through social media and the internet right from their cell phone. You need to be aware of what's out there and take steps in advance to talk to children about what they might hear or see.
Talking to very young children
The reality is that even preschool-age children will hear about major crisis events. It's best that they hear about it from a parent or caregiver, as opposed to another child or in the media, or through overheard conversations.
Even the youngest child needs accurate information, but you don't want to be too vague. Simply saying, "Something happened in a faraway town and some people got hurt," doesn't tell the child enough about what happened. The child may not understand why this is so different from people getting hurt every day and why so much is being said about it.
The underlying message for a parent to convey is, "It's okay if these things bother you. We are here to support each other."
Talking to gradeschool children & teens
After asking your child what they have heard and if they have questions or concerns about what occurred during a school shooting, community bombing, natural disaster, or even a disaster in another country, a parent can say something such as:
"Yes. In [city], [state]"(and here you might need to give some context, depending on whether it's nearby or far away, for example, 'That's a city/state that's pretty far from/close to here'), there was a crisis (explain what the crisis was)and many people were hurt (add more information). The police and the government are doing their jobs so they can try to make sure that it doesn't happen again."
You can follow-up as needed based on your child's reactions and questions.
Talking with children with developmental delays or disabilities
Parents who have a child with a developmental delay or disability should gear their responses to their child's developmental level or abilities, rather than their chronologic age. If you have a teenage child whose level of intellectual functioning is more similar to a 7-year-old, for instance, gear your response to what you might share with most 7-year-olds. Start by giving less information. Provide further information in the most appropriate and clear way you can.
Talking with children with an Autism Spectrum Disorder (ASD)
What's helpful to a child with an ASD may be different. For instance, the child may find less comfort in cuddling than some other children. Parents should try something else that does calm and comfort their child on other occasions. Ask yourself, "Given who my child is, their personality, temperament and developmental abilities and what generally helps calm them when they are worried. What might work for them?"
Signs a child might not be coping well
You may see signs that children are having difficulty adjusting. Some of things to look for are:
Sleep problems: Watch for trouble falling asleep or staying asleep, difficulty waking, nightmares or other sleep disturbances.
Physical complaints: Children may complain of feeling tired, having a headache or stomachache, or generally feeling unwell.
Changes in behavior: You may notice your child eating too much or less than usual. Look for signs of regressive behavior, including social regression, acting more immature or becoming less patient and more demanding or irritable. A child who once separated easily from their parents may become clingy. Teens may begin or change current patterns of tobacco, alcohol or substance use.
Emotional problems: Children may experience undue sadness, depression, anxiety or fears.
Sometimes it can be hard to tell if a child is reacting in a typical way to an unusual event or whether they are having significant problems coping, and might benefit from extra support. If you are concerned, talk to your child's pediatrician, your child's teacher, or a mental health professional or counselor in the school or community.
Don't wait for symptoms. Children often do a good job of hiding their distress. Start the discussion early, and keep the dialogue going.
More information
About Dr. Schonfeld
 David Schonfeld, MD, FAAP, is an Executive Committee member of the American Academy of Pediatrics Council on Children and Disasters and a member of the Section on Developmental and Behavioral Pediatrics. He also serves as Director of the National Center for School Crisis and Bereavement at Children’s Hospital Los Angeles, and Professor of Clinical Pediatrics, Keck School of Medicine of USC.
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