Helping children cope with mass violence

Incidents of mass violence, where several people are injured or killed, can affect the entire community – children and adults alike. Here, a CHOC pediatric psychologist offers insight into behaviors and reactions parents might expect from their children – as well as themselves – and strategies to help.

Coping with violence is very stressful, says Dr. Heather Huszti, CHOC’s chief psychologist. Depending on the incident’s proximity, a parent or child may be directly impacted or know someone who was directly affected. Confusion abounds, and it may be difficult to understand what happened or make sense of it.

Common reactions to mass violence in the community

A child or adult may feel afraid or unsafe

Fearing for safety is a common reaction after incidents of mass violence, whether a person was directly impacted or not. If the people impacted were in places your family frequents or were doing things you do, that can contribute to the fear.

They might struggle with normal routines and feelings

Even if your child doesn’t mention it, they may be experiencing these reactions after an incident of mass violence:

  • They might have trouble concentrating and paying attention at school or work, and may be less productive.
  • They may have difficulty falling or staying asleep, or experience nightmares.
  • Physically, they may have headaches, stomachaches, a racing heart or a change in appetite.
  • They may feel misunderstood or distant from friends or family, and not care about things that used to matter or were important to them.
  • Feelings may run the gamut: sadness, anger, confusion and fear. They may also feel jumpy or irritable, or that they must stay on alert for danger at all times.
  • Thoughts, images or visions of the mass violence event may feel constant to them, and they may be constantly reminded of the violence by sights, sounds, people or places.
  • Additional grief reactions – different for everyone – should be expected if they lost a loved one in the incident.

They may react with behaviors that seem younger than their age

When children are stressed, their behavior can shift back to earlier developmental milestones.  For instance, a child may talk in a more baby-like way or may forget how to do a skill they recently mastered like tying their shoe. This can be a normal response to a tragic event and with support and comfort, they should return to normal shortly (generally within a week).

Concern for family and loved ones may increase

Worrying about friends and family is common, but it could likely intensify or change after mass violence. You or your child may become more aware of the impact of these events on relatives with special needs, or a friend of a specific race, ethnicity or religion. They may grow more protective or anxious about their well-being.

Everyday challenges may seem harder

Experiencing mass violence may magnify typical day-to-day challenges like tests at school, work deadlines, or conflicts with siblings. These problems may seem relatively small compared to mass violence, but this new experience can intensify them and make it harder to cope – especially if you or your child has experienced a traumatic event previously.

Identify issues may prompt stronger emotions

If the incident targeted or impacted a group of people you or your child identifies with, it’s likely your emotions will be even stronger. Others may not understand the discrimination you or your child may have experienced before, during or after the event, and this may lead to feelings of increased threat, fear or danger.

A search for meaning may begin

Understanding why mass violence happened or what systems failed to protect you can be very difficult. Additionally, in incidents of targeted violence, searching for meaning following hate is extremely challenging. This can challenge trust in other people, your usual worldview and more.  There are books specifically for children to help them start to build this meaning. Thinking about volunteering or helping the community in some way can be helpful for children.

How to help children and others after mass violence

Limit media and social media exposure

Avoid the temptation to stay glued to your phone or television. Media and social media coverage is constant following mass violence, but watching it over and over can compound the trauma. Be mindful of children’s exposure to media as well – even if they aren’t in the room, they may overhear news reports. Older children may have their own access to computers and social media. If watching TV or being on your phone helps with coping, try turning on a movie, watching a channel without news alerts, or playing a game.

Answer your children’s questions with age appropriate information

Not all children will have questions after a mass violence event, but if they do ask you questions, try to use simple language that fits with your child’s developmental level. Children may ask if you are safe and you can reassure them that you are and that they too are safe. You can also help put this in perspective: While this is a tragic event and we are very sad, it is also something that is rare. For children, when they see something repeatedly or hear people talk about it over and over, they may think it is happening more widely and frequently than it is.

Stick to routines and healthy habits

Children benefit from routine always, but that will be especially so following a traumatic event like mass violence. Having a daily schedule of eating healthy and regular snacks and meals, exercising, and getting a full night’s rest is more important now than ever.

Remember to have some fun

Give yourself and your family permission to have some fun. It’s OK to disengage from tragedy. Try every day to do something you or your child really enjoys, like taking a bike ride, making a craft, playing or listening to music, or spending time with pets. This will help take your mind off the violence, enhance routine and structure, and infuse more joy into your lives. In addition, family time can be immensely healing for children, so just spending fun time together can help children regain their emotional balance.

Connect with others

Even during times of social distancing, try to find ways to ensure you and your child can connect with family, friends and other people who make you feel more relaxed. Try sending a text message or email, setting up a family Zoom session, meeting at the park for a distanced chat, or make a date for a phone call.

Go easy on yourself

Parents should give themselves some grace – during this time, you might feel like your parenting isn’t meeting your expectations. That’s OK. Ask for parenting support if you need a break.

Seek help

No one should suffer alone following mass violence. Adults shouldn’t hesitate to reach out an EAP program at work, call a hotline, or seek support from a mental health provider. In general, children are very resilient, but in some cases they may need some extra support. It’s always good to seek help early. If your child’s symptoms persist for more than two weeks, you might want to explore other supportive options. Your child’s pediatrician can help make a referral for mental health support too.

Call 9-1-1 or 1-855-OC-LINKS (625-4657) if you or your child is in danger of hurting themselves or others.

Text HOME to 741-741 for free 24/7 text support for people in crisis.

Call 1-800-273-TALK (8255) to reach the National Suicide Prevention Lifeline.

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative and to receive tips and education from mental health experts.
 
 
 

Talking to children about tragic events

When it comes to discussing tragedy with young children, honesty might not always be the best policy, a CHOC psychologist says.

“Shielding them from any exposure should always be the first effort,” Dr. Mery Taylor says. “Children can be unpredictable about how they may respond to information, and even events far away can trigger a traumatic stress response.”

Children, as well as adults, can suffer affects from watching a traumatic event unfold on TV or even hearing about it. Given the potential short- and long-term consequences of coping with a trauma, parents should consider the proximity of the event and whether the child truly must know about specific details of the event.

What is trauma?

  • Trauma is a shocking, scary or dangerous experience that leads to a strong feeling of sadness, stress or worry.
  • Traumas can be natural disasters, like a hurricane or earthquake, or a life event, like the sudden loss of a loved one. They can also be caused by others. For example, as in abuse, car accident, crime or a terrorist attack.
  • Traumas can result from direct experience, witnessing, or repeated or intense exposure to the trauma (i.e., TV or overhead conversations).

Experiencing a traumatic event is shocking and can make you fear for your safety and can contribute to traumatic stress symptoms.

Traumatic stress symptoms can include:

  • Being easily upset or angry
  • Feeling anxious, jumpy or confused
  • Being irritable or uncooperative
  • Feeling empty or numb

Sometimes, shielding children from tragic events can be difficult. Dr. Taylor recommends that parents who are considering discussing a tragedy or trauma with a child consider some other factors:

Proximity of the event

When a tragedy occurs close to home, it may be more difficult to control what the child might see or hear. And even if unaware, children still might sense tension and anxiety from adults around them.

Other caregivers

Together, discuss your concerns about what and how you might share about an event with your child. Come up with a consensus so that those close to the child on the same page and presenting a consistent message. Consider what the school or teachers may relay to the student body. Often, a school district may send out a position statement on tragedies affecting the community. How might this impact what you share with your child?

Siblings and older peers

If your young child is around much older children, consider the likelihood that she may hear something frightening. In these cases, it may be helpful to inoculate her by going ahead and giving her some minimal information while keeping her developmental age in mind. You can always go back and answer more questions as they come. It is not recommended to ask an older child (8 to 12 years old) to not talk about the event with their younger sibling. This would likely only pique their curiosity.

Your child’s personality

All children are different. You know your child best. Is she likely to be scared by tragic news more than most children? Or is she the kid who would likely go explain the event to her class? Let her personality help guide your decision.

Media

School, other children, television, computers and smartphones may lead to your children knowing more than you think. Be sure to ask about their day; let them know you are there for them; and notice changes in behavior or mood that might be an indication that they may have heard something that doesn’t make sense in their world.

We understand that as the caretaker of a child, it can be stressful to make decisions about relaying tragic news to them. Here are more quick tips for parents on talking to children about traumatic events:

Quick tips for parents

  • Children need comforting and frequent reassurance of their safety.
  • Let your child lead the discussion and only answer questions that they ask.
  • Be honest and open about the tragedy or disaster using age-appropriate language. This may take the form of very simple and concise language.
  • Encourage children to express their feelings through talking, drawing or playing.
  • Try to maintain your daily routines as much as possible.
  • Monitor your own anxiety and reactions to the event. Ensure you are practicing self-care.
  • Emphasize what people are doing to help others impacted by the tragedy.

Preschool-aged children

  • Reassure young children that they’re safe. Provide extra comfort and contact by discussing the child’s fears at night, telephoning during the day, and providing extra physical comfort.
  • Get a better understanding of a child’s feelings about the tragedy. Discuss the events with them and find out their fears and concerns. Answer all questions they may ask and provide them loving comfort and care.
  • Structure children’s play so that it remains constructive, serving as an outlet for them to express fear or anger.

Grade school-aged children

  • Answer questions in clear and simple language.
  • False reassurance does not help this age group. Don’t say that tragedies will never happen again; children know this isn’t true. Instead, remind children that tragedies are rare, and say “You’re safe now, and I’ll always try to protect you,” or “Adults are working very hard to make things safe.”
  • Children’s fears often worsen around bedtime, so stay until the child falls asleep so she feels protected.
  • Monitor children’s media viewing. Images of the tragedy are extremely frightening to children, so consider significantly limiting the amount of media coverage they see.
  • Allow children to express themselves through play or drawing, and then talk to them about it. This gives you the chance to “retell” the ending of the game or the story they have expressed in pictures with an emphasis on personal safety.
  • Don’t be afraid to say, “I don’t know.” Part of keeping discussion of the tragedy open and honest is not being afraid to say you don’t know how to answer a child’s question. When this happens, explain to your child that tragedies cause feelings that even adults have trouble dealing with. Temper this by explaining that adults will still always work hard to keep children safe and secure.

Adolescents

  • Adolescents may try to downplay their worries, so encourage them to work out their concerns about the tragedy.
  • Children with prior trauma or existing emotional problems such as depression may require careful supervision and additional support.
  • Monitor their media exposure to the event and information they receive online.
  • Adolescents may turn to their friends for support. Encourage friends and families to get together – virtually if need be – and discuss the event to allay fears.

Should parents opt to discuss tragic events with children, or should the child already be aware of the circumstances, Mental Health America and National Child Traumatic Stress Network offer more ways parents can talk to their children about tragedy-related anxiety and help them cope.

If you think your child would benefit from speaking to a pediatric mental health professional, ask your pediatrician for a referral to a pediatric psychologist.

This article was updated Jan. 15, 2021.

How to talk to kids about racism

By Dr. Ava Casados, psychology postdoctoral fellow at CHOC and Dr. Sheila Modir, pediatric psychologist at CHOC

 As we grapple with recent events, we are all likely experiencing a range of feelings. Regardless of our background, we are processing a lot of information. While we as adults are finding it challenging to know what to do or say, children may be even more affected. Children often turn into little detectives to figure out what adults are worried or upset about, and they question why the news keeps focusing on certain topics and stories.

As a family, you may be thinking about how to talk to your child about current events, race and racism.

Though difficult, talking with children about the value of diversity and need for racial equality is important. This is true regardless of whether stories of injustice and racial violence are in the news or not.

Children of all races and ethnicities have questions about race and racism, so these conversations can be valuable in every household. Research shows that children can internalize racial bias as early as two years and have opinions about race before starting kindergarten. It is never too soon to start the conversation.

These are hard topics to discuss, and parents may be wondering how to talk to kids about racism. There is no single perfect way to do this, but a few suggestions are listed below to help you get started. It is likely we may experience some strong feelings as we think about how to talk to kids about racism, perhaps as we look at resources listed at the bottom of this article.

How to start a conversation about racism with kids

  • Starting the conversation can be hard. Just know that starting the conversation and feeling uncomfortable is better than not having the conversation at all.
  • Asking open-ended questions can be helpful, especially with older children. These questions can be woven into other conversations you have with your child. You can ask questions such as,
    • “What do you think our family values are about people who are different from us?”
    • “What are ways speech and actions can hurt people?”
    • “What have you heard about racism and racial bias?”
    • “What is free speech and what do you think that means?”
  • Particularly with the events in the news, ask children what they may have heard and how they are feeling right now. Let children have the space to talk. They may be fearful; they may want to do something; they may be sad or angry. All of these feelings are OK, and you can let your child know that.

Tips for talking to kids about racism

  • Before you start a conversation, you can look at the links below, so you can feel prepared.
  • You don’t have to plan one large conversation that addresses everything. Think of it as a series of conversations.
  • Taking a “colorblind” approach including statements like, “I don’t see race” can cause people who DO experience racism to feel as if you do not see that racism is a problem. Instead, acknowledge that racism is real and present in everyday life and celebrate the value of diversity by going to museums and events that expose your child to cultures other than your own.
  • Limit exposure to violent media and videos. While we do want to acknowledge the reality of racial violence, we also know that children do not need to see videos of violence in order to know it’s there. Watching these videos directly, or even hearing detailed descriptions of the videos, can be traumatizing to children. It can also traumatize us as adults and make it more difficult to talk to our children.
  • Be open to learning and model that learning to children. You do not need to have the “right” answer to every question, but you can show children that you are interested in learning and seeking answers together.
  • Leave space for anger and sadness. Often, we want to protect children from negative emotions, but anger and sadness are natural responses when children —or adults! — see violence and injustice in their communities. Let children know it’s OK for them to feel this way.
  • While these issues are often not something that we can completely address in a single conversation, we can show children that there are steps that we can take together to respond to injustice. Help children channel emotions into actions such as writing letters, creating art and volunteering.
  • Children learn about the world through the media they view, and oftentimes, the media only shows images of black and brown people as criminals or victims. Be mindful of the images your child is seeing and seek out movies, images and stories that show people of color as strong, intelligent and capable.

Open a developmentally appropriate dialogue

When discussing an important topic like racism with children, we want to make sure we are using developmentally appropriate language so that they are able to fully comprehend a big and meaningful topic. Also remember these conversations offer you an opportunity to learn from and with your child. Here are tips on how to talk to kids about racism in a developmentally appropriate way:

2-7 years old

At this stage, children watch and imitate other people’s behaviors. As parents, modeling and embodying an attitude of respect toward others is critical. Children at this stage are also more aware of physical differences among themselves and their peers and may comment on it. This can offer you an opportunity to celebrate differences.

7 to 11 years old

Children in this stage engage in logical thinking and continue to be quite literal and concrete in how they perceive the world. Because of this, parents can have an open conversation with their child about what is right versus wrong and fair versus unfair.

12 years and older

In this stage, adolescents and young adults can engage in abstract thinking and are now able to consider moral dilemmas, philosophical and ethical issues, and may take on a sociopolitical stance. Finding shared ways to make a difference is important and is an opportunity for you to model to your adolescent how to respond appropriately and effectively when incidences of injustices occur.

Resources for talking to children about race and racism

How to help children cope with grief

It’s difficult for adults to make sense of a tragedy or unexpected death, so consider how difficult it can be for children to do the same. Even events that occur far away – or the unexpected death of a celebrity – can trigger a stress response in children. Here are some ways parents can help.

Monitor your child’s news and social media intake and keep their routine and schedule as normal as possible. If your child is prone to anxiety, reassure them of their safety and ensure they are not dwelling on the tragedy.

Honor your child’s connection to the deceased – even if he or she didn’t know them personally. Talk about why this person was important to them, and the qualities and values that made this person feel special to them. Ask what your child wants to do to pay their respects or process the tragedy. This can be as simple as saying a prayer for the individuals left behind or donating to an organization important to the deceased.

The 5 E’s of Helping Children Navigate Emotions

Parents should also consider the five E’s of helping a child navigate emotions that come with a traumatic event:

Explore what your child already knows in a gentle and calm manner. You can start with a neutral question inquiring about how their school day was.

Explain what has happened in a way that your child can understand based on their age.

  • Address any misinformation your child might have picked up at school. Help them understand that although a sad and/or scary thing did happen, adults work hard to keep children safe daily.
  • Limit information you provide to your child to the questions they ask you. This will help avoid overwhelming them with information they may not already have been exposed to.
  • Provide examples of ways you and others in your community keep your child safe every day.

Express to your child that feelings are normal, and it is OK to feel sad, mad or angry when a tragic event occurs. Remember to reduce media exposure after a traumatic event, as repeated exposure to the event has been associated with psychological distress and intensifying already heightened emotions.

Emotionally model for your child healthy expression of feelings because children take their cues from their parents. Describe how you cope with your distressing emotions (e.g., “When I feel sad, I talk about it with someone who makes me feel safe or I take three deep breaths.”).

Ensure stability by continuing to adhere to your child’s daily routine. This will provide them with a sense of reassurance and safety during a chaotic time. Engaging in a daily routine is not meant to ignore what has happened, rather to continue to provide the child with structure, stability and predictability.

Additional resources

In the wake of a tragic event, it can be difficult for parents to find the words to talk with children and teens. Below are resources and suggestions for parents on how to discuss difficult topics with their children:

When to get help

Grief and shock are common after a loss or community tragedy. When this lasts longer than two to four weeks and is constant and begins to affect everyday life (schoolwork, interactions with family and friends), then therapy might be appropriate.

If you are struggling to help your child process a traumatic event, or if you feel your child could benefit from additional support, ask your pediatrician for a referral to a pediatric psychologist or psychiatrist.

Below are a few resources in Orange County with expertise in children:

How to Help Your Child Navigate the Emotional Aftermath of a Traumatic Event

By Dr. Sheila Modir, pediatric psychology post-doctoral fellow at CHOC

It’s difficult for adults to make sense of a tragedy, so consider how difficult it can be for children. To help parents support their children as they navigate trauma either in their own lives or process a tragic event they see on the news, consider the five E’s of helping a child navigate the emotional aftermath of a traumatic event: 

  • Explore what your child already knows in a gentle and calm manner. You can start with a neutral question inquiring about how their school day was or if anything happened while they were at school.
  • Explain what has happened in a way that your child can understand based on his/her age.
    • This is the time to address any misinformation your child might have picked up at school and help them understand that a scary thing did happen, but also reassure their sense of safety as schools and adults work hard to keep their children safe on daily basis.
    • Limit information that you provide to your child to the questions that they ask you, so that you avoid overwhelming them with information that they may not already have been exposed to.
    • You can provide examples of ways you and others in your community keep your child safe every day (i.e., how when you drop them off at school in the morning and you look both ways before crossing the road, how doctors are working hard to help the children that have been hurt).
  • Express to your child that feelings are normal and it is okay to feel sad, mad or angry when a tragic event occurs. Remember to reduce media exposure after a traumatic event, as repeated exposure to the event has been associated with psychological distress and intensifying already heightened emotions.
  • Emotionally model for your child healthy expression of feelings as children take their cues from their parents. Describe how you cope with your distressing emotions to your child (i.e., When I feel scared when something bad happens to me, I talk about it with someone who makes me feel safe or I take three deep breaths).
  • Ensure stability by continuing to adhere to your child’s daily routine. This will provide them with a sense of reassurance and safety during a chaotic time. Engaging in a daily routine is not meant to ignore what has happened, rather to continue to provide the child with structure, stability, and predictability.

If you are struggling to help your child process a traumatic event, or if you feel your child could benefit from additional support, ask your pediatrician for a referral to a pediatric psychologist or psychiatrist.

Below are a few additional resources on coping with trauma that I often share with my patients and their families:

Helping Children Survive the Aftermath– Florida International University

Mobile App: PTSD Family Coach– U.S. Department of Veterans Affairs

Responding to a School Crisis– The National Child Traumatic Stress Network

Resources for Parents and Caregivers– The National Child Traumatic Stress Network

Helping Traumatized Children: A Brief Overview for Caregivers– Child Trauma Academy

Tragic Events: Parent Resources – The Fred Rogers Company

Learn more about mental health services at CHOC

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