AGE 2 to 6: Reaction
- Generalized fear
- Cognitive confusion, e.g., not understanding that the danger is over
- Helplessness, passivity, e.g. may become mute, withdrawn, and still
- Anxious attachment to caregiver, e.g., clinging, not wanting to be away from caregiver, not wanting to sleep alone
- Sleep disturbances; night terrors
- Regressive reactions, e.g., toileting, dressing, speech
- Engaging in reenactments and play about the event; sometimes with magical qualities/character of the event
- Incomplete understanding of death; e.g., permanency of death, association with sleep, a desire to “fix up” the deceased
- Difficulty identifying and expressing what is wrong; e.g., periodic sadness
AGE 2 to 6: Adult Response
- Need rapid reassurance that they will be okay and taken care of
- Reestablish familiar adult protection
- Give repeated concrete clarification of what has happened and anticipate their concerns
- Provide support, rest, comfort, food, and opportunities to play
- Provide consistent care taking; e.g., assurance of being picked up at school, keeping a regular meal schedule, bedtime and when caregivers will be home
- Be as tolerant as possible with regressive behavior; it is temporary
- Try to remove the association of what happened with specific trigger/reminders; e.g., playgrounds, cars
- Explain the reality of death in age appropriate terms, when the child is open; e.g. a private moment, or while reading
AGE: 6 to 10: Reaction
- Impaired concentration and learning difficulties affecting performance at school
- Radical change in behavior, e.g., quiet child becomes active; active child, lethargic
- Somatic complaints, such as headaches
- Retelling the event with great detail and “savior” endings
- Preoccupation with their behavior during or leading up to the event with feelings of guilt and responsibility
- Specific fears triggered by reminders or while alone
- Fear of being overwhelmed by their own feelings
- Increased difficulty controlling their own behavior and feeling frightened by this lack of control
AGE: 6 to 10: Adult Response
- Allow enough “free” supervised time for play or expression through art, music, or dance
- Encourage your child to let you or the teacher know that they may be having a hard time concentrating while at school
- Try to be patient with any behavior changes
- Reassure the child that s/he will be safe and there are people around to help
- Help your child associate emotional and physical sensations s/he may have had during the event and suggest ways of helping her/him feel better; e.g., changing the subject, doing something else
- As with play, allow time to talk; acknowledge the normalcy of the reaction, what secret images s/he may have, and what specific reminders s/he may have
- The supportive presence of adults will help the child not to be so overwhelmed, and help remind her/him that feelings lead to actions s/he may not like or cannot control. Help her/him to establish a sense of control by doing something proactive, such as organizing a collection drive, making cards to send to those in need, or making red, white and blue ribbons for friends and classmates to wear.
AGE 10 to 14: Reaction
- Become more childlike in attitude
- Be very angry at the unfairness of the event
- Manifest euphoria and excitement at survival
- “See” symbolic meaning to things that led up to the event and assign symbolic reasons for survival
- Suppress thoughts and feelings to avoid confronting the event
- Be self-judgmental about their own behavior
- Manifest psychosomatic illness
AGE 10 to 14: Adult Response
- Try to respond to the emotions that are underlying the behavior and reinforce more mature behavior by including them in the resolution of problems.
- Encourage talking about the event in private moments. Discussions in front of others can lead to emotional reactions.
- Encourage supervised/supportive discussions about the event with peers if peers have been part of the event. Peers can inflame the reaction if not given some support and guidance.
- Provide realistic assessments of personal responsibility and “what could have been done”
- Help keep things in perspective e.g. “These feelings will not last forever.” “You can shape your own future.”
- Help them establish a sense of control by allowing them to do something pro-active such as organizing a collection drive (which the schools has done) or make and send cards to the family.
AGE Adolescent to Adult: Reaction
- Feel anger, shame, betrayal and act out these feelings in school or the community.
- May want to move into the adult world to get away from traumatic events and establish a sense of control over their world.
- Very judgmental about their behavior and that of others.
- Eating and sleeping disorders.
- May have an enhanced sense of immortality or an increased sense of hopelessness.
- Alcohol and drug use may become a problem.
- May engage in high-risk behavior
- May have a fear of being labeled “abnormal”.
AGE Adolescent to Adult: Adult Response
- Acting out may be a way of “pushing the event away”. Help them understand that might be what is going on.
- Encourage postponing major decisions in order to allow time for emotions to settle down and to grieve if necessary.
- Speak to emotions that are underlying the behavior. “This must be a very frustrating, angry time.”
- Help them understand the adult nature of what they are feeling, encourage peer understanding and support.
- Help them not to overreact to the impact this may have on their lives, help them grow from it, not lost in it.
- Acknowledge the “depressed” feeling that may come and that is survivable and normal.
- Acknowledge the anger they may be feeling, and explain how it can contribute to their sense of being “out of control” and “wanting to do something”.
- Encourage them to do something pro-active such as donating blood, if old enough, or volunteering to help at the Red Cross or other organizations.
For all ages:
- Give reassurances and hugs
- Assure them they and their families are safe (if this is the case)
- Limit their exposure to graphic details
- Let them talk and reassure them and solicit their ideas and feelings
– Compiled by Michael B. Murphy (Washtenaw County Crisis Manager)