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Children's Developmental Level

How do children and adolescents at various levels experience and respond to disasters?

People of all ages share some feelings and reactions in response to disaster. Special attention, though, is required to meet the needs of children and adolescents and understanding these needs can help us help them through these difficult times.

Typical reactions for children and adolescents of all ages include:

Fears of future disasters
Loss of interest in school, work, or hobbies
Regressive behavior such as thumb-sucking and toilet-training accidents
Sleep disturbances and night terrors
Fears of events associated with the disaster

Here are some responses of people of various ages, and some suggestions for being helpful to those in these developmental levels.

Preschool (ages 1-5): Children in this age group are particularly vulnerable to disruption of their previously secure world, and need others to help them cope with stress and disruption. Abandonment is a major fear in this age group, and children who have lost family members and even pets or toys will need special reassurance. Typical responses include:

Thumb sucking
Bed-wetting
Fears of the darkness or of animals
Physical and emotional "clinginess" to parents and teachers
Night terrors (PDF)
Loss of bladder or bowel control, constipation
Speech difficulties (e.g., stammering)
Loss or increase of appetite

We can respond helpfully to these difficulties by:

Encourage expression through play or other symbolic creative activities such as coloring or clay sculpting.
Children of this age often express their feelings of grief and loss mostly clearly through non-verbal methods.
Provide verbal reassurance and physical comforting
Give frequent and extra attention
Plan calming, comforting pre-bedtime activities
Allow short term changes in sleep arrangements such as allowing children to sleep with a light on or with the door open, or on a mattress in the parents' or another child's room, or remaining with the child while the child falls asleep.

Early childhood (ages 5-11) Regressive behavior in which children slip back to previous developmental levels, is most typical of children this age. In part this is because they experience loss more intensely, and often in ways that are difficult for them to manage. Some typical forms taken by regression include:

Irritability
Whining
Clinging
Aggressive behavior at home or school
Open competition with younger siblings for parents attention
Night terrors, nightmares, fear of darkness
School avoidance or other problems
Withdrawal from peers
Loss of interest and poor concentration in school

Some things that are helpful are:

Patience and tolerance
Play sessions with adults and peers
Discussions with adults and peers
Relaxation of expectation at school or at home (with a clear understanding that this is temporary and the normal routine will be resumed after a suitable period).
Opportunities for structures but not demanding chores and responsibilities at home
Rehearsal of safety measures to be taken in future disasters

Pre-adolescent (ages 11-14): Peer reactions are especially significant in this age group. The child needs to feel that his/her fears are both appropriate and shared by others. Responses should be aimed at lessening tensions and anxieties and possible guilt feelings.

Typical responses include:

Sleep disturbance, appetite disturbance
Rebellion in the home
Refusal to do chores
School problems (e.g., fighting, withdraw, loss of interest, attention seeking behavior)
Physical problems (e.g., headaches, vague aches and pains, skin eruptions, bowel problems, psychosomatic complaints)
Loss of interest in peer social activities

Some things that may be helpful are:

Group activities geared toward the resumption of routines
Involvement with same age group activity
Group discussions geared toward relieving the disaster and rehearsing appropriate behavior for future disasters
Structured but undemanding responsibilities
Temporary relaxed expectations of performance at school or at home
Additional individual attention and consideration

Adolescent (ages 14-18): Most of the activities and interest of the adolescent are focused in his/her own age group peers. They tend to be especially distressed by the disruption of their peer group activities and the lack of access to full adult responsibilities in community efforts.

Typical responses include:

Psychosomatic symptoms (e.g., rashes, bowel problems, asthma)
Headaches and tension
Appetite and sleep disturbance
Hypochondriasis
Amenorrhea or dysmenorrhea
Agitation or decrease in energy level
Apathy
Irresponsible and/or delinquent behavior
Decline in emancipatory struggles over parental control
Poor concentration

Some things that might be helpful are:

Encourage participation in the community rehabilitation or reclamation work
Encourage resumption of social activities, athletics, clubs, etc.
Encourage discussion of disaster experiences with peers, extended family members, significant others
Temporarily reduce expectations for level of school and general performance
Encourage, but do not insist upon, discussion of disaster fears within the family setting.

Additional Resources

This excellent resource from SAMHSA explains developmental reactions to trauma by grade level. (PDF)

This site by Prepare Response and Recover contains some very helpful information based on a child’s school level.

How to Prepare Children and Teenagers for Disasters

Part of disaster preparedness involves helping children and adolescents recognize the possibility of disasters and begin to be aware of possible responses to them. Although you may think that avoiding these topics would be a gift to your children, we know that preparedness is enhanced by giving children information in a way that is appropriate to their age and developmental level. What is always appropriate is reassuring them of our companionship to them in even the most difficult circumstances.

Of course, disaster preparedness is different for children of different age groups. Here are some tips for preparing children and teenagers of various ages:

Preschool (ages 1-5): Children of this age lack the verbal and conceptual skills to discuss something as abstract as a disaster. So rather than presenting to them various disaster possibilities, a general discussion of “bad things” happening, along with reassurance that they will not be left alone, is what is required. Be sensitive so as not to raise fears of young children through detailed discussion of disasters, and tailor the information to their level of understanding.
Early childhood (ages 5-11): As they begin their school experience, children have more ability to imagine different possibilities. Go to this FEMA website (PDF) for suggestions and to consider their responses to them. Discussing various disasters such as fires and storms can help children begin to prepare for their possibility. Again, fear of abandonment is a major theme of this age group, and reassurance (“whatever happens, we are in it together”) is always appropriate.
Preadolescence (ages 11-14): Children of this age are beginning to be very aware of how they relate to others, and need reassurance mostly that their fears and concerns are normal, and are shared by others of their age. Materials such as these from FEMA (PDF) can help preadolescents start to imagine how they might respond to various disasters. Always it is important to follow children’s lead in responding to questions maybe stirred by news events or television shows.
Adolescence (ages 14-18): Teenagers of this age are increasingly capable of abstraction and empathy, and of “feeling their way into” various possibilities. They are able to consider specific disasters and their implications. Given the emerging sense of service and social commitment in adolescence, volunteering to help with disasters (PDF) may also be a helpful preparedness strategy for this age group.

In summary, here are some principles (adapted from SAMHSA's Caring for Every Child's Mental Health Campaign for disaster preparedness in children and adolescents:

Always start with reassuring children and teenagers of your commitment to keeping them safe.
Be aware that children and adolescents respond to the possibility of disasters at their own developmental level. Don't get too technical or complicated, and talk on their level.
Encourage children to ask questions. Listen to what they say. Provide comfort and assurance that address their specific fears. It's okay to admit that you can't answer all of their questions.
Find out what frightens them. Encourage your children to talk about fears they may have. They may worry that someone will harm them at school or that someone will try to hurt you.
Focus on the positive. Reinforce the fact that most people are kind and caring. Remind your child of the heroic actions taken by ordinary people to help people in disaster, and of the heroism of people responding to disasters.
Pay attention. Your children's play and drawings may give you a glimpse into their questions or concerns. Ask them to tell you what is going on in their play, or in the pictures they draw. These conversations are a great opportunity to clarify their misconceptions, answer questions, and give reassurance.
Develop a plan. Establish a family emergency plan for the future, such as a meeting place where everyone should gather if something unexpected happens in your family or neighborhood. Planning can help you and your children feel safer.

Additional resources:

This FEMA website contains some very helpful information and activities for parents and teachers, including materials in Spanish. (PDF)

This game, in Spanish, focuses on enhancing disaster preparedness. (PDF)

Here are some very informative video clips from FEMA of various disasters, geared to the understanding level of children and preadolescents. (PDF)

Mass Support offers information on preparing kids and teens for emergencies and common reactions to disaster.

FEMA has some coloring books online that children can color explaining what to do during select disasters.

How do children and adolescents at various levels experience and respond to disasters?

People of all ages share some feelings and reactions in response to disaster. Special attention, though, is required to meet the needs of children and adolescents, and understanding these needs can help us help them through these difficult times.

Reactions to disasters may appear immediately after the disaster or after several days or weeks. Most of the time the initial stressful response phase will pass as the child or teenager adjusts. When symptoms do continue, sometimes a more serious emotional problem has developed. In this case, referring the child to a mental health worker who is experienced in working with children and trauma would be necessary.

Typical reactions for children and adolescents of all ages include:

Fears of future disasters
Loss of interest in school, work, or hobbies
Regressive behavior such as thumb-sucking and toilet-training accidents
Sleep disturbances and night terrors
Fears of events associated with the disaster

Here are some responses of people of various ages, and some suggestions for being helpful to those in these developmental levels.

Thumb sucking
Bed-wetting
Fears of the darkness or of animals
Physical and emotional “clinginess” to parents and teachers
Night terrors (PDF)
Loss of bladder or bowel control, constipation
Speech difficulties (e.g., stammering)
Loss or increase of appetite

We can respond helpfully to these difficulties by:

Encourage expression through play or other symbolic creative activities such as coloring or clay sculpting. Children of this age often express their feelings of grief and loss mostly clearly through non-verbal methods.
Provide verbal reassurance and physical comforting
Give frequent and extra attention
Plan calming, comforting pre-bedtime activities
Allow short term changes in sleep arrangements such as allowing children to sleep with a light on or with the door open, or on a mattress in the parents' or another child's room, or remaining with the child while the child falls asleep.

Early childhood (ages 5-11): Regressive behavior, in which children “slip back” to previous developmental levels, is most typical of children this age. In part this is because they experience loss more intensely, and often in ways that are difficult for them to manage. Some typical forms taken by regression include:

Irritability
Whining
Clinging
Aggressive behavior at home or school
Open competition with younger siblings for parents attention
Night terrors, nightmares, fear of darkness
School avoidance or other problems
Withdrawal from peers
Loss of interest and poor concentration in school

Some things that are helpful are:

Patience and tolerance
Play and discussion sessions with adults and peers
Relaxation of expectation at school or at home (with a clear understanding that this is temporary and the normal routine will be resumed after a suitable period).

Typical responses include:

Sleep disturbance, appetite disturbance
Rebellion in the home
Refusal to do chores
School problems (e.g., fighting, withdraw, loss of interest, attention seeking behavior)
Physical problems (e.g., headaches, vague aches and pains, skin eruptions, bowel problems, psychosomatic complaints)
Loss of interest in peers and social activities

Some things that may be helpful are:

Group activities geared toward the resumption of routines
Involvement with same age group activity
Group discussions (PDF) geared toward relieving the disaster and rehearsing appropriate behavior for future disasters
Structured but undemanding responsibilities
Temporary relaxed expectations of performance at school or at home. Additional individual attention and consideration

Typical responses of this age group include:

Psychosomatic symptoms (e.g., rashes, bowel problems, asthma)
Headaches and tension
Appetite and sleep disturbance
Amenorrhea or dysmenorrhea (changes in menstrual cycles)
Agitation or decrease in energy level
Apathy
Irresponsible and/or delinquent behavior
Poor concentration

Some things that might be helpful are:

Encourage volunteer participation (PDF) in the community rehabilitation or reclamation work
Encourage resumption of social activities, athletics, clubs, etc.
Encourage discussion of disaster experiences with peers, extended family members, significant others
Temporarily reduce expectations for level of school and general performance
Encourage, but do not insist upon, discussion of disaster fears within the family setting

Some of this information is excerpted and modified from a SAMSHA publication. (PDF)

Additional Resources

This web page, entitled “Reactions and Guidelines for Children Following Trauma/Disaster,” contains some very helpful and specific information tailored for the most part to various school levels. (PDF)

The National Association of School Psychologists has a very nice website on how to work with school children during and after disasters. (PDF)

This is comprehensive summary page from the United Methodist Committee on Relief entitled, “How Can I Expect My Child to React to Disasters?” lists physiological, emotional, and behavioral reactions by age group. (PDF)

How do I reassure children after a disaster?

The most important job we have as parents and teachers is to accompany children in ways that keep them safe and contribute to their development. This role becomes even more essential following disasters, when children are vulnerable and concerned. Here are some things to keep in mind following disasters in your response to children:

Children need to hear that family and friends who love them are still there to protect and take care of them. When children feel scared or confused, they often feel alone and vulnerable, and a parent leaving, even for a short time, can be very frightening. This is a time for extra intimacy with your child, lots of physical affection and patience, and respect for the fears and concerns that surface. Children need to hear that it is all right to be afraid and confused at times, and that grown-ups feel that way too. But follow up with assurances that you will be there to help them understand their feelings and thoughts. As always, try to be with children in a way that fits with their developmental level.
Children are naturally curious, and disasters stir new concerns and curiosities. They need to know that it is all right to ask questions as part of their meaning-making and sense-making and recovery. You should encourage questions and opinions from children and respond to them as legitimate and important. It is also natural for children to express some of their concerns through humor or jokes. You can help them find more constructive ways to express their feelings and concerns.
Answer children’s questions with accurate information and honest expressions of opinion. The amount and complexity of information should be geared to the child’s age and interest (PDF), but every child, no matter what age, needs honest answers. If you do not know how to answer a question, tell your child that you do not know the answer, but that you will try to find one as soon as you learn more about what is going on. Questions on death need to be answered with support and simple directness as they arise. Children need the reassurance that loss by death does not mean that they are being punished or that they will be abandoned by others close to them. Children’s grief (PDF) tends to take place along different, but similar, pathways to that of adults.
Try to return to a normal daily routine, including school and community-based activities, as soon as possible to further your children’s feeling of security and stability. Children will also feel that their world has become safe again if they can visit their favorite playground, park, or museum, or to see a favorite movie.
Monitor and interpret children’s exposure to media (PDF) following a disaster. Children’s fertile imagination can distort and magnify events portrayed on the television and radio, in the newspaper, in the classroom or play yard, or right around your dinner table in a way that threatens their sense of security and stability. To complicate things, for young children, "seeing is believing." It's hard for them to separate fact from fantasy. With instant replays of news reporting video coverage, children form terrifying misperceptions. If not told otherwise, they can think multiple disasters are continuously happening for days on end! Plan enjoyable activities to distract children's attention from media coverage of disasters. Turn off the television and radio when young kids are present. To help children maintain perspective, we have to limit the re-hashing of crisis.
Some of the stress management techniques presented elsewhere in this website can help not only adults but children as well. Some specific things you can do to help manage children’s stress include:

Providing a physical outlet through play and exercise
Treat aggressive behavior, bed-wetting, and sleep and eating changes as symptoms, not problems. These are normal responses of children to stress (PDF)
Children experiencing nightmares or feeling fearful at night may be comforted by a night light, stuffed animal or doll, or music from a bedside radio. Some children may feel less vulnerable if they have a flashlight by their bed or a whistle to call a parent. If they do awake with fears during the night, sitting with them provides comfort and support and helps to lessen their frightening feelings.
Children, like adults, feel better about overwhelming events when they can do something to help. It is important to give children opportunities to help or volunteer even if it is only a small task of short duration. Being able to join with others increases a child’s awareness that they are not alone and helpless and that there is strength through family and community cooperation.

Some of this material is adapted from “Helping Young Children Respond to War,” by Marzy Sykes, Ph.D.

Books for Parents and Others Helping Children

What Happened to the World? Helping children cope in turbulent times by Jim Greenman. Published by Bright Horizons Family Solutions, JPMorgan Chase, Mercy Corps, and The Dougy Center, 2001.

Bad Stuff in the News: A guide to handling the headlines by Marc Gellman and Thomas Hartman. New York,NY: Sea Star Books, 2002.

The Place I Know: Poems of Comfort selected by Georgia Heard. Cambridge, MA: Candlewick Press, 2002.

Additional Resources

This very helpful website from Illinois University Extension for teachers working with children following disasters. (PDF)

For those who are uncertain about how to talk with children about disasters (and other experiences), this is a wonderful resource from Michigan State University Extension’s Children, Youth, & Family Programs. (PDF)

This is an American Academy of Child and Adolescent Psychiatry website for “helping children after a disaster” that has a lot of well-organized information

How can you support children during a disaster?

Disasters may strike quickly and without warning. As frightening as they can be for adults, disasters can be even more traumatic for children if they lack kind and clear companionship to find their way through. There are some things that you can do to keep children company during these difficult times, and to help them manage their fear and anxiety.

Understand that children of various ages will respond differently to disasters. Find ways to connect with children’s experience that are appropriate to their level of understanding and being in relationship with their feelings.
During disasters, as during other difficult life events, children will look to you and other adults for help. How you react to an emergency gives them clues on how to act. If you react with alarm, a child may become more scared. They see our fear as proof that the danger is real. If you seem overcome with a sense of loss, a child may feel their losses more strongly. Use stress management (PDF) principles and techniques so that you may be a source of guidance and stability for those around you.
Touch or cuddle with your children. Physical touch reassures your child and makes them feel safe. Look into the eyes of your child with your touch. Touching is important for children during disasters. Close contact helps assure children that you are there and will not abandon them, and will help them feel safe. As you touch them, look into their eyes, and say “We are together. We are safe. We will survive.”
Get your child something to cuddle, a transitional object (PDF) such as a toy, blanket, or teddy bear, to serve as a bridge between their disaster experience and their ordinary experience.
Focus on listening. Get down to the child’s eye level and talk to him or her. Try to understand, then to be understood. When you're sure that danger has passed, concentrate on your child's emotional needs by asking the child what's uppermost in his or her mind. Give children simple and accurate information about what has happened. Then listen to what your child says and their questions. Mirror the child’s question through reflective listening (PDF) so that your child feels assured of your presence, and feels understood.
Keep in mind that children’s understandings and fears are different from yours.

The event will happen again.
Someone will be injured or killed.
They will be separated from the family.
They will be left alone.
You can respond to these fears with simple, clear information that is both accurate and reassuring, and again appropriate to the child’s level of understanding.

Children depend on daily routines to organize and regulate their lives: They wake up, eat breakfast, go to school, and play with friends. When emergencies or disasters interrupt this routine, children may become anxious. Try to do what you can to maintain structure and routine during a disaster, even if you and your family have to leave your home to go to a shelter. Having children participate in the family's recovery activities in a way that is appropriate to their developmental level will help them feel that their life will return to "normal."
Include children in recovery activities. Give children chores that are their responsibility. This will help children feel they are part of the recovery. Having a task will help them understand that everything will be all right.
Understand that recovery is a process, not an event. Helping children through the journey of disaster recovery is a difficult but worthwhile effort.

Some of the material on this page is from “Helping Children Cope With Disaster,” developed by the Federal Emergency Management Agency (PDF) and the American Red Cross.