The recent earthquake has left thousands of children in distress. A large number of them have lost their parents. Some have even seen their parents’ dead bodies or witnessed their burials. Some are still looking for their parents, waiting with blurring hopes that they might come and embrace them once again in their arms, put them to bed with a warm kiss or tell them their favourite bedtime story. Many of them have seen their friends, siblings and teachers buried under the rubble of the schools where they had learnt their lessons and played games. Many are themselves hurt and have sustained debilitating injuries.
Children are sensitive beings who need love and care. And when they are faced with death and destruction they are more prone than adults to develop emotional problems. They may find it difficult to understand what has happened. They feel the impact of a crisis, but often are unable to describe how they are feeling and may express themselves indirectly. In psychological terms, this emotional state is known as the post-traumatic stress disorder (PTSD).
Though there is no typical or normal reaction to trauma, there are some common responses seen in children. It is natural for children to first experience some sort of denial. Following trauma, children may become tense and frightened. This may be expressed through attention and concentration problems, clinging dependent behaviour, irritability and disorganized or agitated behaviour. Feelings of anger, sadness or guilt may often emerge. They may show symptoms of social withdrawal and wanting to be alone, and a loss of interest in significant activities. Also, children may begin to regress emotionally or act younger than their actual age.
Many children faced with a traumatic situation tend to relive the trauma, re-enacting the event over and over again. They are prone to sleep disturbances, distressing dreams and nightmares, fearfulness — especially at night or when separated from parents.
Associated problems such as aches and pains, bedwetting, sweating, general misbehaviour, tantrums and attention seeking behaviour are not unusual. Loss of interest in school or poor concentrations and loss of motivation are other common reactions.
Children’s reaction depends on the severity of the trauma, their personality makeup, their characteristic coping style and the availability of support. It also depends a lot on how directly the child was involved in the crisis. If the child experienced destruction and/or death of others, it will have a more profound effect. If the catastrophe involved the death of a family member, friend, classmate or someone close to the child, or if the event involved destruction of the child’s home, school or any other place that is part of the child’s daily routine, there is a greater chance that the child will experience difficulties.
Age is also an important factor in how the child will behave in a traumatic situation. The younger the child, the less ability the child has to understand the event. Experts believe that children who experience traumatic events before they are 11 years old are three times more likely to develop psychological symptoms than those who experience trauma as a teenager.
Long-term effects of a traumatic event depend on the child’s age, ability to communicate and relate to others, where the event took place and if the child is injured.
After any tragic event, survivors struggle to deal with the physical and emotional trauma of the disaster and need to be taken care of. Children who have undergone a major traumatic event, like the recent earthquake, need to be reassured of future safety and support. It is important to encourage them to talk about their feelings, their fears and any questions that come to their mind about the cause of the disaster or future safety. Children also need to be reassured that all efforts are being taken to help and support the affected people and their needs are being taken care of.
To help children overcome their emotional state, measures should be taken to start their schooling as soon as possible as getting back to school gives children some routine and focus which helps in their emotional recovery. When the child is among his own age group, he has more chances to overcome the effects of trauma. He should be given space to laugh, play and be himself among his peers. Playtime allows children to be children and helps them overcome the stress the trauma has had on their lives. After a crisis, the freedom to play and be children is important. As part of rehabilitation of these children activities such as art, music or drama can be organized to facilitate the expression of feelings generated by the trauma and to develop effective coping strategies.
Children often need to tell their story over and over again. Writing, drawing and play are effective mediums for children to overcome traumas. Activities that will calm children can be planned; children can be encouraged to use art (drawing, painting, and clay modelling), or write poems and diary to express their emotions.
Another way to help these children is to get them involved in caring for others affected by the crisis. Actively doing something to help others refocuses children’s thoughts; they also realize that they are not the only ones affected. Children should be made to believe that they have support of people throughout the world. This will reassure them that others care about them, making them feel less lonely and vulnerable.
It is not possible for the child to overcome its loss in a single day; it needs time and should be given time that it needs to come to terms with the situation. Also, considering the massive tragedy and the loss and destruction these children have seen it is highly probable that many children will continue to experience emotional problems for a long time, even years, and will need professional psychological help. It is up to all of us to come forward and help those who need our care to start life all over again, before these children reach a stage where professional help is the only answer.
