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Helping children recover from the trauma of disaster

Story highlights
  • Most kids will emerge from these experiences fine, but for some, the effects can linger for years
  • A child's exposure to stressors during and immediately after the disaster is a key factor

Hurricane Harvey's historic floods have killed dozens of people. As of Thursday, an estimated 32,000 more had been evacuated into shelters, and approximately 210,000 had registered with the Federal Emergency Management Agency for assistance.

Disasters, whether natural (like hurricanes and floods) or man-made (like wars), can cause tremendous upheaval in people's lives.

Imagine what being evacuated from your home -- even temporarily -- would feel like. What about having your home and all of your possessions destroyed? For adults, these are traumatic and deeply distressing experiences. For kids, they may be even more distressing. Losing a home for a kid may mean losing the only home he or she has ever had.

According to the U.N., young people, including children, are the largest group of people affected by disasters across the world. Over 100 million youth around the world are exposed to disasters each year. In the United States, it's estimated that approximately 14 percent of children will experience a disaster in childhood.

What made the rain in Hurricane Harvey so extreme?

As a professor at Georgia State University, I have studied how kids cope after disasters like Hurricane Katrina or major wildfires, and how children respond to ongoing trauma like the Gulf War. I've found that most kids will emerge from these experience just fine. But for a small minority, the effects can linger for years.

Distress symptoms are common in the aftermath of disasters

It's very common for children to report symptoms of post-traumatic stress, depression and anxiety after a disaster.

These symptoms might look like nightmares or flashbacks to the disaster, avoiding reminders of the event or being more worried about events in general. Children may also have trouble in school or be more sedentary. Very young children do not have well-developed verbal skills, and they may not be able to describe their own emotional distress.

But for most kids, these symptoms don't last long. My colleagues and I followed children after Hurricane Andrew in 1991 and found that a year after the event, most kids had bounced back or were recovering from symptoms of trauma. Just 20 percent still reported elevated symptoms.

In another study following kids after Hurricane Katrina in 2005, we found that 71 percent bounced back and returned to normal levels of functioning within one to two years after the disaster.

Older victims of Harvey may need special attention as Texas recovers

A small minority of children are more deeply affected. About 4 percent of the children we followed after Katrina reported severe symptoms that had not resolved more than two years later. For example, children reported having flashbacks to Katrina, avoiding reminders of the event and feeling irritable.

For these children and those who bounce back relatively quickly, experiencing post-traumatic stress may have lasting impacts. In one study, we assessed children living in Kuwait who were exposed to the Gulf War in 1991, and followed up with them again 10 years later. Kids who reported higher levels of post-traumatic stress symptoms in 1991 experienced more difficulties in terms of their education and occupation outcomes as they moved into adulthood.

Why do some kids struggle while others rebound?

A child's exposure to stressors during and immediately after the disaster is a key factor that predicts whether he or she will struggle after potentially traumatic events. For instance, did the child think he would die during the disaster? Did she witness someone being hurt? What other stressors did she experience?

School-aged children are often able to describe these stressors clearly, despite the fact that their language skills are less well-developed. For example, my colleagues and I asked children in grades three and four to write about their experiences during Hurricane Ike. One child wrote, "My home sunk. My tracter [sic] sunk. My cat ran away." Another child wrote, "There was no food that we could get but we got some from the red cross [sic]."

Adults don't always know what kids are feeling

Surprisingly, adults are not good judges of what children experience during disasters. In fact, research suggests that parents are not great judges of child behavior and feelings generally.

In our study of children after Hurricane Katrina, we asked mothers and children what happened during and after the storm. There was very little agreement between what moms thought had happened to the child and what the child said had happened. For example, we asked mothers and children whether their homes were badly damaged and whether clothes and toys were ruined during the disaster.

How childhood trauma can affect mental and physical health into adulthood

Higher levels of disagreement in responses between mom and child predicted higher levels of distress in the child. These differences may highlight the need for parents to recognize their children's distress in order to be able to meet their child's needs.

How can you help children be more resilient after a disaster?

Changes in academic performance, how often they're seeing friends, or less enjoyment of favorite activities can all be warning signs that children may be struggling after a disaster.

Stressors such as parents changing jobs or someone in the family becoming ill tend to increase after disasters, and they can make recovering from a disaster even harder for children. Adults should be aware of that and teach children coping skills like identifying feelings and problem-solving.

Since parents might not be that good at guessing how their child feels, it's good to ask them. Don't assume that you know. At the same time, if children say they're feeling fine after the trauma and appear to be functioning well, don't assume they're "hiding" how they really feel.

Also, the news often displays the worst experiences that happen to people during disasters. Exposing children to too many of these images and stories may retraumatize them. Give children information that is appropriate for their age.

The most important thing is to get children back into their routines as soon as possible. Routines are comforting to children, and help them feel like life is "back on track."

Betty Lai is an assistant professor of public health at Georgia State University. She receives funding from the National Science Foundation. Work described here has been funded by the National Institute of Mental Health and the United States Department of Homeland Security.
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