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Children Coping with Terrorism and Disasters: Diagnosis & Treatment
10 CEUs Children Coping with Terrorism and Disasters: Diagnosis & Treatment

Section 1
Impact of September 11, 2001 Terrorist Attacks on Children

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New Content Added: To update the content we have added Terrorism & ISIS and PTSD information found at the end of the Table of Contents.

On this track, we will discuss the impact of September 11, 2001 on children, and a technique for reducing post traumatic stress as a result of media exposure.

On September 11, 2001, an estimated 3,000 children lost a parent in the terrorist attacks on New York and Washington D.C.  The average age of these children was nine years old.  In the years following the attacks, a great deal of attention has been focused on how these children, and other children exposed to the events, have been affected by the trauma.

The New York City Board of Education reported after 9/11 that school children in the city experienced rates of Post Traumatic Stress Disorder five times higher than normal.  Even children up to 3,000 miles away from the events felt the trauma keenly.  Experts studying the effects on young people say that adolescents growing up today are struggling with the sense of invulnerability and optimism that usually characterizes adolescent life.

One of the primary ways in which children who were not directly affected by the terrorist attacks became exposed to traumatic stress is through the television and the news. 

Case Study Analysis: David's Screaming
David, age 4, was brought in to see me by his father, Albert, about a month after the terrorist attacks of September 11, 2001.  Albert stated, "I was completely convinced I had kept David from knowing about the attacks.  I knew he was having trouble sleeping at night, but I thought that was because he was having trouble adjusting to daycare. 

"The last week, when a plane flew above the daycare, David started screaming and ran under a tree.  So I asked David if he had heard about anything happening in a place called New York.  Sure enough, he had.  And when I asked him if that was why he’d been getting up at night, David told me he was scared a plane would fly into our house!"

I reminded Albert that it is often a continual surprise just how much children pick up from even brief television viewing.  I stated, "Even if you completely eliminate television from your home , children will hear things from older kids, or see the covers of newspapers and magazines at the store or the doctor’s office.  Instead of focusing on trying to protect David completely, you might want to consider working on strategies to help recognize and cope with the information David does absorb." 

Specific guidelines for helping children process information they learn from outside sources will be discussed in detail on Track 5 of this course.

Case Study Analysis: Nellie's Nightmares
Another client, Leroy, brought his eight year old daughter Nellie in to see me after Nellie began having repeating, terrifying nightmares.  Leroy stated, "I work in television, so I know how important news coverage can be.  So I figured it would be important for Nellie to see the news regarding September 11th… I mean, it was a historic event!  The TV was on all day, and Nellie was right there with me all day.  Now I realize that I made a terrible mistake.  How do I know how much TV is too much for Nellie before I make a mistake like that again?" 

I stated to Leroy, "The best advice may be not to have the television news on at all when Nellie is around.  Tape the news and watch it after Nellie goes to sleep.  Even if the television is just ‘in the background’, Nellie may still be responding to it on some level.  Besides, a study in the Wall Street Journal indicates that background news about war and terrorism isn’t good for adults either.  The study revealed that adults who keep the news on in the background may be at greater risk for depression, stress, and a weakened immune system."

I have found that there are two sets of guidelines useful for parents who want to reduce the impact of the media of terrorism on their children.  The first set of guidelines concerns children under the age of seven, like David.

 3 Guidelines for Children Under Seven

Guideline #1
- Turn the TV Off
The first guideline for children under seven is to turn the TV off.  I stated to David’s father, Albert, "Turning the TV off can be one of the hardest steps for families.  But research indicates that for children under two, there is no positive impact of even educational TV, and the best solution is just to turn the TV off.  This is good advice for any child under seven as well." 

Guideline #2 - Take the TV Out of the Child's Bedroom
The second gudeline for children under seven is to take the television out of the child’s bedroom.  This may be initially the most upsetting step to your child.  However, it is also the step that makes the most sense.  If David has a TV in his room, you cannot monitor how much TV or what kind of TV he is watching." 

Guideline #3 - Choose Educational Television for the Child's Permitted Screen Time
In addition to turning the TV off and taking the TV out of the child’s bedroom, a third guideline for children under seven is to choose educational television for the hours when the child is permitted screen time.  I stated to Albert, "parents who reported that their children primarily watch educational programming report that the media has much less of a negative impact on their children."

 4 Guidelines for Children Ages Seven to Four

Guideline #1 -Set Limits
Regarding children ages seven to ten, like Nellie, there are four guidelines regarding television viewing.  The first guideline for children ages seven to ten is to set limits.  According to the Center for Media and Family Studies, a safe amount of screen time, including TV, video games, and computer use (except for homework) is no more than ten to twelve hours per week.  Of course, in homes with multiple children, parents must balance the guidelines for each child with a routine that makes sense for the entire family. 

However, do you, as I do, usually encourage families to watch as little television as possible, regardless of children’s ages? 

Guideline #2 - Watch the News Together
A second guideline for children ages seven to ten is to watch the news together.  I stated to Leroy, "One of the best thing you can do for Nellie concerning the news is to watch it with her.  That way you are right there to see what she is taking in, answer any questions, and change the channel if you feel it is necessary or that Nellie is becoming distressed." 

Guideline #3 - Talk
In addition to setting limits and watching news together, a third guideline regarding television viewing for ages seven to ten is to talk.  I stated to Leroy, "By talking to Nellie about what she sees, you can help shape her developing media literacy.  That is, her understanding of how different forms of media shape the stories she sees and the information she takes in." 

Guideline #4 - Encourage Alternate Activities
Finally, the fourth guideline for children ages seven to ten is to encourage alternate activities.  While parents may not, and perhaps should not, eliminate television from their homes, I encourage parents to help their children develop alternate forms of amusement, such as reading, sports, or crafts.  Often, I find it useful to remind parents that the best way to encourage better entertainment choices is to model better entertainment choices.

Think of your Nellie or David.  Would reminding their parents of these age-dependent guidelines be useful for him or her?

On this track, we have discussed the impact of September 11, 2001 on children, and a technique for reducing post traumatic stress as a result of media exposure.

On the next track, we will discuss four aspects of the long-term effects of terrorism on children.  The four aspects we will discuss are: the effects on preschool children, on middle and high school students, on elementary students, and on middle school students in communities distant from the terrorist event. 

Peer-Reviewed Journal Article References:
Henry, D. B., Tolan, P. H., Gorman-Smith, D., & Families and Communities Research Group, Institute for Juvenile Research, University of Illinois at Chicago. (2004). Have There Been Lasting Effects Associated With the September 11, 2001, Terrorist Attacks Among Inner-City Parents and Children? Professional Psychology: Research and Practice, 35(5), 542–547.

Hoover, S. A., Sapere, H., Lang, J. M., Nadeem, E., Dean, K. L., & Vona, P. (2018). Statewide implementation of an evidence-based trauma intervention in schools. School Psychology Quarterly, 33(1), 44–53. 

Kilmer, R. P., Gil-Rivas, V., & Roof, K. A. (2020). Associations between children’s self-system functioning and depressive and posttraumatic stress symptoms following disaster. American Journal of Orthopsychiatry. Advance online publication. 

Marshall, A. D., Roettger, M. E., Mattern, A. C., Feinberg, M. E., & Jones, D. E. (2018). Trauma exposure and aggression toward partners and children: Contextual influences of fear and anger. Journal of Family Psychology, 32(6), 710–721.

Saigh, P. A., Yasik, A. E., Mitchell, P., & Abright, A. R. (2011). The psychological adjustment of a sample of New York City preschool children 8–10 months after September 11, 2001. Psychological Trauma: Theory, Research, Practice, and Policy, 3(2), 109–116.

Stuber, J., Galea, S., Pfefferbaum, B., Vandivere, S., Moore, K., & Fairbrother, G. (2005). Behavior Problems in New York City's Children After the September 11, 2001, Terrorist Attacks. American Journal of Orthopsychiatry, 75(2), 190–200.

Online Continuing Education QUESTION 1
How much screen time is appropriate for children between the ages of two and five? To select and enter your answer go to CEU Test.

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