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Monday, September 12, 2011

Local Psychiatrist Explains How to Effectively Discuss Hurricanes With Children

Unfortunately, natural disasters, such as hurricanes, are a part of life in Florida. Most children know that hurricanes are “bad,” but they may not understand much else about them. Therefore, it is critical to discuss hurricanes with your child before they happen, and to have a family emergency plan in place, which should be shared with children in terms they can understand.

The most important message you can convey as a parent or caregiver is that your child is safe and will continue to be safe throughout the duration of the disaster. This assurance is critical because it provides comfort to children at a stressful time. Let your child express how he or she feels and listen attentively. Find some quiet time sitting on the couch together. Don’t have the discussion while you or your child are doing something else. Time devoted exclusively to the discussion of the disaster sends a message of how important the discussion is to your child. Whether the hurricane is coming or has already affected some other location, explain was has happened or what is about to happen in a calm, matter-of-fact way. Do not provide information that is not relevant or may be too upsetting. For example, if there have been fatalities related to the hurricane, do not share this information with very young children. Try not to minimize your child’s expression of fear or upset. Also, realize that very young children (4 and younger) may not be able to express in words what is bothering them. Instead, they may “act out” by becoming clingy or more emotional than usual. Be aware that these might be signs of distress.

After a disaster, it is important to re-establish routines as quickly as possible. This provides the child with a sense of control of the environment, and builds confidence that life will go on. Try to keep your same routine in terms of sleep times and meals. Confirm your expectations that homework still needs to be completed, household tasks still need to be done, etc. Also, try to limit your child’s exposure to the trauma on television and the Internet. Although you should acknowledge the disaster, there is little purpose in continued exposure through the media. This continued exposure leads to ongoing emotional reaction and memories that serve little purpose in terms of healing.

Remember that it is normal to feel stress during and after a disaster. Children may express stress by fear that the disaster will happen again soon. This can potentially affect the child’s sleep patterns, appetite and reactions to daily activities. For example, a child that is stressed may eat less, have nightmares with frequent awakenings and have physical manifestations, such as a stomach ache. Some children also react by becoming more irritable, having trouble concentrating, crying easily and losing interest in activities they typically enjoyed. If such symptoms continue after a few weeks and they adversely affect the child’s ability to function at home or at school, a consultation with a pediatrician or psychiatrist might be indicated.

Be reassured that most emotional, behavioral and/or physical changes as a result of exposure to a natural disaster resolve on their own in a short period of time. Post traumatic stress disorder is a specific diagnosis with symptoms present for at least one month. Whether a child develops such a disorder depends on numerous factors, including the degree of the threat or injury. As a parent or caregiver, you know your child best. Ongoing concerns are always best treated by a visit to the physician.


This article was contributed by Dr. Kristine Vallrugo. Dr. Kristine Vallrugo completed residency training at the Mayo Clinic in Rochester, Minn., before conducting her fellowship in child and adolescent psychiatry at Northwestern University Medical Center in Chicago. Vallrugo is board certified in psychiatry, and had a private practice in Chicago. With a master’s in health law, she practiced medical malpractice in Chicago for six years. Her professional experience includes forensic psychiatry; working to evaluate prisoners for insanity defense, fitness for trial and competency. Since moving to Florida, Vallrugo has joined a private practice in Sarasota, focusing on children and adolescent psychiatry. She is a married mother of three with two step-children.

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