1	Effects of Deployment on Children and Adolescents Tripler Army Medical Center Child and Adolescent Psychiatry Service
2	Objectives Review the emotional cycle of deployment Discuss the effects of deployment and loss on children and adolescents Discuss ways that adults can help students cope with the upcoming deployment Briefly review when referral is warranted Acknowledgement: Much of material pulled from articles and presentations by Dr. Faran, Dr. Pincus, Dr. Lee, Dr. Saito, and Dr. Brown
3	Schools: The Most Universal Natural Setting Over 52 million youth attend 114,000 schools Over 6 million adults work in schools Combining students and staff, one-fifth of the U.S. population can be found in schools
4	Emotional Cycle of Deployment Pre-deployment – 1-6 months before Deployment – first month after leaving Sustainment – 2-5 months during deployment Re-deployment – last month Post-deployment – 3-6 months after
5	Pre-Deployment Anticipation of loss versus denial “You don’t really have to go, do you?” Train-up, bonding with units Mental and physical distance from family Getting affairs in order Arguments Dangerous for younger couples
6	Deployment Mixed emotions from soldier and spouse Relief – anger – disoriented – sadness – numbness Sleep difficulties Phone calls – email – waiting for that 1^st call Worries about “Can I handle everything?”
7	Sustainment New routines established New sources of support – FRG Feel more in control after being ‘tested’ Independence New confidence – “I can do this.” Careful about rumors
8	Changes in Children and Adolescents During Deployment Sadness Denial, shock and confusion Anger and irritability Inability to sleep / Nightmares Loss of appetite Children are physical in their grief - watch their bodies - understand play and actions – often repetitive themes – often cycles
9	Changes in Children and Adolescents During Deployment Fear of being alone Physical complaints such as stomachaches and headaches Loss of concentration Guilt over failure to prevent loss Depression or loss of interest in activities Regression—bedwetting, thumb-sucking
10	Changes in Children and Adolescents During Deployment Boisterous play Withdrawal from friends Sharp drop in school performance School refusal Excessively imitating or asking questions about war / disaster Profound emotional reactions
11	Re-Deployment Anticipation of homecoming Can be agonizing with changing schedules Excitement and apprehension Changes during time away New independence Burst of energy- “nesting” – getting ready Difficulty making decisions
12	Post-Deployment Honeymoon period Loss of independence Need for “own” space by soldier and spouse Renegotiating routines, responsibilities Reintegration with family 1 y/o might be scared - preschooler guilty School aged kids often want attention Adolescents might pretend not to care, moody
13	Family Support Group Communication – between family and military Referrals- jobs, education, relocating, finances Activities / Recreation Planning- legal matters, family care plan, medical/dental, finances
14	What Adults Can do to Help Students Cope with Deployment Maintain normalcy when possible Reassure safety – especially that other parent is not going to leave Increase physical contact – connect on different sensory levels Answer questions honestly as possible at child’s level of development - validate feelings and give kids a chance to talk
15	What Adults Can do to Help Students Cope with Deployment Expect behavioral regression Project calm and control as adult Expect expressions of separation anxiety Keep routines Help students do something to help others Help students take action and take action with them
16	What Adults Can do to Help Students Cope with Deployment 11. Facilitate communication with loved ones 12. Anticipate that children with special needs or mental health issues may decompensate more easily 13. Be available and “askable” 14. Don’t be afraid to say “I don’t know.” Part of keeping the discussion open and honest is not being afraid to say you don’t know how to answer a question.
17	What Teachers Can Do to Help Teachers are the experts in the classroom and know their students well Follow your instincts Recognize and be ready to deal with the fact that some kids will have parents leaving and others will not Use this background knowledge to develop creative ideas
18	What Teachers Can Do to Help Class discussions on deployment What, where, why, how long Personal journals- some kids write better about feelings Bulletin board – share pictures, experiences Record on calendar deployments and re-deployments of parents
19	What Teachers Can Do to Help Make scrapbook of educational progress while parent is away Take pictures of events, projects to send Daily hypothetical problem solving Helps students increase problem-solving skills that will be tested during deployment Ask kids to give examples from school/home 5 steps – (1) Define (2) Brainstorm (3) Discuss alternatives (4) Decide on action (5) Evaluate
20	Warning Signs for Referral Persistent fears that interfere with daily life Sleep disturbance over weeks Loss of concentration / irritability Behavioral problems that are atypical Increase in physical complaints without cause Withdrawal from friends and family
21	www.mwrarmyhawaii.com Great resource! ACS info Deployment info MWR info