1	Helping Children Cope in Stressful Times Laura Epstein, M.S. School Psychologist Jarrett Horibata, M.S. School Psychologist Ann Sato, SBBH Resource Teacher
2	Learning Objectives Understand stress reactions and be able to identify when students are using maladaptive and adaptive coping strategies Learn what information is appropriate to share with students Learn how this information is to be communicated How to identify when students need assistance
3	Learning Objectives How to take care of yourself during these stressful times Learn what long term psychological problems may develop Learn what can be done to prevent these problems from occurring Learn how life will change at school, home and in the community and how students can deal with these change Learn what the role is of the entire school staff in helping students through this difficult time
4	Factors Associated with Degree of Psychological Distress Experienced Exposure Relationships Initial Reactions Perceived Threat Personal Factors Related to Severe Distress(family factors, social factors, mental health, developmental level, previous disaster experience)
5	What to look for in preschool students Thumb sucking Bedwetting Clinging to parents Sleep disturbances Loss of appetite Fear of the dark Regression in behavior Withdrawal from friends and routines
6	What to look for in elementary school children Irritability aggressiveness Clinginess Nightmares School avoidance Poor concentration Withdrawal from activities and friends
7	What to look for in Adolescents Sleeping and eating disturbances Agitation, increase in conflicts Physical complaints Delinquent behavior Poor concentration
8	Who are the most vulnerable children? Close proximity to targeted or “high” target areas Suffered first hand exposure Parents are active duty or reservists Parents are veterans of the Gulf War Parents are first responders Of non-US origin Suffer from a pre-morbid(pre-existing) condition
9	What is the best formula for helping kids cope? Appropriate guidance Caring Adults Development of critical emotional and cognitive coping skills
10	What can adults do to help? First and foremost….take care of your own needs Talk to other adults Take care of your physical health (proper nutrition, rest, exercise) Make time, however small, to do things you enjoy Focus on your strengths Limit your television time Maintain a normal routine Have a family plan
11	Model calm and control Avoid appearing anxious or frightened Provide structure Honestly express own emotions in a matter of fact way
12	Acknowledge and normalize their feelings Listen and empathize Emphasize other people’s resiliency Be optimistic
13	Reassure Children’s Sense of Safety and Security Reminders that trustworthy people are in charge Engage children in enjoyable activities that reinforce stability and normalcy Stress that emergency workers, federal law enforcement and schools are working together to provide safety and security
14	What can teachers do in the classroom? Elementary school children need brief, simple information and need reassurances that the daily structures of their life won’t change Upper elementary children and early middle school children are typically more vocal about asking questions (we need to be prepared for these questions) and might need assistance separating reality from fantasy
15	What can teachers do in the classroom? Upper middle and high school students typically display strong and varying opinions, may want to share concrete safety and prevention suggestions and are typically more committed to help affected victims All students should be encouraged to verbalize their thoughts and feelings
16	Teachers can… Take time to think about difficult issues (how do you want to frame events and your reactions to them?) Don’t be afraid to say “I don’t know” Listen to what students talk about Know who has family overseas Make time for class discussion (or activities if the children are young such as journals, bulletin boards and recording on a calendar deployments of parents)
17	Teachers can…. Integrate current events into social studies/geography, if appropriate Help children explore and express their opinions respectfully Facilitate communication with loved ones Be available and “askable” Help students to do something to help others Make scrapbook of educational progress while parent is away Take pictures of events and projects for child to send to parent
18	Preventive Measures Maintain as normal a routine as possible Expect behavioral regression Expect expressions of separation anxiety Anticipate that children with special needs or mental health issues may decompensate more easily Know the signs of children’s mental or emotional distress Be aware of potential impacts of large group discussions (differing opinions) Stop teasing, harassment, bullying, immediately
19	Keep Informed of Current Events Know the facts about the developments in current deployment as well as protections against terrorism at home Don’t speculate Prepare to answer questions factually Be prepared to actively guide discussion about difficult issues
20	Considerations for students with cognitive limitations Children with developmental or cognitive impairments may not understand events or their own reactions to events and images These students tend to respond based more on observations of adult and peer emotions Discussions need to be specific, concrete and basic
21	Considerations for Emotionally Disturbed Students These students already have limited coping skills with which to handle “normal” daily stress Pre-existing depressive and anxiety disorders are likely to be exacerbated (greater withdrawal, heightened agitation, increased feelings of worthlessness and despair, increase in nervous behaviors such as thumb sucking, nail biting, pacing,sleep problems)
22	Considerations for Emotionally Disturbed Students Children with a history of suicidal thinking or behavior are especially prone to increased feelings of hopelessness and need to come to the attention of school personnel For students with severe behavior disorders, stressful current events could trigger maladaptive externalizing responses (behavioral outbursts without obvious cause, fights at school or home, substance abuse, disobedience)
23	Warning Signs for Referral for Additional Assistance 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
24	Where to go for help School counselors SBBH therapists School Psychologists Counseling services provided by the military
25	Resources www.mwrarmyhawaii.com (this site has information from the military including counseling services and other special programs for children with deployed parents) American Academy of Child and Adolescent Psychiatry (http://aacap.org) American Red Cross (http://www.redcross.org) American School Counselors Association (www.schoolsounselor.org) American Psychological Association (www.apa.org)
26	Resources Federal Emergency Management Agency (http://www.fema.org/) National Association of School Psychologists (www.nasponline.org) National Center for Post Traumatic Stress Disorder (www.ncptsd.org/facts/specific/fs_children.html)
27	References Helping Children Cope in Unsettling Times, Tips for Parents and Teachers (NASP handout) Effects of Deployment on Children Adolescents (power point presentation from Tripler Army Medical Center, Child and Adolescent Psychiatry Service) Helping Children Cope in Unsettling Times (power point presentation from Leeward SBBH staff)