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Children and Disaster
Prepared by the Substance Abuse and Mental Health Services Administration
(SAMHSA) Disaster Technical Assistance Center (DTAC), ESI, under contract
with the Emergency Mental Health and Traumatic Stress Services Branch, Center
for Mental Health Services, SAMHSA.
Peer-Reviewed Journal Articles
Baker, D.R. (2002). A public health approach to the needs of children
affected by terrorism. Journal of the American Medical Women’s Association.
57(2): 117-8,121.
Children who have witnessed large-scale disasters exhibit emotional,
physical, and psychological reactions, and the recent terrorist attacks may
have also increased the risks of substance abuse and mental illness. The author
argues that a public health strategy is needed to address the needs of America’s
children.
Barber Starr, N. (2002). Helping children and families deal with
psychological aspects of disaster. Journal of Pediatric Health Care. 16(1):36-9.
This article discusses strategies for nurse practitioners to help
children cope with disasters. The author includes a selection of age-appropriate
resources and offers advice for parents.
Beauchesne, M.A., Kelley, B.R., Patsdaughter, C.A., and Pickard,
J. (2002). Attack on America: Children’s reactions and parents’ responses.
Journal of Pediatric Health Care. 16(5):213-21.
This is a descriptive, qualitative study, following September 11,
about the types of anxiety expressed by children and parents’ response to
children’s concerns.
Bonnerjea, L. (1994). Disasters, family tracing and children’s rights:
Some questions about the best interests of separated children. Disasters.
18(3): 277-83.
This article discusses family tracing in disaster situations, which
may raise issues such as children’s rights and the importance of traditional
coping mechanisms within communities.
Boyden, J. (1994). Children’s experience of conflict related emergencies:
Some implications for relief policy and practice. Disasters. 18(3):54-67.
This paper criticizes the standard relief interventions for traumatized
children, specifically the “apocalypse model,” which interprets relief intervention
as only repair. The author argues for broader recognition of the population
of traumatized children, and modified relief interventions for every emergency.
Breton, J.J., Valla, J.P., and Lambert, J. (1993). Industrial disaster
and mental health of children and their parents. Journal of the American Academy
of Child and Adolescent Psychiatry. 32(2):438-45.
This is a study of families following an industrial disaster on Montreal’s
South Shore in 1988, examining the correlation between the mental health of
parents and their children, and the ability of parents to accurately monitor
a child’s reaction to a disaster.
Bromet, E.J., Goldgaber, D., Carlson, G., Panina, N., Golovakha,
E., Gluzman, S.F., Gilbert, T., Gluzman, D., Lyubsky, S., and Schwartz, J.E.
(2000). Children’s well being 11 years after the Chernobyl catastrophe. Archives
of General Psychiatry. 57(6):563-71.
This is a study evaluating the mental health status of 300 10 to
12-year-old evacuees in Kyiv, Ukraine, who were in utero or infants at the
time of the Chernobyl disaster. Using data obtained from children, mothers,
and teachers, it was determined that the trauma of the disaster was not passed
on to the children.
Broughton, B.K. (2002). Assessing children’s responses to terrorism.
Journal for Specialists in Pediatric Nursing. 7(1):4.
This is a letter to the editor from a nurse at the Children’s Hospital
of Philadelphia calling for more resources on children exposed to disasters,
specifically for nurses.
Clements, Jr., P.T. (2001). Terrorism in America: How do we tell
the children? Journal of Psychosocial Nursing and Mental Health Services.
39(11):8-10.
This is an editorial summarizing the difficulties of providing disaster mental
health services to children.
Coffman, S. (1998). Children’s reactions to disaster. Journal of
Pediatric Nursing. 13(6):376-82.
This is a review of children’s reactions to disasters and subsequent
mental health outcomes such as posttraumatic stress disorder.
Coffman, S. (1996). Parents’ struggles to rebuild family life after
Hurricane Andrew. Issues in Mental Health Nursing. 17(4):353-67.
This is a phenomenological study that discusses a need for nursing
intervention to assist parents in rebuilding family life following the Hurricane
Andrew disaster.
Coffman, S. (1994). Children describe life after Hurricane Andrew.
Pediatric Nursing.20(4):363-8, 375.
This is a nursing study of children left homeless by Hurricane Andrew.
Children revealed negative feelings of uncertainty and stress, but also a
positive sense of maturation.
Cohen, J.A. (2003). Treating acute posttraumatic reactions in children
and adolescents. Biological Psychiatry. 53(9):827-33.
This is a review of trauma-focused, cognitive-behavioral therapy
(TF-CBT) studies of traumatized children who have experienced sexual abuse
within one to six months. The report focuses on the lack of research on the
efficacy of providing early interventions to acutely traumatized children.
Cournos, F. (2002). The trauma of profound childhood loss: A personal
and professional perspective. Psychiatric Quarterly. 73(2):145-56.
This paper examines posttraumatic stress disorder as a long-term effect of
experiencing profound loss in childhood through the author’s personal experience
and recent literature.
Deering, C.G. (2000). A cognitive developmental approach to understanding
how children cope with disasters. Journal of Child and Adolescent Psychiatric
Nursing. 13(1):7-16.
The author applies cognitive developmental theory to case studies
of flood victims to explain how children understand and react to disasters.
Goodman, R.F., Brown, E.J., and Courtney, M. (2002). Helping children
affected by trauma and death. The Harvard Mental Health Letter. 18(12):4-5.
This article discusses the New York University Child Study Center
that is servicing 5,000 traumatized children and 500 bereaved children of
September 11 first responders. The author includes an overview of outreach
materials, diagnostic tools, and lessons from the literature.
Green, B.L., Grace, M.C., Vary, M.G., Kramer, T.L., Gleser, G.C.,
and Leonard, A.C. (1994). Children of disaster in the second decade: A 17-year
follow-up of Buffalo Creek survivors. Journal of the American Academy of Child
and Adolescent Psychiatry. 33(1):71-9.
This is a long-term follow-up of child survivors of the Buffalo Creek
dam collapse. Findings indicate that the children had recovered, and that
increases in substance abuse were minimal. The study utilized the Psychiatric
Evaluation Form, the Impact of Event Scale, the SCL-90, and the Structured
Clinical Interview for DSM-III-R.
Hanze, D. (2002). How to help children and adolescents deal with
the threat of terrorism. Journal for Specialists in Pediatric Nursing. 7(1):42-4.
This editorial discusses how to work with children’s fears and anxieties,
and how to treat children who have been severely traumatized.
Harbison, S. and Novak, J.C. (2002). Bioterrorism, children, and
the United States’ health and security. Journal of Pediatric Health Care.
16(5):265-6.
The author details the Bioterrorism Preparedness Act, which establishes
initiatives such as national preparedness and response planning, development
of national stockpiles, enhancement of controls on dangerous biologic agents,
and protecting the safety of the water supply. This preparedness planning
is contrasted with the national nursing shortage and an impending public health
crisis if it is not resolved.
Hoven, C.W., Duarte, C.S., and Mandell, D.J. (2003). Children’s
mental health after disasters: The impact of the World Trade Center attack.
Current Psychiatry Reports. 5(2):101-7.
This is a literature review of systematic studies published between 1999–2002
of posttraumatic stress disorder (PTSD) reactions in children. The paper further
predicts emerging literature following the September 11 attacks, and a revitalization
of the PTSD field.
Jeney-Gammon, P., Daugherty, T.K., Finch, Jr., A.J., Belter, R.W.,
and Foster, K.Y. (1993). Children’s coping styles and report of depressive
symptoms following a natural disaster. The Journal of Genetic Psychology.
154(2):259-67.
Discussed within the context of competing theories of childhood depression,
the study examined the correlation between children’s coping strategies and
subsequent depressive symptoms following exposure to a disaster.
Jones, R.T., Ribbe, D.P., Cunningham, P.B., Weddle, J.D., and Langley,
A.K. (2002). Psychological impact of fire disaster on children and their parents.
Behavior Modification. 26(2):163-86.
This study measured the short-term mental health status of families victimized
by a major wildfire. The high-loss group, determined by a Resource Loss Index,
exhibited greater posttraumatic stress disorder (PTSD) symptoms than the low-loss
group. PTSD symptoms were also significantly correlated between parents and
their children.
Klingman, A., (2001). Israeli children’s reactions to the assassination
of the Prime Minister. Death Studies. 25(1):33-49.
The study employed the Bar-Ilan Picture Test for Children with fourth-grade
Israeli children two days following the assassination of Prime Minister Yitzhak
Rabin. Children’s responses are similar to the findings of epidemiological
studies of trauma and disaster.
Koplewicz, H.S., Vogel, J.M., Solanto, M.V., Morrissey, R.F., Alonso,
C.M., Abikoff, H., Gallagher, R., and Novick, R.M. (2002). Child and parent
response to the 1993 World Trade Center bombing. Journal of Traumatic Stress.
15(1):77-85.
This study compared children who had been in the World Trade Center bombing
in 1993 with a control group using the Posttraumatic Stress Reaction Index
and a Fear Inventory. Parents of the traumatized children were also interviewed.
The exposed children exhibited symptoms of posttraumatic stress disorder and
disaster-related fears.
La Greca, A., Silverman, W.K., Vernberg, E.M., and Prinstein, M.J.
(1996). Symptoms of posttraumatic stress in children after Hurricane Andrew:
A prospective study. Journal of Consulting and Clinical Psychology. 64(4):712-23.
This study employed five factors in a conceptual model to evaluate the evidence
of posttraumatic stress disorder in third to fifth-grade children during the
school year following Hurricane Andrew.
Laor, N., Wolmer, L., Spirman, S., and Wiener, Z. (2003). Facing
war, terrorism, and disaster: Toward a child-oriented comprehensive emergency
care system. Child and Adolescent Psychiatric Clinics of North America. 12(2):343-61.
The authors advocate for an ecological systems approach for children affected
by disasters, appealing to institutions of health, education, and government
to cooperate and network on local, national, and international levels to increase
awareness and lessen the impact of disasters on children.
Leavitt, L.A. (2002). When terrible things happen: A parent’s guide
to talking with their children. Journal of Pediatric Health Care. 16(5):272-4.
This is a handout to be used by pediatric nurse practitioners to provide advice
to parents regarding how to help their children in a disaster. The handout
is divided into age brackets and offers guidance in recognizing signs of stress
in children.
Libow, J.A. (1992). Traumatized children and the news media: Clinical
considerations. The American Journal of Orthopsychiatry. 62(3):379-86.
This article appeals for clinical research to determine the extent of the
news media’s effect on child victims of disasters.
Lonigan, C.J., Shannon, M.P., Taylor, C.M., Finch, Jr., A.J., and
Sallee, F.R. (1994). Children exposed to disaster: II. Risk factors for the
development of post-traumatic symptomatology. Journal of the American Academy
of Child and Adolescent Psychiatry. 33(1):94-105.
This study assessed levels of stress anxiety in children following Hurricane
Hugo. Using the Posttraumatic Stress Disorder Reaction Index, 5,687 school-aged
children were surveyed regarding their experiences and reactions. Results
indicate higher rates of posttraumatic symptoms in females and younger children.
Luna, J.T. (2002). Collaborative assessment and healing in schools
after large-scale terrorist attacks. International Journal of Emergency Mental
Health. 4(3):201-8.
This article provides a guide to expanding school and community-based Critical
Incident Stress Management (CISM) programs in schools to conduct large-scale
assessments and action plans in response to the September 11 terrorist attacks.
McDermott, B.M. and Palmer, L.J. (1999). Post-disaster service provision
following proactive identification of children with emotional distress and
depression. The Australian and New Zealand Journal of Psychiatry. 33(6):855-63.
This is a proactive study of traumatized students in western Australia, six
months following a bushfire, was conducted to identify the students most in
need of limited therapeutic resources. The identified students exhibited emotional
distress associated with the evacuation experience, trait anxiety, and fear
of losing a parent.
McLellan, F. (2001). Psychologists warn of effects on bereaved children
after U.S. terrorist attack. Lancet. 358(9288):1168.
This editorial discusses the release of emergency mental health funding from
the Federal government to serve the thousands of bereaved children from the
September 11 attacks.
Melnyk, B.M., Feinstein, N.F., Tuttle, J., Moldenhauer, Z., Herendeen,
P., Veenema, T.G., Brown, H., Gullo, S., McMurtie, M., and Small, L. (2002).
Mental health worries, communication, and needs in the year of the U.S. terrorist
attack: National KySS survey findings. Journal of Pediatric Health Care. 16(5):222-34.
Keep your children/yourself Safe and Secure (KySS), a national campaign by
the National Association of Pediatric Nurse Associates and Practitioners (NAPNAP),
conducted a national survey that determined a need for children/teens and
their parents to communicate more freely with each other and with their medical
providers to create opportunities for mental health interventions.
Milgram, N. and Toubiana, Y.H. (1996). Children’s selective coping
after a bus disaster: Confronting behavior and perceived support. Journal
of Traumatic Stress. 9(4):687-702.
This study evaluated data obtained from 675 seventh graders following the
deaths of 19 and injury of 14 classmates in a traffic accident. Results indicate
that personal loss and situational variables affected confronting behavior
and stress reaction levels.
Patt, H.A. and Feigin, R.D. (2002). Diagnosis and management of suspected
cases of bioterrorism: A pediatric perspective. Pediatrics. 109(4):685-92.
A collection of fact sheets, diagnostic and treatment information, educational
resources, and emergency contacts is provided for medical professionals in
pediatrics regarding potential bioterrorism cases.
Pfefferbaum, B., Sconzo, G.M., Flynn, B.W., Kearns, L.J., Doughty,
D.E., Gurwitch, R.H., Nixon, S.J., and Nawaz, S. (2003). Case finding and
mental health services for children in the aftermath of the Oklahoma City
bombing. The Journal of Behavioral Health Services and Research. 30(2):215-27.
The article summarizes the findings of an Oklahoma City bombing study of traumatized
middle school children seven weeks following the disaster, as well as the
role of school social services. Posttraumatic stress symptoms are associated
with the initial response to the disaster and subsequent television media
exposure.
Pfefferbaum, B., Doughty, D.E., Reddy, C., Patel, N., Gurwitch, R.H.,
Nixon, S.J., and Tivis, R.D. (2002). Exposure and peritraumatic response as
predictors of posttraumatic stress in children following the 1995 Oklahoma
City bombing. Journal of Urban Health. 79(3):354-63.
A study of 2,000 middle school children seven weeks after the Oklahoma City
bombing determined that one’s initial peritraumatic exposure is a strong indicator
of posttraumatic stress over time.
Pfefferbaum, B., Nixon, S.J., Tivis, R.D., Doughty, D.E., Pynoos,
R.S., Gurwitch, R.H., and Foy, D.W. (2001). Television exposure in children
after a terrorist incident. Psychiatry. 64(3):202-11.
Within the context of emotional and physical exposure to the Oklahoma City
bombing, this study of 2,000 middle school children in Oklahoma City revealed
an association between the exposure to bomb-related television viewing and
posttraumatic stress disorder (PTSD) symptomatology. The article advocates
for research to determine whether television viewing predicts PTSD symptoms
in children.
Pfefferbaum, B. (1997). Posttraumatic stress disorder in children:
A review of the past 10 years. Journal of the American Academy of Child and
Adolescent Psychiatry. 36(11):1503-11.
This is a literature review of posttraumatic stress disorder (PTSD) in children,
specifically addressing factors such as comorbidity, gender, age, developmental
level, cultural competence, and children’s response to disaster. The author
further summarizes the assessment, treatment, and clinical presentation of
PTSD over the past decade, and addresses the lack of longitudinal research.
Pine, D.S. and Cohen, J.A. (2002). Trauma in children and adolescents:
Risk and treatment of psychiatric sequelae. Biological Psychiatry. 51(7):519-31.
This is a literature review summarizing research on factors that predict psychiatric
consequences in children exposed to trauma, as well as the positive outcomes
of cognitive behavioral therapy (CBT) in children victimized by sexual abuse.
The review advocates for CBT as a tool to ease anxiety symptoms in children
exposed to terrorism.
Poster, E.C. (2002). Helping children respond to 9/11. Journal of
Child and Adolescent Psychiatric Nursing. 15(2):43-7.
This is a collection of letters from clinicians in the field responding to
children and schools after September 11.
Pynoos, R.S., Goenjian, A.K., and Steinburg, A.M. (1998). A public
mental health approach to the postdisaster treatment of children and adolescents.
Child and Adolescent Psychiatric Clinics of North America. 7(1):195-210.
This article extols the importance of mental health intervention programs
for children exposed to disaster and guides mental health officials in implementing
triage and treatment procedures.
Schonfeld, D.J. (2002). Almost one year later: Looking back and looking
ahead. Journal of Developmental and Behavioral Pediatrics. 23(4):292-4.
A commentary discussing the developmental-behavioral pediatrics field in the
year following September 11, 2001. The author advises parents on how to talk
to their children about anniversary events and provides guidance to teachers
on addressing grief in the classroom.
Seidman, R.Y., Hutchinson, B., Buckner, S.K., Myers, S.T., Miller-Boyle,
D., MacRobert, M., and Heath, S. (1998). The response of children to disaster.
The American Journal of Maternal Child Nursing. 23(1):37-44.
A study of children’s reactions to the Oklahoma City bombing, obtained through
the analysis of a random sample of 1,005 items sent to the Children’s Hospital
of Oklahoma from classrooms, church groups, and individuals across the country.
The letters, pictures, stories, jokes, and journals gave researchers insight
into the grieving process of children nationwide.
Shaw, J.A. (2003). Children exposed to war/terrorism. Clinical Child
and Family Psychology Review. 6(4):237-46.
The article discusses the prevalence of psychological morbidities in children
exposed to war or terrorism, specifically in the context of child soldiers,
effects of parental absence, refugee status, and traumatic bereavement. The
psychological reactions of war-related stressors are outlined, as well as
possible indicators of posttraumatic stress disorder. Future research topics
are recommended.
Shaw, J.A., Applegate, B., and Schorr, C. (1996). Twenty-one month
follow-up of school-age children exposed to Hurricane Andrew. Journal of the
American Academy of Child and Adolescent Psychiatry. 35(3):359-64.
A study examining the posttraumatic stress symptoms in 30 school-age children,
exposed to Hurricane Andrew, over a 21-month period using Pynoos’ Posttraumatic
Stress Disorder Reaction Index and Achenbach’s Teacher’s Report Form.
Stoppelbein, L. and Greening, L. (2000). Posttraumatic stress symptoms
in parentally bereaved children and adolescents. Journal of the Academy of
Child and Adolescent Psychiatry. 39(9):1112-9.
A study comparing posttraumatic stress symptoms between a parentally bereaved
group of children, a disaster group, and a non-trauma control group. Parentally
bereaved children reported more posttraumatic stress symptoms than the other
two groups.
Stuber, J., Fairbrother, G., Galea, S., Pfefferbaum, B., Wilson-Genderson,
M., and Vlahov, D. (2002). Determinants of counseling for children in Manhattan
after the September 11 attacks. Psychiatric Services. 53(7):815-22.
A study of children living in Manhattan during the September 11 attack, who
received counseling, revealed that their parents’ own level of posttraumatic
stress determined the extent of the child’s counseling. A discussion of school-based
counseling is included.
Swick, S.D., Jellinek, M.S., Dechant, E., and Belluck, J. (2002).
Children of victims of September 11th: A perspective on the emotional and
developmental challenges they face and how to help meet them. Journal of Developmental
and Behavioral Pediatrics. 23(5):378-84.
This article advises parents of bereaved children of September 11 victims
on the role of the surviving parent, depression in children, the influence
of the nature of the parent’s death, and developmental concerns. The authors
promote resiliency and grief counseling.
Veenema, T.G. and Schroeder-Bruce, K. (2002). The aftermath of violence:
Children, disaster, and posttraumatic stress disorder. Journal of Pediatric
Health Care. 16(5):235-44.
The article describes the relationship between children who have been exposed
to trauma and posttraumatic stress disorder (PTSD) and various symptoms of
PTSD.
Wolmer, L., Laor, N., and Yazgan, Y. (2003). School reactivation
programs after disasters: Could teachers serve as clinical mediators? Child
and Adolescent Psychiatric Clinics of North America. 12(2):363-81.
The article proposes a solution to the avoidance of treatment by posttraumatic
stress disorder victims by employing teachers as mediators in large-scale
interventions within schools.
SAMHSA and Other Publications
SAMHSA’s National Mental Health Information Center
Center for Mental Health Services
Age-specific Interventions at Home for Children in Trauma: From Preschool
to Adolescence
SAMHSA’s National Mental Health Information Center
Center for Mental Health Services
Cómo ayudar a los niñosa vérselas con el miedo y
la ansiedad
SAMHSA’s National Mental Health Information Center
Center for Mental Health Services
Helping Children Cope With Fear and Anxiety
SAMHSA’s National Mental Health Information Center
Center for Mental Health Services
How Families Can Help Children Cope with Fear and Anxiety
SAMHSA’s National Mental Health Information Center
Center for Mental Health Services
Reaction of Children to a Disaster
American Academy of Pediatrics
Family Readiness Kit: Preparing to Handle Disasters
National Institute of Mental Health
Helping Children and Adolescents Cope with Violence and Disasters
State Program Materials
California FEMA Crisis Counseling Program
Coping Strategies for Adolescents After a Disaster
California FEMA Crisis Counseling Program
Helping Children After a Disaster
Florida FEMA Crisis Counseling Program
Checklist for Parents: Did the Disaster Affect Your Child?
Guam FEMA Crisis Counseling Program
Teaching Aids for Emotional Recovery After a Disaster
Missouri FEMA Crisis Counseling Program
Children’s Responses to Trauma: Preschool Through Second Grade
Pennsylvania FEMA Crisis Counseling Program
…And the Next Day, the Kids Came to School: Lesson Plans for Teachers
Texas FEMA Crisis Counseling Program
My Disaster Book
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