PTSD: National Center for PTSD
Terrorist Attacks and Children
Terrorist Attacks and Children
When terrorist attacks occur, children may witness or learn about these events by watching TV, talking with people at school, or hearing adults discuss the events. For instance, the September 11, 2001, attacks and the Oklahoma City bombing received widespread attention and media coverage and many children were exposed.
How should we speak to children about these events when they occur? Should we shield them from such horrors or talk openly about them? How can we help children make sense of a tragedy that we ourselves cannot understand? How will children react? How can we help children recover? Fortunately, in the US there have been relatively few terrorist attacks.
How Do Children Respond to Terrorism?
Research findings show that many children can be strongly affected by terrorist attacks. In a national sample of adults surveyed three to five days after the September 11th attacks, 35% of parents reported that their children had at least one stress symptom. Almost half reported that their children were worried about their own safety or the safety of a loved one. Two years after the Oklahoma City bombing, 16% of children who lived 100 miles away from Oklahoma City reported significant PTSD symptoms related to the event. This is an important finding because these youths were not directly exposed to the trauma and were not related to people who had been killed or injured.
There is a wide range of reactions that children may display following a terrorist attack. Many symptoms are similar to those experienced following any traumatic event. For information about how children of different ages may respond to trauma, please see PTSD in Children and Adolescents. You will also find information about rates of PTSD in children exposed to other types of trauma.
What Are the Risk Factors for Stress Symptoms after Terrorism?
Findings from a study following the Oklahoma City bombing found that two factors related to increased stress symptoms in children:
- Higher levels of television coverage viewed by the child
- Higher parental distress
This latter finding indicates a relationship between parental and child distress. Other studies indicate that more severe reactions are related to being female and knowing someone injured or killed. In addition, symptoms of arousal and fear presenting seven weeks after the bombing were significant predictors of PTSD.
How Professionals and Parents Can Help Children Cope with Terrorism
Create a safe environment
One of the most important steps you can take is to help children feel safe. If possible, children should be placed in a familiar environment with people to whom they feel close. Keep their routine as regular as possible. Children find comfort in having things be consistent and familiar. Try to limit adult conversations about the event when around the child.
Provide children with reassurance and extra emotional support
Adults need to create an environment in which children feel safe enough to ask questions, express feelings, or just be by themselves. Let children know they can ask questions. Ask children what they have heard and how they feel about it. Reassure the child that they are safe and that you will not abandon them.
Be honest with children about what happened
Provide accurate information, but make sure it is appropriate to their developmental level. Very young children may be protected because they are not old enough to be aware that something bad has happened. School-aged children will need help understanding what has happened. You might want to tell them that there has been a sad accident and that many people have been hurt or killed. Adolescents will have a better idea of what has occurred. It may be appropriate to watch selected news coverage with your adolescent and then discuss it.
Monitor children's exposure to the media
After terrorism or disaster, avoid exposing your child to reminders of the event. This could include scary TV programs or news programs.
Tell children what the government is doing
Reassure children that the state and federal government, police, firefighters, and hospitals are doing everything possible. Explain that people from all over the country and from other countries offer their services in times of need.
Be aware that children will often take on the anxiety of the adults around them
Parents have difficulty finding a balance between sharing their own feelings with their children and not placing their anxiety on their children. For example, the September 11th attack on the United States was inconceivable. Our sense of safety and freedom was shattered. Many parents felt scared and fearful of another attack. Others were angry and revengeful. Parents must deal with their own emotional reactions before they can help children understand and label their feelings. Parents who are frightened may want to explain that to their child, but they should also talk about their ability to cope and how family members can help each other.
Try to put the event in perspective
Although providers and parents may be anxious or scared, children need to know that attacks are rare events. Children also need to know that the world is generally a safe place.
- Schuster, M.A., Stein, B.D., Jaycox, L.H., Collins, R.L., Marshall, G.N., Elliott, M.N., Zhou, A.J., Kanouse, D.E., Morrison, J.L. & Berry, S.H. (2001). A national survey of stress reactions after the September 11, 2001, terrorist attacks. New England Journal of Medicine, 345, 1507-1512.
- Pfefferbaum, B., Nixon, S., Tucker, P., Tivis, R., Moore, V., Gurwitch, R., Pynoos, R., & Geis, H. (1999). Posttraumatic stress response in bereaved children after Oklahoma City bombing. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1372-1379.
- Pfefferbaum, B., Seale, T., McDonald, N., Brandt, E., Rainwater, S., Maynard, B., Meierhoefer, B. & Miller, P. (2000). Posttraumatic stress two years after the Oklahoma City bombing in youths geographically distant from the explosion. Psychiatry, 63, 358-370.
- DeWolfe, D. (2001). Mental Health Response to Mass Violence and Terrorism: A Training Manual for Mental Health Workers and Human Service Workers.
- Pynoos, R. & Nader, K. (1993). Issues in the treatment of posttraumatic stress in children and adolescents. In J.P. Wilson & B. Rapheal (Eds.), International Handbook of Traumatic Stress Syndromes (pp. 535-549). New York: Plenum.
- Monahon, C. (1997). Children and Trauma: A Guide for Parents and Professionals. San Francisco: Jossey Bass.