Durham, N.C. - As Halloween approaches, children are seeing images of monsters, ghosts and gruesome scenes on a daily basis. For most kids, these images are just good, scary fun. But for some small children, they can be terrifying. Liz Rende, a pediatric nurse practitioner in the Division of Pediatric Neurology at Duke University Medical Center, says parents need to pay special attention what to kids see at this time of year.

"For the younger child who has difficulty discerning what's real and what's pretend, parents need to limit the child's exposure to TV commercials. A three- or four-year-old shouldn't go to a haunted house, which can be overwhelming and certainly frightening."

Rende says if your child has a Halloween nightmare, give comfort and reassurance, and talk about it together the next day. If nightmares persist past Halloween season, she suggests that you consult your pediatrician.

"By age six or seven, most children are able to discern what's real and what's pretend. But certainly in a younger, preschool-age child, they do not have that ability. The world of pretend is quite real to them."

I'm Cabell Smith for MedMinute.