The Impact of Trauma on Children

More than one quarter of American children will experience a serious, traumatic event like physical abuse or gun violence before they turn 16. Most events happen at home, in their neighborhoods and at school.

But in the 15 years since the September 11 terror attacks, researchers have found that even events that unfold via media, such as the indelible live images of the collapsing Twin Towers, can also affect children hundreds of miles away.

“We lived 9/11. We watched it happen,” said Robin Gurwitch, Ph.D., a Duke clinical psychologist and member of the National Advisory Committee on Children and Disasters and the National Child Traumatic Stress Network.

“The events changed children’s world view and their sense of safety,” she said. “Children close to the event had significantly higher risk for mental health consequences. But mental health professionals also started to see children that were hundreds of miles away reporting new worries or concerns.”

Before 9/11, psychologists typically considered only children who witnessed trauma or experienced a direct loss to be at higher risk for mental health consequences in the ensuing weeks and months, Gurwitch said. The attacks on 9/11, and the saturation and repetition of those terrifying images, changed that.

“Many children were too young to understand that what they were seeing was the same footage being repeated,” Gurwitch said. “They thought more and more towers were falling.”

The events opened a new sphere of awareness and research on how large-scale crises affect children, she said, including new national resources to address their mental health.

The National Child Traumatic Stress Network (NCTSN) was in its infancy in September 2001, having just received millions of dollars from the Substance Abuse and Mental Health Services Administration (SAMSHA) to support children’s mental health. Immediately after the attacks, SAMSHA and NCTSN began efforts to support children touched by large-scale trauma -- and specifically acts of terrorism.

In addition to providing on-the-ground support during crises, Gurwitch and other experts with the network have trained news media on how to cover tragedy and trauma while considering the minds of their youngest viewers.

The events on 9/11 and the U.S. military response that followed also created a generation of more than 2 million children who have had a parent deployed to Iraq or Afghanistan. Mental health services for these children and families have expanded over the past two decades, Gurwitch said.

“During the Vietnam War, the typical service member was a single man,” Gurwitch said. “Almost 50 percent of service members now are parents, and a majority of them have a child under age 8. These children don’t know anything different than a world where a parent can be deployed, and they won’t see them for months at a time.”

In a new era of digital and social media, children have unprecedented and direct access to images and information -- much of it, unfiltered -- such as recent footage of a police shooting streamed on Facebook Live.

A parent’s first instinct is to shield their child completely. But select information worded in an age-appropriate way can offer children clarity and reassurance, Gurwitch said. Gurwitch, in partnership with the American Psychological Association, offers suggestions for parents in talking to their children:

• Limit exposure to news coverage and social media.
• Start a conversation. Ask children what they know and correct rumors, misinformation and misperceptions.
• Ask how they’re feeling and validate their feelings.
• Recognize that talking about events and sharing their feelings can be difficult; it takes trust, courage, and support to share their thoughts.
• Don’t be afraid to say “I don't know,” to questions such as why someone would commit an act of violence or terrorism. Answer in an age-appropriate way to the best of your abilities.
• Use the events to discuss your values and beliefs about how we treat others.