How to support children after a mass casualty event

Devastating tragedies like mass shootings have ripple effects across local communities, our state, and the nation. Similar to adults, children and adolescents are likely to experience a range of emotions after hearing about this potentially traumatizing situation. Below are some tips for caregivers and parents on how to talk to youth in the aftermath of a shooting and help decrease their distress. These tips are meant for caregivers of children ages six and older.

Follow these six S’s below:

1. Provide a sense of safety and security. When the world feels out of control, it can help children to know that the adults surrounding them are there to protect them and keep them safe. It can also be helpful to remind kids of the things they can and do control (e.g., what they choose to eat for breakfast, what activities they do after school, who they spend time with) and help them to distinguish between “kid worries” (e.g., homework) versus “adult worries” (e.g., how to keep kids safe).
2. Use simple and straightforward language. Speak to children in language they can understand. Well-intentioned adults sometimes provide either too much information, which can be overwhelming, or too little information, which can cause further confusion and anxiety. It is best to allow children to guide the conversation as much as possible. For example, a caregiver can say, “You may have heard some very sad news about what happened today. What questions do you have about that?”
3. Provide supervision. Like adults, children and adolescents can feel overwhelmed after repeatedly hearing about the shooting through media outlets. Caregivers can help by monitoring what children are watching on TV, limiting exposure to the news, and answering any questions that come up for them.
4. Maintain structure. In times of chaos, children find comfort in predictability. Stick to a familiar routine as much as possible, such as maintaining regular bedtimes, keeping up with regular family activities, etc. to help reduce distress.
5. Encourage social support. Social support is a major protective factor for adults and children alike during times of stress. Provide opportunities for youth to feel close to family, friends, and those who can provide care and support.
6. Adults should engage in their own self care. Children take their cues from the adults in their lives who can impact their distress. Caregivers should be mindful of their own stress and anxiety levels and ensure they are getting the support they need, whether that means connecting with their own support systems, taking breaks from work or other stressors, or reaching out to a therapist. Caregivers should also be on the lookout for signs that their child may need a higher level of support from a mental health professional. These signs can include:
   1. In younger children (ages 6 to 11): excessive clinginess, separation anxiety, new fears, difficulties eating or sleeping, irritability or angry outbursts, and/or excessive crying.
   2. In older youth or adolescents (ages 12 to 18): nightmares, trouble sleeping, social withdrawal, extreme sadness, risky behaviors (e.g., substance use, reckless driving), and/or self-harm.

The guidelines were developed by Julie Kaplow, PhD, ABPP, Executive Director, Trauma and Grief Center at Children's Hospital New Orleans. Dr. Kaplow also serves as the Executive Director of The TAG Center at the Meadows Mental Health Policy Institute in Houston.