Pediatric psychologist Annette La Greca from the University of Miami in Coral Gables, Florida, has worked with students following disaster situations, including in the months and years following Hurricane Andrew. She spoke with Angela Oddone, MSW, mental wellness program coordinator for the NEA Health Information Network, about the psychological impact that terrorism may be having on students.

What do school staff need to know now?
It's important for educators to recognize that children's reactions unfold over time. An event like this is not something children (or adults) "get over" quickly, especially for those with high levels of exposure to the disaster. The process of recovery -- psychologically and otherwise --will occur very gradually over time.

Beyond initial crisis response, how can school staff help students recover from this experience?
Maintain a balance between sticking to routines and yet being flexible within those routines to respond to kids' needs. That will be key in the weeks and months ahead.

Everyone now is on a fast learning curve in terms of honing their skills at managing stress. By setting an example, school staff can teach students how to give themselves and each other time and permission to focus on the September 11 attacks and all aspects associated with it, including the psychological aspects. Equally important, however, will be teaching how to give ourselves and each other permission and opportunities to experience time off from these events as well.

What do school staff need to know about post-traumatic stress?
Symptoms of post-traumatic stress--for example, difficulties concentrating, greater irritability-- are normal reactions to an abnormal event. I think that is the most important thing of all to keep in mind. We may be experiencing our emotions, our behaviors, and each other in ways that we have never experienced before.

Although stress symptoms [listed in box, top right] may be disconcerting to us at times, it is important to understand and remember that they are normal for a situation such as this one.

How might children's experience of the terrorism compare with that of adults?
Children can show any of the classic stress symptoms that we adults may also be experiencing. In particular, it may be helpful for educators to keep in mind that students may have more difficulty focusing at times. Changes in students' capacities to concentrate and pay attention may occur while they are at school and when they are at home in terms of completing homework assignments.

Some of the changes that we may notice in children will be psychological in nature. But other significant factors could come into play. For example, we might predict that a downturn in the economy may mean that some students will also be having to accommodate other types of adjustments at home, such as a parent's loss of a job.

We in the adult world are now living in an environment that requires us to tolerate an uncomfortable degree of uncertainty. The good news for children and schools is that we can maximize the certainty in children's lives through the routines they ordinarily experience at school. Those routines may also be comforting and helpful to school staff as well.

Can we expect measures like standardized test scores to be affected?
Yes, absolutely. We can expect test scores to be noticeably affected by the impact that terrorism has had on our country, especially for students who lost a family member or friend, or those who have close personal ties to the disaster sites.

From a statistical viewpoint, in some school districts, it may not be meaningful to compare scores from tests taken prior to the September 11 terrorist attacks to scores from tests taken in the months after that event.

When interpreting testing results, it is important to make sure that scores are an accurate indicator of what we are trying to measure. What was true before the terrorist attacks is now just more obvious: far too many variables exist--including those associated with the powerful and extenuating circumstances of our nation being attacked by terrorism-- for standardized tests to truly measure school performance.

One or more of these symptoms may indicate that a child is in distress*:

• Feeling more nervous, jumpy and irritable
• Having more stomachaches, headaches, or other physical complaints
• Greater difficulty concentrating in school (especially due to thoughts or feelings about the disaster, or because of lack of sleep)
• Fearful behavior, especially fear of being alone, being separated from family members, or fear that something bad will happen to a family member
• Extreme worry that
  another bombing/disaster may happen
• Loss of interest in previously preferred and enjoyable activities

* Note: As indicators of post-traumatic stress, these symptoms should be observable as a change that's occurred since the traumatic event occurred.

Recommended Resources

• "Children Experiencing Disasters: Prevention and Intervention" by Annette La Greca in Handbook of Psychological Services to Children and Adolescents (Oxford Press).

Web Sites

• FEMA for Kids-www. fema.gov/kids/-from the Federal Emergency Management Agency.
• Helping Children Cope: A Guide to Helping Children Cope with the Stress of the Oklahoma City Explosion-www.apa.org/ practice/kids.html-from the American Psychological Association.
• "Facts for Families" fact sheets from the American Academy of Child and Adolescent Psychiatry include: "Helping Children After Disaster"-www.aacap.org/publications/factsfam/disaster.htm; and "Post-Traumatic Stress Disorder" - www.aacap.org/publications/factsfam/ptsd70.htm.
• The National Mental Health Association offers tips for parents in talking with their kids about tragedies. Go to http://www.nmha.org/reassurance/children.cfm.