We hear it on the news almost every day in this country – another shooting with casualties at a workplace, worship site, store, or school. Gun violence has risen to the forefront of public consciousness and now is considered a public health crisis.
In 2018, gun violence became the leading cause of death for all children and teens ages 1 to 19, surpassing motor vehicle accidents for the first time in history. In 2019, 3,371 American children and teens were killed with guns – enough to fill more than 168 classrooms of 20. The Child Welfare League of America (CWLA) reports that more than 25% of children witnessed an act of violence within the last year, and more than 5% witnessed a shooting.
And while mass shootings grab the headlines and fleeting public and policymaking attention, routine gunfire takes the lives of nine children and teens every day of the year in this country.
As these events become more and more common, the collective toll it is taking on the psychological health of American children continues to grow. Although those directly affected by gun violence have received attention, far less attention has been paid to the social, emotional, physical, and mental health impact of gun violence on those traumatized by it – especially children and adolescents.
How to Start the Conversation With Your Child
When an episode of mass violence happens, you may want to just forget about it. But if your child knows about it, you should discuss it.
“Bad news is always best delivered by a parent or other trusted adult,” says Chelsea N. Grefe McCann, PsyD, program director, Behavioral Science Division, UPMC Children’s Hospital of Pittsburgh and a child psychologist with the Whole Child Wellness Clinic. “Children model their reactions and behaviors after the adults around them, so be mindful of your own emotions and reactions as you give information.”
Dr. Grefe says parents and caregivers need to consider not only the age of the child but their developmental and cognitive levels when talking about these events. “You know your child best. Give the amount of information your child needs,” she adds.
For example, if your child is very young and not likely to know about or be exposed to information about the incident, you may not need bring it up. Or if your child is prone to anxiety, you might limit the details because more information can worsen anxiety. Monitoring your own use of media, including in the car, might be needed to avoid overexposing delicate ears.
“To get the conversation going with an older child or preteen, a parent or caregiver might say, ‘I’d like to talk to you about something scary that happened today. Someone came into a school and hurt some teachers and students. What have you heard about it? What questions do you have?'” says Dr. Grefe.
If your child’s information is wrong, correct inaccuracies with honest answers without lots of detail to prevent misinformation. It’s also important to validate their emotions toward the incident so they know it is normal to have strong feelings about it.
“Allow your child to ask questions,” she says. “Kids might have very specific questions that you can answer to reassure them, but it’s also ok for parents to say, ‘I don’t know.'”
The Child Mind Institute recommends that parents and caregivers help children cope with a traumatic event by listening with understanding, staying in control of their own emotions with breathing techniques, and responding with specific, age-appropriate language when talking with children.
The worst response is not to talk about it, Dr. Grefe says. “If kids have questions and we don’t answer them, we’re sending the message that we shouldn’t talk about these things. Then kids may get an even worse image in their minds than the real situation.”
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Fears About Safety
If your child has fears of gun violence happening to them at their school, reassure them and explain to them the specific steps your school has taken to keep them safe.
“Know your school’s safety response,” adds Dr. Grefe. “Find out the specific steps your school has taken to keep kids safe, such as closed vestibules, lockdown drills, and safety procedures. Make sure kids know to call 911 and that police will come. Many schools may also have security officers to help keep them safe.”
Older children with lingering concerns can gain some of their power back by becoming an advocate. Tell them to speak up: “If you see something, say something.” Let them know that they should tell a teacher or trusted adult if they see a classmate exhibiting disturbing or threatening behaviors, mood swings, or behavior changes; engaging in risky behaviors or substance use; or making online threats, so their peer can get help.
Children might express sadness and worry about the students who lost their classmates or families who lost their children. Writing letters and cards or drawing pictures for kids and loved ones of victims can help children feel empowered by helping. Taking part as a family in prayer vigils, memorials, donations to causes, activism, and other forms of support also can make children feel empowered and part of a community doing something to help.
Emotional and Behavior Changes
Children and adolescents who have experienced or been exposed to gun violence often turn to trusted adults, such as parents, teachers, and other caregivers, for information, comfort, and help. Many different reactions are common after episodes of violence. Here are some common symptoms of trauma to watch for so you can support your child and yourself.
According to the National Child Traumatic Stress Network, some reactions you might see in your child include:
- Symptoms of PTSD, such as anxiety, fear, and worry.
- Sleep changes – nightmares, not wanting to sleep in their own bed.
- Irritability or anger.
- Sadness or grief.
- Changes in academic progress.
- Regression in behaviors – such as bedwetting, separation anxiety, using baby talk.
- Withdrawal from engagement and activity with peers.
- Strong reaction to reminders or increased sensitivity to sounds.
“Traumatic stress symptoms are a normal response to a significant adverse event,” says Dr. Grefe. “If your child witnessed the event, knew someone who died, or heard about it on the news – those are three different levels of adverse event experience. Parents and caregivers need to monitor their children to see how they’re coping.”
Things Parents Can Do to Help
Some ways parents and caregivers can help young people get through acts of violence include:
- Being mindful of your own reaction because kids take the lead of adults. You may have to monitor your own emotional response around your children.
- Limiting kids’ exposure to media, TV, podcasts, and conversations.
- Keeping to your household’s regular routines, schedules, and rules as much as possible.
- Allowing conversations to happen naturally. Kids may be reflective, needing time to process the information and bring it back home before they talk about it.
- Offering reassurance.
“Some children may repeatedly ask questions needing reassurance,” says Dr. Grefe. “A hug and words of reassurance can go a long way.”
When to Seek Help
Over time, reactions to the violence should start to lessen. But call your child’s doctor if serious symptoms develop. Serious symptoms of trauma include:
- Safety concerns — threatening self-harm or harm to others.
- Panic attacks.
- Seeing things.
- Hearing voices.
If your child is still showing persistent symptoms of trauma reaction after several weeks or if they exhibit any of these serious symptoms, make an appointment with a child mental health professional.
From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.