Helping Children Cope with Stressful Social Events

Dealing with stresses is part of our everyday life in a fast-paced city. These stressors may affect young children albeit they might not yet fully understand what is happening around them. Adults can help to reduce the negative impacts of stress on children by minimising their exposure to stressful circumstances. Nonetheless, it is more challenging to shield children from the latest social unrest in the past few months. For example, children may inadvertently witness media images or overhear conversations, if not arguments, about various incidents among their family members, relatives or even passers-by; their daily routines may also be affected. Their mood and behaviours may also be affected when their caregivers are emotionally disturbed by the social movement. Caregivers often feel concerned and uncertain about how to respond when their children ask about the news, express fear or worry, or re-enact scenes related to the social incidents in play. As a child-related professional, parents may turn to you for advice on how to help young children cope with stressful social incidents.

1. Possible Reactions to a Stress-provoking Event

It is common for younger children to manifest changes in behaviours in face of stressful events1,2, for instance, they may appear clingier than usual, exhibit aggressive or withdrawn behaviours, regress to earlier behaviours (e.g. thumb-sucking, bed-wetting, etc.), show changes in appetite or sleep, or express the events repeatedly in their play or drawing. Preschool children may appear more irritable, non-compliant and have difficulty paying attention and concentrating3. They may also ask questions or discuss the events repeatedly, or use terms associated with the current social context recurrently in daily conversations, which reflects their preoccupation with the issues.

Monitoring and Mitigating Stress Reactions in Children

Caregivers should be reassured that many of the above stress reactions are normal unless they last for a prolonged period of time (2-4 weeks) and cause significant interference with everyday life.1 Studies have also shown that secure and trusting relationships with parents or caregivers could buffer young children against damaging and prolonged stress reactions, and support the development of healthy stress response systems4. Hence, by providing supportive and responsive relationships, caregivers and childcare workers play a vital role in supporting their children's adjustment and enhancing their resilience towards adversities in life in the future.

2. Adult Influence on Children's Perception of Events

In fact, how caregivers and professionals working with children respond to and talk about those incidents would determine how children perceive them, the extent to which they are affected by the social events and how they could adjust accordingly. While infants and toddlers may not be able to comprehend what is happening, they may express similar emotions or behave differently in response to the distress experienced by their caregivers1. Even if adults avoid talking about the incidents in front of their children, the avoidance itself conveys the message that they are too scary or upsetting to be discussed5. Professionals and caregivers should be aware of their own reactions and interpretations of the events and be mindful in how these may affect their children.

3. How to Help Children Cope Emotionally

The key to support children's adjustment is to make sure they feel connected, cared about, and loved2. Regardless of the age of the children, caregivers should be encouraged to help children to adapt by spending more time with them2, strengthening their sense of security and supporting expression of emotions using the following ways6.

(a) Reinforcing Sense of Security

To help younger children feel safe, professionals may suggest caregivers to provide extra comfort through touches, cuddles or let the children stay close to them, adhere to daily routines (e.g. having dinners at fixed time or stick to the usual bedtime routine despite changes in other daily activities), or doing familiar things (such as singing a song or reading a story) together7.

While older children will also benefit from the above strategies, caregivers may also offer verbal reassurance of their company and protection as well as safety of the family. They may also instil sense of predictability by providing prior notice and explanation on changes in daily routines, such as school suspension.6

(b) Supporting Expression of Emotions

To help children adjust emotionally, professionals and caregivers could help by listening emphatically, helping children to articulate their feelings when they struggle with it (e.g. labelling the emotions, providing them with aids such as feelings cards to talk about them), and telling them it is normal and acceptable to have those feelings (e.g. “Many children feel scared when they see something like this happened”, “a lot of things happened, I think you are upset about them”).6, 7

For younger children, they may express their emotions non-verbally through play or drawings. Children who are more emotionally disturbed may express themselves in a repetitive or disorganized manner, or through difficult behaviours.7 Professionals and caregivers need to be sensitive and follow their children's pace in listening to, facilitating and guiding their children's expression of emotions and concerns. Adults should not force children to talk about their feelings when they do not want to2.

(c) Addressing Questions

Children of all ages may also ask questions ranging from literal ones (e.g. why certain places look different) to more sophisticated ones questioning about the motives and moralities of different people involved in the events, or what to expect next. Professionals and caregivers should avoid responding in a hurried and automatic manner; instead, try to explore and identify their underlying emotions and concerns and address them as suggested above. As noted above, adults should also be aware of their own perception, judgement and values before responding to the questions of their children, as they may be inadvertently passed on to their children.

(d) Talking about the Events

While some children may not directly discuss about the events, caregivers may also need to have conversations with their children about the social events especially if they seem somewhat emotionally affected. While caregivers may feel uneasy about having these conversations, professionals may encourage caregivers to discuss difficult events proactively, candidly and calmly in age-appropriate language can help children feel safer and more secure8. This will also provide an opportunity for adults to gently correct any distortions or misunderstanding of the events3.

Before having these conversations, caregivers should mentally prepare or rehearse for them, and start the conversation at a quiet time that was free from distractions8. Adults may start by asking the children what they have already heard, or how they think about what is happening.3,8 Keep the conversations simple and factual without providing details or too much information about tragic circumstances9. Communicate understanding and acceptance of any feelings or worries, and providing reassurance of security as noted in the preceding paragraph could help the children adjust emotionally.

(e) Role-Modelling

Professionals and caregivers may share their emotional reactions with their children, but they should be expressed in language that the children could understand. Adults may express sadness and empathy for people adversely affected, while it is important for them to share ideas for coping when they share their fear and worry, to avoid overwhelming the children with sense of helplessness and hopelessness.3 Most importantly, helping the children's coping through difficult times rely on parental role-modelling2. The ability for caregivers to demonstrate resilience and remain connected and emotionally available to their children would be critical to prevent children from suffering significant stress reactions in the midst of the social events.

4. Parental Self-Care Tips

In order to support children to go through such difficult time, it is crucial for caregivers to take good care of themselves first2,5. Professionals who work closely with families should encourage distressed caregivers to adjust emotionally, by attending to their basic needs (e.g. adequate dietary intake and sleep), practicing relaxation exercise (e.g. diaphragmatic breathing, mindful breathing, guided imagery (only available in Cantonese), progressive muscle relaxation (only available in Cantonese), engaging in activities that they enjoy, reaching out to others for emotional support and sharing of childcare duties, etc. It is also important to limit exposure to news and/or social media on the social unrest to avoid becoming emotionally overwhelmed by the events.

5. Seeking Professional Help

If children or their caregivers are observed to have significant adjustment difficulty and psychological reactions, such as persistent sleep disturbances, significant change in appetite, depressed, withdrawn, or difficulty to concentrate, professional help is warranted. Professionals working with children, e.g. paediatricians, teachers, social workers, etc., should take note of these warning signs and arrange timely referrals to appropriate mental health and/or community services for children and their families whenever deemed necessary.

Local Resources

If the caregivers or children are experiencing heightened stress response in need of professional support, caregivers may approach the following community resources:

Reference

  1. National Child Traumatic Stress Network. (2010). Age-Related Reactions to a Traumatic Event. Retrieved December 24, 2019, from https://www.nctsn.org/resources/age-related-reactions-traumatic-event
  2. SAMHSA (2012). Tips for Talking With and Helping Children and Youth Cope After a Disaster or Traumatic Event – A Guide for Parents, Caregivers, and Teachers. Retrieved December 24, 2019, from https://store.samhsa.gov/product/tips-talking-helping-children-youth-cope-after-disaster-or-traumatic-event-guide-parents/sma12-4732
  3. National Child Traumatic Stress Network (2014). Talking to the Children about Mass Violence. Retrieved December 24, 2019, from https://www.nctsn.org/resources/talking-children-about-mass-violence
  4. Center on the Developing Child (2007). The Impact of Early Adversity on Child Development (InBrief). Retrieved December 14, 2019, from https://developingchild.harvard.edu/resources/inbrief-the-impact-of-early-adversity-on-childrens-development/
  5. American Academy of Pediatrics (2001). Responding to Children's Emotional Needs during Times of Crisis. Retrieved December 14, 2019, from https://www.healthychildren.org/English/healthy-living/emotional-wellness/Pages/Responding-to-Childrens-Emotional-Needs-During-Times-of-Crisis.aspx
  6. National Child Traumatic Stress Network (2012). Psychological First Aid (PFA) Field Operations Guide Appendix E. Retrieved December 24, 2019, from https://www.nctsn.org/resources/psychological-first-aid-pfa-field-operations-guide-appendix-e
  7. National Child Traumatic Stress Network (2005). After a Crisis: Helping Young Children Heal. Retrieved December 24, 2019, from https://www.nctsn.org/resources/after-crisis-helping-young-children-heal
  8. American Psychological Association (2015). How to talk to children about difficult news. Retrieved from https://www.apa.org/helpcenter/talking-to-children
  9. American Academy of Pediatrics. (2019). Talking to children about tragedies and other news events. Retrieved December 24, 2019, from https://www.healthychildren.org/English/family-life/Media/Pages/Talking-To-Children-About-Tragedies-and-Other-News-Events.aspx