TUESDAY, April 16 (HealthDay News) -- It's the day after the Boston Marathon bombings and three people are dead, including an 8-year-old boy who came to cheer on friends during the race. The boy's mother and sister are both seriously injured. A nation is on edge -- again. And parents are wondering what to tell their young children and how to help them cope with the carnage.
"If it's a very young child, I would keep him away from TV sets, try to limit their access to the kind of news that I've been watching myself on TV," said Dr. Alan Hilfer, director of psychology at Maimonides Medical Center in New York City.
"As kids get a little older, they take their leads from their parents. If their parents are frightened and anxious, the kids will be frightened and anxious," Hilfer added. "If parents are able to present a calmer [response], the kids will begin to relax more. If the parents reassure the kids that this is something the police and federal authorities are looking into, and they'll figure out who did this and how to deal with it, kids will be less frightened."
By now, children have already seen and heard a lot about the Boston tragedy, noted Dr. Rachel Yehuda, a psychiatrist and post-traumatic stress disorder expert at Mount Sinai School of Medicine in New York City.
"Children already know -- I don't think that parents need to bring up events like this because they'll hear about it from their friends and in their schools, on the news," Yehuda said. "The parent's job is to make the child feel very safe and encourage the child to ask any questions that they have."
On the other hand, Yehuda said, parents should "resist completely minimizing the anxiety, because we do live in a world where it is important to prepare ourselves and our children for adversity. But the idea that bad things happen but you can be safe is a more powerful message than 'don't worry, that can never happen,' which is fictitious and doesn't ultimately serve to calm down a child. You can't go against the reality," she explained.
"'Why would anybody want to do this?' is not only a child's question," she added. "The answer to that is, 'The world is full of different kinds of people and most people are very, very good -- like how we're trying to raise you. But there are some damaged people out there who want to harm innocent people and luckily there aren't too many of them.'"
Sadly, past tragedies -- from the Sept. 11 terrorist attacks in 2001 to the school shooting massacre in Newtown, Conn., in December -- have given health professionals lots of experience dealing with the emotional impact of mass calamities.
"We've learned, unfortunately, from so many other difficult situations that really, what we want to do is provide what we call psychological first aid," said Dr. Victor Fornari, director of child/adolescent psychiatry at North Shore-LIJ Health System in New Hyde Park, N.Y.
Psychological first aid means "just to stabilize emotions, help students' and children's behavior return to normal, and to try to help them re-engage in their usual activities and classroom learning," he said.
"Try to reassure them and return them to their functioning, and really be very active listeners, so that for those who have particular concerns, they can be identified," Fornari added.
Certain young people may be more affected by events like the Boston bombings, Fornari explained.
"Because we know that about 10 percent of the adolescent and child population already experiences an anxiety disorder, people who are already of heightened anxiety may have additional worries," Fornari said. But, in past tragedies "the vast majority of children and families were able to follow whatever the events were, read about them, follow the mourning and the grief period, and return to their activities," he added.
"If parents detect that their child is worrying excessively, they may want to consult their pediatrician or their family physician or another trusted person," Fornari suggested.
The 8-year-old boy killed Monday in Boston was Martin Richard, of Dorchester, Mass. "It touches people in a particularly poignant way when you know that an innocent child died, particularly knowing the circumstances, and just how tragic that is," Fornari said. "We can put a face on that terror."
Adults have their own anxieties to deal with as the world reacts to the events in Boston. U.S. cities including Los Angeles, Washington, D.C., and New York are ramping up police presence in public venues. In London, security arrangements for Prime Minister Margaret Thatcher's funeral on Wednesday are being intensified, the Associated Press reported.
Such very public escalations of security can put people under greater stress. Both Fornari and Yehuda agreed that doing something positive and reaching out to others can help everyone cope. "If kids are impacted, you can allow them to retell the event, either through writing, through artwork," Fornari suggested.
"Children and adults often feel very powerless when this kind of an event occurs," Yehuda said. "But doing something, being positive, is a great way to make a child and an adult feel less helpless and less terrified. A child can always be encouraged to do something positive -- like writing letters to people that are in the hospital, for example, or trying to raise money, or trying to see if there are any kids that we can send something to, to cheer them up."
If you're anxious and on edge, Yehuda said to "try to become part of a problem-solving solution. Within an hour of the explosion yesterday, there was an online social media website in Boston where people offered their homes and their beds, to do things for other people."
Connecting with others helps, too, she said.
"It's an incredibly moving and important aspect of trauma to know that you are in a community where the good really outweighs the bad, and that for every person out there who has an intent to harm, there are millions with the opposite intent," Yehuda said. "So something good can come out of these tragedies. One is, we find our humanity."
Mental Health America has more on helping children cope with tragedy.
SOURCES: Alan Hilfer, Ph.D., director of psychology, Maimonides Medical Center, New York City; Rachel Yehuda, Ph.D., psychiatrist, professor and director, traumatic stress studies division, Icahn School of Medicine at Mount Sinai, New York City; Victor Fornari, M.D., director, division of child/adolescent psychiatry, North Shore-LIJ Health System, New Hyde Park, N.Y.: April 16, 2013, Associated Press
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