AHA News: How to Take Care of Kids When a Natural Disaster Strikes

THURSDAY, July 21, 2022 (American Heart Association News) -- The day Reina Pomeroy unintentionally became an expert on how natural disasters affect children began pleasantly enough.

On that sunny December morning, she and her husband, David, had taken their sons, ages 7 and 2, out for a hike near Boulder, Colorado. Fierce winds sent them back to their home in nearby Louisville, which they had moved into about five months earlier.

Around 11:30 a.m., as they were attempting to settle their youngest down for a nap, Reina noticed the sun had turned from yellow-white to "fire-sky orange," a hue she knew from growing up in California. Her husband soon confirmed – a smoky blaze had broken out in parched grasslands to the west.

Within 45 minutes, the Pomeroys were thinking about evacuating. Reina told their older son, "If we can never come back here, what would you want?" He grabbed his stuffed bear and his blanket.

Outside, the wind was tossing garbage cans around like tumbleweeds. The smoke became so thick she could not see across the street. By 1:35 p.m., the Pomeroys were fleeing in their SUV.

That night, when the car they abandoned in their garage alerted them the temperature had hit 200 degrees, they knew their house was burning. As the adults grappled with the news, their 7-year-old watched. "My son saw me lose it," Reina said. "There was not like a strategic, 'Here's how we talk to our kids about the thing.' It was more, 'Here's how I'm reacting.'"

The Dec. 30 Marshall Fire, which killed two people and destroyed nearly 1,100 homes, was a personal calamity for Pomeroy and her family. But her experience in having to guide her children through disaster is hardly unique.

Each year worldwide, an estimated 175 million children are affected by natural disasters. And as the U.S. enters the peak time for hurricanes, wildfires and more that some scientists call "Danger Season," experts say it's important to understand children's needs.

Children are particularly vulnerable to long-term consequences from disasters, said Betty Lai, an associate professor in Boston College's counseling, developmental and educational psychology department. "Because youth are still growing and still gaining experiences on how to deal with the world, experiencing a disaster event at a young age can have a larger impact on youth than it might on adults," said Lai, author of several studies about how disasters affect kids.

Disruptions to everyday life can have an exaggerated effect on children, said Dr. Justin Zachariah, a pediatric cardiologist and associate professor at Baylor College of Medicine and Texas Children's Heart Center in Houston.

"While all people may be creatures of habit, children specifically rely on structure as a foundation for the rest of their lives," said Zachariah, who helped write a 2017 American Heart Association scientific statement on childhood and adolescent adversity. A disaster can upend everything children require to thrive – home, family, schools, neighborhoods and connections with friends.

A child's perception of danger can be a significant predictor of long-term response to a disaster. Lai said children can suffer stress even if their lives are never directly at risk, if they have to change schools or a parent loses a job.

Children's responses vary greatly, Zachariah said. Some might appear unaffected, while post-traumatic stress can lead others to shut down or become hyper-responsive.

Both mental and physical health can suffer. Studies have associated childhood adversity with long-term risk of heart attacks, strokes and other problems. Traumatized children might have sleep issues or nightmares, Lai said. They might struggle in school because of missed classes or develop difficulty concentrating. Symptoms can last for years.

A disaster does not need to mark a child for life, though. Children "are often a lot more resilient than we give them credit for," Zachariah said.

Studies show that most children can bounce back. But not all do. So adults need to stay alert for difficulties, Lai said.

They also need to set the emotional tone. "Children's response to a disaster is heavily predicated on their parents' response to that disaster," Zachariah said.

The younger kids are, the more they will look to a parent as to how concerned they should be, he said. "If you have a young child going through a natural disaster, but that young child's basic needs are being met and the parent is not exerting or exhibiting any signs of distress, the child may not pick up that there's something going on."

Parents have to walk a tightrope when dealing with scary realities. Zachariah recommends "as much honesty as is appropriate" to the parent-child relationship. An older child can handle more transparency than a young one. Hiding harsh facts, though, "is generally going to be an exercise in futility, because the kids will figure it out," he said.

Lai agreed. "We know that children are very perceptive," she said. "So even if you don't say it, they may understand that something big is happening. And it can become even scarier for children to not have something be discussed."

After a disaster, getting children back into their routines is crucial, she said. "Routines are very comforting and provide structure for children, and also their families."

Children also need opportunities to express themselves, Zachariah said. "Developmentally and neurobiologically, they may not be able to bring those things that are in their subconscious to their conscious awareness." But a parent can ask a child to draw a picture or write a story about how they are feeling. Those might reveal irrational thoughts that would not occur to an adult – such as fear that a disaster was punishment for something the child did.

Teachers can provide guidance about when it may be time to seek professional help such as counseling, Lai said.

She and Zachariah said parents can help kids by taking care of themselves. That ensures parents "have the reserve to deal with the unexpected challenges and guide the kids through those changes," Zachariah said.

Parents don't have to hide their own feelings, Lai said. "Modeling how you seek support yourself, and connecting with them over your shared grief and shared feelings, can be very helpful."

In Colorado, Reina has spent her year juggling such issues.

She co-founded Marshall Together, a support network for Marshall Fire survivors. Today, as construction on their new home begins, she and her husband talk about events in age-appropriate ways with the boys. (She asked that their names not be used to protect their privacy.)

Her youngest, now 3, talks about "the fire house." He'll miss an item, then remember, "Oh, I had this in the fire house, but it burned up.'"

He never saw the ruins of their home. But on New Year's Day, his older brother, now 8, stood in the space where his second-floor bedroom fell. There, the avid reader found copies of beloved books such as "Charlotte's Web" in the ashes.

His reactions have been complex, his mother said. His school "did a tremendous job" of offering counseling. But sometimes, when she brings up the fire, he tells her, "Can we not talk about this?"

Other times, out of nowhere, he'll ask a random question that reflects his anxiety, such as wanting to know which part of the house caught fire first. "And I'll tell him what I know," Reina said.

She copes with her own difficult moments in part by stepping away when she needs to. "I'll go meditate, kind of pull it together for like 10 minutes, and then come right back."

Her advice to others who have gone through disaster with children is to understand that "this is a long game."

Every tragedy is different, Reina said. "But I think on the whole, grief is not linear, and it takes a long time to resolve. And so just give yourself a lot of compassion. I think it's OK that we don't get it done in one day."

Advice on how to help children prepare for and cope with disasters is available from the Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration and the American School Counselor Association.

American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email editor@heart.org.

By Michael Merschel, American Heart Association News

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