Maintain Routines
Children of all ages can benefit if the family keeps to their usual routines for meals, activities, and bedtimes. Keeping the routine as close to normal as possible allows a child to feel more familiar and therefore more secure and in control. As much as possible, children should stay with people with whom they feel most familiar.

Reaffirm Relationships - Remember Hugs
Love and care in the family is a primary need. Following a tragedy children may become more dependent for a period of time. Give they extra hugs or touching if needed. Physical closeness is needed. It can also be of benefit for grieving adults. Let them keep the light on at night or not sleep alone or return to having their favorite teddy bear or blanket. Don't complain about their clinging behavior.

Limit Exposure to News Coverage
As adults we know that overexposure to the media can be traumatizing. Children can also become traumatized by watching tragic events on television, particularly those in the preschool to kindergarten age groups who are often unable to distinguish between fantasy and reality. Babies, toddlers and preschoolers should be shielded from media reports as much as possible. It is best not to allow children or adolescents view footage of traumatic events over and over, or watch the media coverage alone. Parents should view the images in newspapers and magazines before allowing their children to see the images. With events such as the September 11, 2001 tragedy there were many graphic photos--planes crashing into buildings, people jumping out of buildings, images of the dead, images of destruction--that would be very disturbing to children and even some adults. Their exposure should be limited and parents or teachers should watch the news coverage with the children to be available for answering questions.

Feelings and Reactions
Following a death, loss or tragic event children may express their feelings and react in different ways. Parents and other significant adults in the child's life need to acceptance of the various feelings and emotions that may result. Some children may become withdrawn and unable to talk about the event. Others will feel intensely sad or angry at times and at other times they may act as though the disaster never happened. Some children may appear not to have been affected by the events. Some may have delayed reactions that may take days, weeks or months to manifest. Some children may never have a reaction. How parents and other adults react makes a difference to how your child recovers from the trauma. Parents should be prepared to tolerate regressive behaviors and accept manifestations of aggression and anger especially in the early phases after the loss.

Other ways of Expressing the Loss
Children may find it useful if they are given other ways of expressing how they are feeling. Some useful alternative ways of expression include painting, drawing, or writing about the event. Adults or older children can help pre-school children to reenact the event since pre-school children may not be able to imagine alternative "endings" to the disaster and hence may feel particularly helpless. It may also be helpful to have children write a letter to the person who has died. Plant a tree. Make a poster or collage with drawings, pictures and thoughts.

Activities for Children by Age

Birth to 2 years
Activities for home: frequent cuddling, caring, maintain routines, remain calm.
Preschool and Kindergarten
Activities for home or school: play acting, physical contact, puppets, art, stories, large muscle movement (throwing balls, etc.).
School Age (7 to 12 years)
Activities for home or school: play acting, puppets, drawing and painting, sharing their experiences in groups, reading, creative writing or discussion.
Middle School to High School (12 to 18 years)
Activities at school: general classroom activities, literature or reading, peer helpers, health class, art class, speech/drama, social studies/government, history.

American Academy of Child and Adolescent Psychiatry. Fast Fact # 8. Children and Grief. Updated November 1998. Available at: http://www.aacap.org/publications/factsfam/grief.htm .

National Mental Health Association. Helping Children Cope With Loss. 2001. Available at: http://www.nmha.org/reassurance/childcoping.cfm .

American Academy of Child and Adolescent Psychiatry. Fast Fact # . Helping Children After a Disaster. Available at: http://www.aacap.org/publications/factsfam/disaster.htm .

National Institute of Mental Health. Helping Children and Adolescents Cope with Violence and Disasters. Available at: http://www.nimh.nih.gov/publicat/violence.cfm .