Support crucial for kids after trauma

(CNN) -- School shootings such as the one at Sandy Hook Elementary in Newtown, Connecticut, may have long-lasting consequences, but with proper support, many children are able to move on, experts say.

Children need to be with their families as quickly as possible after exposure to such horrific events, said Steven Marans, director of the National Center for Children Exposed to Violence/Childhood Violent Trauma Center at Yale University's Child Study Center.

Marans and colleagues are making themselves available to Connecticut officials, including the governor's office and state police.

The good news is that most kids do bounce back from a single incident of trauma, said James Garbarino, professor of psychology at Loyola University Chicago and author of "Lost Boys: Why Our Sons Turn Violent and How We Can Save Them." If children can get back into their normal routines and get proper support, he said, they will do well.

Long-term issues are more likely for children who were very close to someone who died in a shooting, who witnessed the event or who were in close physical proximity to it, Garbarino said.

In addition, "Kids who are having difficult lives before the event are the ones most likely to have issues," Garbarino said.

For instance, if a child's parents are going through a divorce or if the child had been fighting with a parent on the day of the event, he or she may feel more of an impact from a traumatic event such as a school shooting, he said.

Moreover, if a child is frequently exposed to violence, such as by living in an abusive household or a dangerous neighborhood, a school shooting may add to existing trauma that child has stored up, Garbarino said. In those situations, it's hard to lean on the idea of "going back to normal."

There is evidence that elementary-school children are particularly vulnerable to trauma, more so than teenagers or adults, Garbarino said. This may be because although these children have enough awareness of a situation to appreciate danger, their brains and bodies haven't matured to manage the effects in the way teenagers and adults can.

Symptoms

Trauma from a school shooting can manifest itself in physical ways, such as stomachaches, headaches and sleeping difficulties, said Nancy Rodda, senior director of clinical services for Genesee County Community Mental Health in Flint, Michigan. In Rodda's county, a 6-year-old boy shot a 6-year-old girl to death at an elementary school in 2000.

Stress can instigate a variety of behaviors: For instance, anxiety can lead to poor eating, which can lead to stomach discomfort, Rodda said.

Alexis Wassick, a student at Sandy Hook Elementary, said Friday that "people were even like, they kind of got a stomachache."

Kids may start depending on their parents for things they're normally able to do on their own, Marans said. They may also become more irritable.

It's not only a single event that puts children at risk for developing long-term mental health problems such as post-traumatic stress disorder, anxiety and depressive disorders, Marans said. How well they were doing before a school shooting will have a big impact.

There's also the issue of survivor's guilt, Rodda said. Children who have lost friends may wonder why they themselves lived.

Support

One of the best predictors for good outcomes is when kids have adequate support from their families and communities, Marans said.

Parents should listen to their children, reassure them that they are safe and look out for any changes in behavior, Rodda said. Let children ask questions, and don't force anything on them, Garbarino said.

"There's a balance between talking about it but also not dwelling on it too much," Rodda said. "Overexposure can increase stress."

Getting back to routines is key for children to move on, Garbarino said. If Friday is usually pizza night, have pizza. If swim practice usually happens on Saturday, take your child to swim practice at the normal time.

If children are too scared to return to school, parents should try to go with them as far as they will go, Garbarino said. If a child becomes hysterical upon arrival, take him or her back to the car and see if you can ease the fear, he said. Avoid reinforcing the fear.

It's important for adults to get the help they need too, Marans said, so they can be resources for the children who need them.

"It's such a convergence between our worst nightmares coming true, and there is a sense of helplessness and loss of control that we need to address," he said.

Interventions include helping parents understand the emotional consequences of an event like this and what to look for in their children.

The Child & Family Traumatic Stress Intervention program, which was developed at Yale at Marans' center, aims to increase communication between parents and children and prevent longer-term disorders.

When other risk factors are present that make recovery more difficult, there are other strategies. These include trauma-focused cognitive behavioral therapy, a specific type of psychological therapy that targets thinking and behaviors.

"With the right help, children are very resilient," Rodda said. "We have many different ways to help people to have experienced a trauma now that allow them to come out on the other side as survivors."

Based on previous experiences, Garbarino estimates that 85% of kids would return to normal functioning, from a mental health standpoint, within a year after an event like the Connecticut shooting.

"Not to say they would have forgotten it," he said, "They may still make life choices because of it."