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Saturday, May 06, 2006

Article - Post Katrina Childhood Stress - Powerful

The alternative number for those in crisis is 1-800-273-TALK. This number will put callers in touch with the federally funded National Suicide Prevention Lifeline, a service that has been in operation since January, 2005


Amid the ruins, Katrina's children struggle
By Rukmini Callimachi, AP WriterMay 1, 2006

(AP) - Each time the 3-year-old gets in the bathtub, she thinks she's going to drown. Monica whimpers when her grandmother turns on the faucet, sobbing softly at first, then wailing as the tub begins to fill.
"She cries and cries. 'Don't be crying,' I tell her. 'I gotta wash your hair,'" says her exasperated grandmother, Ruth May Smith.
There's no use telling her she won't drown; the word isn't yet part of the toddler's vocabulary. And it won't do much good to tell her that grandma will take care of her, either; Monica learned the hard way that those she loves can't always protect her.
There were seven children inside the family's Gulf Coast home on Aug. 29 when the 30-foot wave, unleashed by Hurricane Katrina, crashed down upon it. As the walls began to crumble, the older children swam out. Monica, the littlest, was still inside with her grandmother and two aunts. None could swim.
The toddler went under. She would have drowned if not for a family friend who dove in, fished her out and placed her inside a floating cooler.
In her plastic ark, the girl bobbed to safety - but the storm's high water mark is still imprinted inside her, as it is in thousands of others who survived the storm.
Some 1.2 million children under 18 were living in counties rendered disaster zones by Katrina. As many as 8 percent, or 100,000, are expected to develop post-traumatic stress disorder, according to one assessment.
Most experts say the toll is likely far higher. Of the first 1,000 children screened by the Louisiana State University Health Sciences Center, 27 percent displayed symptoms of trauma, including nightmares, flashbacks, heightened anxiety and bedwetting, says Dr. Joy Osofsky, a professor of pediatrics and psychiatry at LSU's Harris Center for Infant Mental Health.
A study by the Mailman School of Public Health at Columbia University and the Children's Health Fund compared children displaced by Katrina with other kids surveyed in urban Louisiana in 2003. Katrina's victims were more than twice as likely to have behavioral or conduct problems; the same was true of depression or anxiety.
How children respond and the severity of their reaction varies widely. But eight months after Katrina, patterns are beginning to surface.
For teenagers, depression is setting in, as they realize it could be years before they're back in their homes, if ever.
Elementary- and middle-school children are struggling with the loss of their toys. They battle nightmares and intrusive thoughts. Their anxiety comes out in physical symptoms, like recurring stomach aches.
For children under 6, their faith in their parents' ability to protect them has been shattered. To make themselves feel secure, they regress, sticking close to their parents and returning to behavior they'd previously outgrown, such as thumbsucking and bedwetting.
"Huffing and puffing and blowing your house down is only supposed to happen in fairy tales. Now, anything can happen," says Dr. Lynne Rubin, a founding member of the New York Disaster Counseling Coalition, which counseled children after 9/11.
During the London blitz in World War II, Anna Freud, the daughter of the famed psychoanalyst, observed that children sent to safe homes in the countryside fared worse than those who waited out the bombings in shelters alongside their mothers.
It was the separation, rather than the exposure to the war, that proved more traumatic.
More than 5,000 children were separated from their families in the hectic days after Katrina made landfall, according to the Center for Missing and Exploited Children. Those who lost a parent often become unmoored, focusing their angst on their surviving parent.
When her father takes a nap, 8-year-old Gabrielle Riley circles the bedroom, on edge. Eventually, she quietly turns the doorknob. "I just go in his room and see if he's OK. But sometimes he don't answer me so I just scream loud, 'Daddy are you OK?'" she explains.
Gabrielle's mother caught pneumonia during the family's evacuation to Houston and died in her sleep. Ever since, Gabrielle has been unable to fall asleep by herself, curling up with her grandmother, instead. It's a recurring pattern, say child psychologists, as children retreat into what is most familiar.
More than 60 years ago, Anna Freud had a second observation: While children who hunkered down in London's bomb shelters with their guardian fared better emotionally than those sent out of harm's way, the children who did best of all were those whose mothers stayed calm. If the mother showed fear, the child sensed the threat implicitly - and symptoms of trauma surfaced later.
Like youngsters in London, many child victims of the story sensed the threat in their parents' reaction and, in Katrina's aftermath, in TV footage.
April Ocker didn't let her daughter out of her sight during the hurricane. But since then, 5-year-old Breanna has harbored a horrible fear: "I'm afraid my Mommy is going to go away and not come back," says the little girl, her brown bangs covering saucer-like eyes.
Sitting nearby, her mother tries to comfort her, stroking her hair. But it's hard to reassure a child who saw trees crashing around her family's trailer, parked 5 1/2 miles from the beach in Pass Christian on Mississippi's Gulf Coast. Katrina nearly wiped the quaint city off the map.
With the hurricane bearing down, April placed Breanna and her 8-year-old brother inside the trailer's bathtub, hoping the tub's strong walls would protect them. The tub survived, but the children are scarred.
When it rains, Breanna says, she hides under the coffee table. She can fall asleep only in her mother's bed; she trails her mother like a shadow. April occasionally gets called to Breanna's school, three minutes from home, because of the girl's sobbing.
April has taken a job at the local Boys & Girls Club, which runs an after-school program for children, so she can be near Breanna in the afternoons.
Breanna describes the hurricane like this: "It sounds like a monster."
It's a monster that's never far away. Even in her mother's arms sleeping at night, Breanna says she often has nightmares.
"A monster is running after me. There's a bear, too," she says.
For adults, the hurricane's damage is the twisted houses, ripped from their foundations, and such things as bloated couches, spit out onto the street.
For their children, it's the muddy teddy bear and the headless stuffed rabbit, poking out of the rubble of one ruined house. It's the baby doll lying in another heap, her arms raised above her head, as if waiting to be picked up. It's the stuffed frog impaled on a radiator fan and the alphabet magnets still adhering to the side of a toppled refrigerator.
A beloved toy is much more than a physical object for a child.
"If you lose a favorite teddy bear, you haven't just lost a toy. You've lost one of the means by which you keep yourself feeling safe," says Dr. Claude Chemtob, a clinical professor of psychology and pediatrics at Mount Sinai School of Medicine in New York.
But the loss extends far beyond their favorite teddy bear.
For Katrina's children, their destroyed homes have become their Ground Zero. They go back again and again, sifting through the rubble, looking for tiny pieces of their rooms. They mourn each destroyed toy, each fragment of a school art project, each mottled action figure.
Objects that were insignificant before the storm have become loaded with meaning.
Like the pink, plastic barrette 10-year-old Jasmine Lombard found on the dank carpet of her flooded room. It's the kind sold by the dozen for $3.99 at the corner grocery.
Returning for the first time, Jasmine spotted the barrette and picked it up. She held it close in her cupped hands, as if she'd stumbled across a family heirloom. "This is the only memory I have of this entire neighborhood," she says.
Some kids - like 6-year-old Michael Watts, Jasmine's next-door neighbor - are taking matters into their own hands. As the storm approached, he did what his parents told him: Pack a single bag. Don't take more than a few day's worth of clothes.
He returned to find his toys caked in mud.
That's when he asked his parents for a suitcase, one with wheels and a handle. In it, he began storing every new toy he was given since the storm.
Now, he doesn't let the suitcase out of his sight, lugging it behind him on errands, to the store, to restaurants and to sleep-overs. Inside are his treasures: Sponge Bob and Batman. A Game Boy. A growing collection of plastic, Hulk-like men.
It annoys his grandmother, Deirdre Domino. No more taking the suitcase to school, she says.
"I tell him, 'Michael, take out a few and take them with us,'" Domino says. "He says 'Mawmaw, what if we have another hurricane?'"
"Make no mistake: This is a crisis and it should be dealt with as an emergency," says Marian Wright Edelman, the founder and president of the Washington, D.C.-based Children's Defense Fund, which in a recently released report called for immediate emergency mental health services in the Gulf states.
Overwhelmed, child psychologists in New Orleans say case loads have doubled, both because of the heightened need and because so many doctors have not returned. "I used to be able to book a new child within two weeks. Now, I'm booking appointments two months out," says child psychologist Carlos Reinoso, author of the book "Little Ducky Jr. and the Whirlwind Storm," which tries to explain the hurricane to children.
What mental health professionals fear most is the impact down the road. The 1988 earthquake in Armenia that killed 25,000 people. Tracking more than 200 children over five years, researchers at the University of California at Los Angeles' Trauma Psychiatry Program found that those who were given professional help early on fared better and showed fewer symptoms at the end of the study. Those who got no help did not improve.
A child such as 3-year-old Monica _ so traumatized she thinks she's going to drown in a bathtub - clearly needs help, says Dr. Bruce Perry, a senior fellow at the Child Trauma Academy in Houston. Without it, he says, she risks a future of drug and alcohol abuse, high blood pressure, crime and child abuse.
"This crisis is foreseeable, and much of its destructive impact is preventable," Perry says. "Yet our society may not have the wisdom to see that the real crisis of Katrina is the hundreds of thousands of ravaged, displaced and traumatized children."
Some may already be beyond help.
No one noticed that a 14-year-old girl in Pass Christian - once a straight-A student - had stopped reading since Katrina.
The girl, who asked that she not be identified because she felt embarrassed, used to lose herself in books. "I would picture myself as the main character in whatever I was reading. I read so much that I would lose track of time," she says.
Now, she has a hard time concentrating. Horrible images intrude as she reads.
She remembers the drowned man, impaled on his plywood fence. She pictures her favorite skirt high up in the branches of a tree.
Last month, she locked herself inside the bathroom of her family's FEMA trailer and lifted a bottle of Lysol to her lips. Her mother found her passed out on the toilet seat, her head leaning against the trailer's plastic wall, the floor slick with the disinfectant.
The girl recovered from the suicide attempt, but her family doesn't have the resources to get her professional help, relying instead on teachers and school counselors.
To this girl, the world is a tunnel of darkness. She sees no way out.
"It's like I can't see my future anymore," she says.


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