What impact did the Boston Marathon bombing have on children?

March 31st, 2014

jennifergreenHolt1-423x636As we approach the first anniversary of the Boston Marathon bombing, many of us will be exposed to the horrifying images and videos of that day. Jennifer Greif Green and Melissa Holt are professors in Boston University’s School of Education. In the following Q&A with Professor Voices, Green and Holt discuss their research on the impact the bombing had on children and how teachers and other educational professionals can help them deal with the anniversary.

Professor Voices: What impact did the Boston Marathon bombing have on children?

Green & Holt: We know from research following other terrorist attacks (such as 9/11 and the Oklahoma City bombing) that these events can have a considerable effect on children’s psychological functioning.  After mass crises, we see increases in depression, anxiety, posttraumatic stress disorder, and behavioral problems in children. For most children, these problems diminish over time, but some children have more severe or long-lasting responses.

We are currently collaborating with colleagues and students at the BU Center for Anxiety and Related Disorders, as well as our colleague Jonathan Comer at Florida International University to study how parents and teachers perceived children to respond to the Boston Marathon bombing. We are finding that after the Boston Marathon bombing children had higher rates of psychological problems than what we typically see, and this was particularly true for children with greater levels of exposure to either the bombing itself or events related to the manhunt.

PV: Boston schools were on break when the Marathon bombing occurred. How did teachers respond to students when schools were back in session?

G&H: We surveyed Boston-area teachers following the bombing last year and found that there was a great deal of variability in how teachers responded to students when schools were back in session.  Some teachers focused extensively on the attack, modified their lessons, and increased supports for their students.  Other teachers did not address the events at all – sometimes because of the age of the students, because of school policy, or because they were in communities that were further from the attack.  We are currently looking at the data from our survey to identify trends and patterns in school crisis response.

PV: As the 1-year anniversary approaches, media coverage of the event will be heavy with images and video of the events of the day. How can schools prepare teachers, children, and staff with what they may face during this time?

G&H:  In our article published in the National Association of School Psychology newsletter, we highlight five key suggestions for schools as we approach the 1-year anniversary of the bombing.

  • It is important for schools to recognize that students will have a range of responses and needs.  For some students, the anniversary will bring up many of the same feelings of distress, fear, and grief as the attack itself.  Other students might be relatively unaffected by the anniversary.  Students with greater proximity to the area of the bombing, as well as greater exposure to the events that unfolded related to the manhunt can be expected to have more intense responses to the anniversary. In general, schools might expect to see students acting out more, describing physical symptoms, becoming withdrawn, and also just behaving as usual – all of these responses are normal.
  • Schools should communicate clearly with staff and parents about their plans for responding to the anniversary.  It is important for responses to be well-planned and coordinated. Parents often want to know what they can expect their children will be discussing at school.  The National Association of School Psychologists has some very useful resources for guiding parents and schools in how to talk about crisis events (http://www.nasponline.org/resources/crisis_safety).
  • Schools should provide specific guidelines to teachers about whether and how to discuss the 1-year anniversary with their students.  Some messages that teachers can provide to students is that they are safe, that adults are doing everything possible to keep children safe, and that it is understandable to have a wide range of feelings in response to the anniversary. Teachers and schools should consider delaying significant tests or major assignments directly preceding and following the anniversary.
  • In addition to children being affected, parents, teachers, and other key caregivers might also be affected by the anniversary of the event. Prior to addressing events with students, it is important that adults are aware of their own feelings.  Schools with staff and parents who were intensely affected by the event should consider offering supports for adults.
  • Most children can be expected to adjust well following the anniversary, but schools and parents should keep an eye out for children who might be significantly distressed by the anniversary and be in need of additional support. As we describe in our article, some key signs that children are not adjusting well are withdrawal or sadness; fear or nervousness; acting out or behavioral problems; inattention or hyperactivity; and threats to self or others. Schools should consider whether children need additional support when these symptoms are very different from the child’s typical behavior, continue beyond the anniversary, are more pronounced than the responses of most peers, or are particularly extreme or intense.

All responses by schools should be considered in the context of the culture of the school and community.  The resources and supports needed for students in Watertown and Cambridge will likely be more significant than those for students in communities that were not as directly affected.  Further, some schools serve children who face daily violence and trauma; this context needs to be taken into consideration when considering the extent to which this specific trauma affected the community.

PV: Do children who were not at tragic events like the Marathon bombing, 9/11, or the Sandy Hook shootings develop symptoms of posttraumatic stress disorders as a result of media coverage of the events?

G&H: Yes, media exposure can lead to many of the same responses described earlier.  Re-watching images of the Marathon bombing (or the other crises you described) can increase children’s feelings that the world is a scary and threatening place.  We expect there to be a high degree of media coverage around the 1-year anniversary of the bombing, as well as of this year’s Boston Marathon.  Parents and teachers should be encouraged to limit exposure to these images for children (and themselves!).

PV: Do anniversaries of these crisis events cause additional distress in children? What can teachers & school psychologists do to help in responding to these events?

G&H: They certainly can.  Studies following other types of traumas have found that anniversaries of events can lead to distress that is similar to distress related to the original events. These responses are sometimes called “anniversary reactions” and are more likely to occur when children are exposed to reminders of the traumatic events.

There are a number of things that schools can (and should) do to respond to crisis events when they occur:

  • Train in crisis response, using an evidence-based model, such as the PREPaRE model, which has been developed by Steve Brock and his colleagues. This model (and other crisis responses models) emphasize the importance of preparing in advance for the potential of crises, including having clear policies for how crises will be addressed, and a crisis response team designated for this purpose.
  • Have a clear response policy in place.
  • Communicate that policy and response strategy to all school staff and parents as quickly as possible.
  • Provide a range of support services for students (including opportunities for individual counseling, classroom-based supports, and ongoing monitoring).

All schools and communities are different, and therefore available resources, as well as student and staff needs, should inform the crisis planning and response.

Contact Jennifer Greif Green at 617-353-3253 or jggreen@bu.edu.
Contact Melissa Holt at 617- 358-4668 or holtm@bu.edu.

For additional commentary by Boston University experts, follow us on Twitter at @BostonUNews.

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