If a child has heard that people died in a school bus accident, then it is appropriate for a parent to acknowledge what is true without euphemism. Difficult facts should then be followed with an acknowledgment of the difficult feelings that can come with them. "How does this make you feel?" or "It makes me so sad that some children died in that accident" are examples of labeling and bearing these strong feelings. Again, parents should be sure to be curious about their child’s feelings as well as modeling how they handle such feelings.
After having a chance to discuss some of the factual details of the news and the emotions that follow, it will be critical for parents to offer appropriate reassurance and even a potential course of action. School-age children have the cognitive capacity to learn about complex issues that may be reflected in news events, such as global warming or mental illness, but they usually lack the emotional maturity to comfortably hold the anxiety and uncertainty that can follow. Therefore, parents should offer clear reassurance to their school-age children.
Although they cannot promise total immunity from illness, risks, or accidents, they can remind their children about how they are safe. For example, after discussing that there is fighting in Syria in which some children have been injured or killed, they should remind their children that their family lives in a safe community where there is no war or fighting. There may be an opportunity to teach their children about how to protect themselves in specific situations if the difficult topic lends itself to this. They could, for example, review what children should do in case of a fire or if they witness a physical fight or are offered a ride by a stranger.
Finally, school-age children can feel very distressed by the unfairness that is often a component of newsworthy events. At this stage in development, children are working hard to master and follow the rules in all sorts of settings, from soccer to social situations to algebra. They can become very upset when the rules don’t seem to apply, and, of course, life is often unfair in ways that parents cannot make right. Offering their children some perspectives, values, and actions they might take in response to a specific tragedy or injustice is helpful for their children’s coping and their development.
Parents may talk with their children about ways to raise money to help victims of an earthquake or to collect food for people displaced by a flood. Or they might want to think about working with friends and teachers at their school to create a bike safety curriculum. There are many schools and communities that have been profoundly affected in positive ways by efforts that grew from such conversations between concerned school-age children and their parents.
Pediatricians are uniquely qualified to help parents manage these difficult topics when they arise. Some parents may ask about this directly, but it may be helpful to create a handout to keep in the waiting room about this issue. Or you could create a page on your practice’s website. You also should remain attuned to when parents mention troubling news events in passing and take those opportunities to find out how they have handled them with their children. Although parents naturally feel that there are stories they would prefer to shield their children from, with your guidance they can see that even these difficult topics present opportunities to support their children’s preparation for adolescence and adulthood.
Dr. Swick is an attending psychiatrist in the division of child psychiatry at Massachusetts General Hospital, Boston, and director of the Parenting at a Challenging Time (PACT) Program at the Vernon Cancer Center at Newton Wellesley Hospital, also in Boston. Dr. Jellinek is professor of psychiatry and of pediatrics at Harvard Medical School, Boston. He is also chief of clinical affairs at Partners HealthCare, also in Boston. E-mail Dr. Swick and Dr. Jellinek at pdnews@elsevier.com.