NEWTOWN, Conn. -- In the aftermath of a deadly shooting at a Newtown elementary school, in which 20 young children and eight adults were killed, individuals in the community and across the nation are coping with tragedy and trauma. That trauma can occur without physical injury and can last long after the medical problems heal, according to the American Psychological Association.
n Watch for signs of severe stress: Signs include re-experiencing the trauma during play or dreams, avoidance of reminders of the trauma and general numbness to all emotional topics, increased "arousal" symptoms such as trouble staying or falling asleep, irritableness and difficulty to concentrate. Fears and phobias often are developed. Children may also keep repeating a part of the trauma.
n Be supportive: Children will benefit greatly from support and caring expressed by the adults in their lives.
n Be available: Let children know you are available to talk with them. Let children ask questions. It is OK if you don't know the answers to the questions.
n Be caring: Help children express their feelings with care and understanding.
n Be reassuring: Acknowledge the frightening part of the event. Explain what happened in words the child understands. Reassure children they are safe and loved. and let them know it is OK to feel upset.
n Be thoughtful: Be aware of how you talk about the event and cope with the tragedy. Children often learn how to cope by watching the reactions of parents, peers and the media. Keep in mind children may not express their concerns verbally.
n Be creative: For children too young to truly express their feelings, consider expressive techniques such as play, art and music.
n Remind them that trustworthy people are in charge: Explain that the government emergency workers, police, firefighters, doctors and other authority figures are helping people who are hurt and are working to ensure that no further tragedies occur.
n Tell the truth: Don't pretend an event has not occurred or is not serious - and stick to the facts. They will be more worried if they think the parent is shielding them from the truth. Talk to them. Answer their questions.
n Get back into routine: To help create a sense of security, try to maintain family schedules for daily activities such as eating, playing and sleeping.
n Give children the amount of information they can understand: This involves turning off news reports of the event and controlling or limiting their exposure to threatening images on TV.
n Encourage multiple methods of grieving: Join a support group, attend a church function or go to a community center where others are holding rituals dealing with grief. Often, during the grieving process, discussing feelings with others helps in understanding the event and knowing you are not alone.
Sources: American Psychological Association (APA), Brett Holden, Ph.D., KidsHealth.org, PBS, National Association of School Psychologists,