Question of the Week

September 11, 2006


Television and radio are once again saturated with pictures, interviews, and stories from September 11, 2001. While some are upset with the fictionalized accounts, others are pleased to see the accounts of that day being remembered and retold. While most people agree that the events of September 11 need to be remembered, many disagree about how, and in what ways should these events be presented to children who -- in some cases -- were too young to remember that day. Other children, just a few years older, remember it all too well.

"The relationship between news consumption and psychological distress among children is a vital public health concern (e.g., Libow, 1992). Although researchers have delineated the psychological consequences of trauma on child victims, including posttraumatic stress disorder, less is known about the short- and long-term impact of media coverage of tragedy on child victims and bystanders. ... Three to five days after the September 11 attacks, 560 adults were contacted via random digit dialing (Schuster et al., 2001). ... Among children whose parents did not limit their television viewing, a positive relationship was observed between the number of hours of television watched and the number of stress symptoms experienced. Interestingly, there was a positive association between the number of hours of television watched and the number of hours of family discussion about the attacks."

The more they watched, the more they talked. Even so, the more they watched, the more they were upset by the events. More specifically...

"Four to five months after the September 11 attacks, 2001 adults in New York City were contacted via random digit dialing (Fairbrother, Stuber, Galea, Fleischman, & Pfefferbaum, 2003). Four hundred thirty four of them were identified as primary caregivers of children between the ages of four and seventeen. According to the parents, 86% of the children saw airplanes hitting the towers, 87% of the children saw the towers collapsing, 87% of the children saw people running from a cloud of smoke or debris, 48% of the children saw people falling or jumping from the towers, and 77% of the children saw at least three of these four images. There was a positive association between seeing at least three of these four images and having a severe or very severe posttraumatic stress reaction."

What is "a severe or very severe posttraumatic stress reaction"?

"One of the cardinal symptoms of traumatic reactions, and specific symptoms of posttraumatic stress disorder, is both an avoidance of trauma-related cues and psychological and physiological distress upon exposure to such trauma-related cues. Clearly, news reports regularly contain such trauma-related cues (sounds, images). This type of exposure to reminders of the event(s) can be extremely distressing to survivors, and many find it quite difficult to calm down after such exposure. This is the basis of the traumatic response that is supported by ample theoretical, clinical and empirical evidence. ... [E]xperts suggested that survivors limit viewing of news after September 11, 2001, and many experts currently are suggesting to survivors that they tape anniversary programs so that survivors may regulate their exposure and decide if, when and how to watch these programs later."

Between news reports, special reports, and made-for-TV specials, it can be difficult to avoid overexposure. Parents and teens may struggle to find the right balance of what they (and the younger children they care for) should watch. Teachers have still one more source to consider when trying to find the right balance, and the right way to present material.

"Five years after Sept. 11, 2001, the terrorist attacks are beginning to surface in some academic textbooks, but there is little guidance for teachers on how to impart the lessons of that day. ... Some high school educators choose to devote several lessons to it during discussions about modern history, while others simply mention it while reviewing current events. ... 'There is already a whole generation of kids who were not alive when 9/11 happened,' said Gardner, executive director of WTC United Family Group..."

While the generation of kids who were not yet born are thinking about kindergarten in the next year, some elementary students were alive, but too young to remember the events of the day. Teachers and parents are called upon to address the questions of young students -- some of whom are learning about the events of 9/11 for the first time. For some it is an event in history as detached from their lives as WWII or Pearl Harbor, for other young students, the events are more real.

"There are dozens of children like Gabi Jacobs, born to September 11 widows in the months after the attacks. Five years later, as they approach kindergarten, they are just beginning to grasp the stories of their fathers and of the day that changed their lives forever. ... Already, some of these children can tell you Daddy died when bad guys took control of some airplanes, and then flew them into the towers. Others haven't even heard the word 'terrorist' and don't know there was anything more than a big fire. ..."

As a teacher, where does one begin?

"... Permeating class lessons with such a sensitive subject also can be difficult, especially in areas where more students were directly impacted. 'It's hard because we've lost former students who worked in the towers, we have children who lost parents . . . but this is something we have to teach,' said Jack Shea, supervisor of the English and Social Studies departments at Rumson Fair-Haven Regional High School. 'Did we avoid teaching about Pearl Harbor? Of course not.' ... With help from the Taft Institute for Government at Queens College, WTC United, Gardner's group, hopes to incorporate Sept. 11 into the classroom. It plans to have its National 9/11/01 Civic Education Program for use in high schools by September 2007, which will include printed materials, an instructional DVD and interviews with children directly affected by the tragedy. 'What we're doing is very much based on Holocaust education studies, where you draw on first-hand experiences of people directly impacted in an effort to really engage the youth.'"

Teachers (and parents) want to engage their students (and children), but don't want to traumatize them. This desire to reach students in a meaningful way while still being sensitive to their emotional needs and individual situations is not unique to the topics surrounding September 11. As the school year begins, few teachers know much about where their students are coming from. Even as the year progresses, it is difficult to know the personal histories of every student.

A unique example:
Years ago, I had a fellow teacher share with me an experience in class. As the elementary students prepared to play a game of hangman, one girl raised her hand and shared, "That's how my parents died."

More commonly:
Students who have lost loved ones in car accidents, may have a strong emotional reaction when watching graphic videos in Driver's Ed. Students who lived through Katrina may have difficulty seeing pictures (or videos) of areas that have been destroyed by any number of natural disasters. Students with a parent serving overseas in the military may have a strong stress reaction when viewing images (or hearing graphic descriptions) when learning about past wars.

"Posttraumatic stress disorder (PTSD) is a very strong stress reaction that can develop in people who have lived through an extremely traumatic event, such as a serious car accident, a natural disaster like an earthquake, or an assault like rape. Physical or sexual abuse, manmade traumas such as shootings, and military combat can cause PTSD, too. You don't have to be hurt to experience PTSD - for some people, simply witnessing or being threatened with great physical harm is enough to trigger it. Events that can lead to PTSD involve feelings of helplessness, fear, or horror, and a sense that life or safety is in danger. It's normal to be stressed out and anxious after going through something traumatic."

The feelings may be normal, but that doesn't mean that they can't be overwhelming, and it doesn't mean that they can't get out of control if left to grow.

"Getting the right care and support after a traumatic experience can help these symptoms run their course and subside in a few days or weeks and allow a person to move on. But when a person has PTSD, the symptoms of a stress reaction are intense and last for longer than a month. For some people, the symptoms of PTSD begin soon after the trauma. Other people may have a delayed reaction that comes months - or even years - later. Delayed PTSD symptoms can be triggered by different things, such as the anniversary of an event or seeing someone who was involved in the situation."

Questions of the Week:
What topics might cause severe stress reactions for your peers, friends, family members, or fellow students? What topics might be difficult for teachers to teach in a manner that meets the varied needs of the students in the class? What issues might be more difficult to discuss where you live? With families on the move, and students from many different backgrounds in any given class, how can teachers (and fellow students) handle potentially emotionally charged topics in a way that is sensitive to the varied experiences that may be present in the classroom?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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