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Section 26
Treating Children Traumatized

Question 26 | Test | Table of Contents

Forty percent of the children and teenagers who made their way back to New Orleans-area schools in the aftermath of Hurricane Katrina continued to suffer from serious psychological symptoms a year after the disaster, according to new research from scholars who have worked with those young people.

"Many people have raised the issue of whether there will be scarring over the lifetime of these children," said Dr. Howard J. Osofsky, who chairs the psychiatry department at Louisiana State University's Health Sciences Center in New Orleans. "From a social-policy point of view, I think there is real concern to not forget these children at the national level."

Dr. Osofsky and his wife, Joy D. Osofsky, a professor of pediatrics and psychiatry at the LSU center, were among a handful of Gulf Coast-area researchers at a recent conference here who gave updates on the storms' impact, more than a year and a half later, on children, families, and schools in those hard-hit communities.

Katrina displaced about 650,000 people in Louisiana alone, scattering families across the state and throughout the United States, according to researchers at the March 29-April 1 meeting here of the Society for Research in Child Development, a Washington-based social science group. As a result of the diaspora, the state's public school enrollment dropped from 741,000 in October 2004--the year before the hurricanes struck--to 657,000 by the end of the next school year, nine months after the disaster occurred. As late as October of this school year, one researcher said, statewide enrollment in Louisiana was still 50,000 students shy of what it had been two years earlier. "There are still thousands of children displaced from the state of Louisiana, and we don't know where they are," said Gary J. Asmus, who is the director of management-information systems for the Center for Child Development at the University of Louisiana at Lafayette.

Follow-Up Surveys: The Osofskys were part of a Louisiana State University trauma team of mental-health professionals that worked with displaced families in Orleans, St. Bernard's, and Plaquemines parishes--three areas that were especially hard-hit. They lived for four months aboard a cruise ship that provided temporary housing for emergency workers and their families, 80 percent of whom had also lost homes as a result of Katrina and the severe flooding it unleashed.
In the months following the disaster in late August 2005, the trauma team screened more than 9,000 children and teenagers in those three jurisdictions. The surveys were done between December 2005 and March 2006, as children began to return to school, and again at the beginning of this school year. The researchers also repeated surveys on 184 of the children who were screened in the first go-around to get an idea of whether circumstances had improved for them. In addition, screenings are set to begin this week on children enrolled in public preschool programs.

"One thing to recognize is that children of all ages were traumatized," said Ms. Osofsky. "People sometimes think younger children forget." Yet one-quarter of the children in 3rd grade or younger exhibited enough symptoms of psychological distress to meet the cutoff for referral to mental-health services, according to the surveys. Among the 4th to 12th graders screened, one-half were found to be in need of services, even as late as this past fall. The telltale behaviors among younger children included excessive clinginess, repeated talk about the hurricanes, sadness, and worries about the future. "Every time we get a storm or thunderstorm, there's a lot of increased anxiety," Ms. Osofsky said.

Depression Rises: The adolescents reported experiencing problems concentrating, and increases in headaches, irritability, and risk-taking behaviors, such as underage drinking and sexual activity. "We've also been seeing, more recently, increases in depression because of the slowness of recovery," Ms. Osofsky said, referring to efforts to restore the New Orleans region to its prestorm condition. Also, 13 percent of that older group asked to see a counselor. "If you think about it, for a teenager to say they want to talk to somebody, that's really something," Ms. Osofsky said.

Still, the persisting need for mental-health services is not surprising, given the extent of disruption that children experienced, the researchers said. While almost all the children had been displaced from their homes after Hurricane Katrina, one-third of the 4th to 12th graders and 17 percent of the younger children also were separated from a parent or some other primary caregiver at one point. That's particularly worrisome, the researchers said, because studies as far back as World War II show that children can better bear traumatic experiences with parents by their sides.

In the Osofskys' study sample, the need for mental-health services was 9 percentage points greater among children who had experienced that kind of separation than it was for children who stayed with their families. "It's important to know if … there were separations that could've been avoided," Ms. Osofsky said. The results also showed that young hurricane survivors attended an average of three different schools in the months following Katrina, with some enrolling in as many as nine schools. Mr. Asmus' statistics, meanwhile, indicated that, in New Orleans, two-thirds of students had missed at least 60 days of school; half had missed three months or more and had not been enrolled anywhere else during that period.

Children Living Alone: The children who had attended school elsewhere reported having had mixed experiences, said researchers at the conference. "Many were well accepted," Dr. Osofsky said. "Others were not. In some schools, they were called trailer trash. Because their culture was different or they talked differently, they were often teased."

Three-quarters of the children said a parent had been unemployed in the aftermath of the storm, and 11 percent said that a family member or a friend had died as a result of the disaster. Among the youngest children, nearly a third said they had been separated from a pet at some point as well. The psychological distress also has not eased, the researchers said, because circumstances have not improved for many families in the year and a half since Katrina. In the fall surveys, 27 percent of the children in both age groups said they were still living in trailers.  "We also have to be aware that there are still some children living alone, " Ms. Osofsky said.

All the researchers said their findings suggest a need for emergency officials to develop disaster-recovery plans that do a better job of coordinating information on children, providing services to families, and taking into account the needs of children.

Lasting Impact
A trauma team of mental-health professionals from Louisiana State University screened more than 9,000 children in metropolitan New Orleans to gauge Hurricane Katrina's impact on their lives. Among children in grades 4 through 12 surveyed a year after the storm:
65% had homes damaged in the storm
70% had moved
27% had been separated from a primary caregiver
69% had transferred to a new school
14% had lost a family member or friend
40% had a parent who was unemployed
34% had been separated from a pet
- Viadero, Debra; Long After Katrina, Children Show Symptoms of Psychological Distress; Education Week, 4/11/2007, Vol. 26 Issue 32, p7

Personal Reflection Exercise #12
The preceding section contained information regarding treating children traumatized by Hurricane Katrina.  Write three case study examples regarding how you might use the content of this section in your practice.
Reviewed 2023

Update
Mental health in refugee children

- Dangmann, C., Dybdahl, R., & Solberg, Ø. (2022). Mental health in refugee children. Current opinion in psychology, 48, 101460. https://doi.org/10.1016/j.copsyc.2022.101460


Peer-Reviewed Journal Article References:
Breslow, A. S., & Brewster, M. E. (2020). HIV is not a crime: Exploring dual roles of criminalization and discrimination in HIV/AIDS minority stress. Stigma and Health, 5(1), 83–93.

Hoover, S. A., Sapere, H., Lang, J. M., Nadeem, E., Dean, K. L., & Vona, P. (2018). Statewide implementation of an evidence-based trauma intervention in schools. School Psychology Quarterly, 33(1), 44–53.

Mitzel, L. D., Vanable, P. A., & Carey, M. P. (2019). HIV-related stigmatization and medication adherence: Indirect effects of disclosure concerns and depression. Stigma and Health, 4(3), 282–292.

QUESTION 26
What five problems were reported by adolescents traumatized by Hurricane Katrina? To select and enter your answer go to Test.


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