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DTAC Bulletin
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Behavioral Health is Essential To Health - Prevention Works - Treatment is Effective - People Recover

SUPPLEMENTAL RESEARCH BULLETIN  | JULY 2012

 

 

 

The Substance Abuse and Mental Health Services Administration (SAMHSA) Disaster Technical Assistance Center (DTAC) is pleased to send you this supplement to our ongoing monthly e-communication, the DTAC Bulletin. This supplement will be sent twice annually in an effort to inform the field of new and salient research. Please email your feedback or suggestions for topics to: DTAC@samhsa.hhs.gov To subscribe, please enter your email address into the “SAMHSA DTAC Bulletin” section of the SAMHSA DTAC Resources page of our website at http://www.samhsa.gov/dtac/resources.asp.

DTAC is administered by the Emergency Mental Health and Traumatic Stress Services Branch of the SAMHSA Center for Mental Health Services Division of Prevention, Traumatic Stress, and Special Programs, located at 1 Choke Cherry Road, Rockville, MD 20857.

 

 

 

Nikki D. Bellamy, Ph.D.
Federal Technical Co-Project Officer
Phone: 240-276-2418
Fax: 240-276-1890
E-mail: nikki.bellamy@samhsa.hhs.gov

CDR Erik Hierholzer
Federal Technical Co-Project Officer
Phone: 240-276-0408
Fax: 240-276-1890
E-mail: erik.hierholzer@samhsa.hhs.gov

 

 

 

 

INTRODUCTION TO THE SAMHSA DTAC SUPPLEMENTAL RESEARCH BULLETIN

 

 

Over the last several decades, there has been a considerable amount of research conducted to study the behavioral health impact of disasters. SAMHSA DTAC introduces the first issue of the Supplemental DTAC Research Bulletin, which will be published bi-annually. The purpose of the Research Bulletin is to provide practitioners, planners, and other responders a summary of the most recently published research and literature reviews. Each of the Supplemental Research Bulletins will highlight a number of chosen articles related to a specific topic of interest. In this first Research Bulletin, we examine the topic of the emotional impact that natural and man-made disasters have on children and youth.


Children and Disasters

As the field of disaster behavioral health has evolved, we’ve seen a continued and growing concern about how disasters impact one of our most vulnerable populations, children. Although many children and youth learn to adapt to disasters and other adverse situations, the stress and losses they experience as a result can have long-lasting impacts on their development. Too often, children and their specific needs for recovery are overlooked as adults underestimate the extent to which children are affected by disasters emotionally. The research in these articles alerts us to the importance of addressing this high risk population.

The articles included in this edition were identified by searching Academic Search Complete, Child Development & Adolescent Studies, PsycInfo and PsycARTICLES online databases for relevant research in the United States within in the last five years. Several of these articles emanate from Child Development, which published an issue that included a special section on disasters and their impact on child development. Together these articles cover the types of symptoms that children and youth experience as a result of exposure to traumatic events and typical recovery patterns, as well as general implications for practice, policy, and the disaster response planning process. Specifically, we focus on issues concerning children with disabilities and associated barriers in disaster situations, the impact of previous victimization or traumatic experiences on children’s symptoms following a disaster, gender differences in susceptibility to posttraumatic stress disorder (PTSD) and other mental health issues, and how communities and child welfare agencies can better prepare for the displacement of foster children as a result of disasters.

The organization of the bulletin begins with an examination of risk factors linked to children’s responses to disaster, then discusses protective factors and resilience, followed by a discussion of social and environmental factors related to children’s disaster response, and concludes with suggestions for policy and practice. Abstracts for each of the five articles are included at the end of the discussion to provide additional information about the original research articles.

 

1. Becker-Blease, K. A., Turner, H. A., & Finkelhor, D. (2010, July/August). Disasters, victimization, and children’s mental health. Child Development, 81(4), 1040–1052. doi: 10.1111/j.1467-8624.2010.01453.x
 
2. Daughtery, L. G., & Blome, W. W. (2009). Planning to plan: A process to involve child welfare agencies in disaster preparedness planning. Journal of Community Practice, 17, 483–501. doi: 10.1080/10705420903300504

3. Kronenberg, M. E., Hansel, T. C., Brennan, A. M., Osofsky, H. J., Osofsky, J. D. & Lawrason, B. (2010, July/August). Children of Katrina: Lessons learned about postdisaster symptoms and recovery patterns. Child Development, 81(4), 1241–1259. doi: 10.1111/j.1467-8624.2010.01465.x

4. Murphy, S. A. (2010). Women’s and children’s exposure to mass disaster and terrorist attacks. Issues in Mental Health Nursing, 31, 45–53. doi: 10.3109/01612840903200035

5. Peek, L., & Stough, L. M. (2010, July/August). Children with disabilities in the context of disaster: A social vulnerability perspective. Child Development, 81(4), 1260–1270. doi: 10.1111/j.1467-8624.2010.01466.x
                                                    

 

 

 

RESEARCH REVIEW

 

 

Factors Influencing Children’s Response to a Disaster
 

Children observe and learn much about the world around them from every situation they encounter on a daily basis. Their growth and development are highly influenced by exposure to their physical and social environment especially traumatic events such as disasters. The research noted here identifies those variables that have the potential to lead to negative emotional outcomes for some children.

Becker-Blease, Turner, and Finkelhor’s 2010 article provides the first research to estimate the prevalence of disaster experiences among children in the U.S. The article defines disaster experiences as events of human or natural causes that include the threat of death, bereavement, a disrupted support system, and difficulty maintaining basic human needs. This study was conducted between 2002 and 2003 on 2,030 children and adolescents aged 2–17 years old in the U.S. Of the study’s participants, 76 percent were Caucasian, 11 percent were African-American, 9 percent were Hispanic, and 4 percent were of other races. 50 percent were female. The researchers found that 14 percent of children in these age ranges had experienced a disaster within their lifetime, and 4 percent within the last year (p. 1046).

Although children and youth display many behavioral and psychological responses to traumatic or disaster situations that are similar to adults, including fearfulness, sadness, sleep disturbances, and posttraumatic stress symptoms, they also may exhibit additional problems coping, such as aggressive behavior, school phobia, and learning difficulties (Becker-Blease et al., 2010; Kronenberg et al., 2010; Peek & Stough, 2010). The scope and severity of each disaster combined with key demographics such as gender, age, race, socioeconomic status (SES), and other social factors can significantly influence the mental health responses of both adults and children (Murphy, 2010). The most significant difference between child and adult responses is that children are additionally influenced by how their caregivers respond. For example, if a caregiver exposes the child to their own anxiety, the child may become anxious and cry, even if they don’t know why.

       Age. Many of the articles point to different symptomatology dependent on the age of the child when the disaster occurs. For example, several literature reviews indicate that younger children’s reactions commonly include increased fear, sleep disturbances, separation anxiety, reenactment of the trauma during play, regression, or guilt; whereas older children may experience disruption in forming identity, difficulty concentrating, social withdrawal, and increased risky behaviors such as alcohol or other substance use (Blos, 1967; Pynoos, 1993; Steinberg, Brymer, Decker, & Pynoos, 2004; Vogel & Vernberg, 1993; as cited in Kronenberg et al., 2010, p. 1243; Murphy, 2010, p. 50). Furthermore, some studies indicate that younger children show a higher severity of symptoms; Kronenberg et al. references studies that have shown increased likelihood of younger children developing depression, PTSD, avoidance, and hyperarousal symptoms than older children (McDermott & Palmer, 2002; Shannon, Lonigan, Finch, & Taylor, 1994; as cited in Kronenberg et al., 2010, p. 1243). At the same time, other studies have also suggested this is not always the case, which warrants the need for more research to support this conclusion (Vogel & Vernberg, 1993; Bal, 2008; as cited in Kronenberg et al., 2010, p. 1243; Green et al., 1991, as cited in Becker-Blease et al., 2010, p. 1041). 

       Gender. The poorer mental health outcomes for girls and women post disaster highlights gender as a known risk factor and is noted across several of the articles cited in this review (Kronenberg et al., 2010; Murphy, 2010; Peek & Stough, 2010). Murphy’s (2010) literature review found that 94 percent of disaster studies showed females more negatively affected than males (p. 45). Similarly, Kronenberg et al. (2010) pointed to a recent study that suggested females are twice as likely as males to report posttraumatic stress symptoms, and note differences in how the genders responded behaviorally; girls displayed more emotional reactions, including guilt, whereas boys displayed more cognitive or behavioral reactions, including academic difficulties and concentration problems (Kronenberg et al., 2010, p. 1244). Kronenberg et al. note that some studies have indicated that females are more likely to report expressions of depression and PTSD, rather than significant differences in diagnoses of these illnesses (Kar and Bastia, 2006; Shannon et al., 1994; as cited in Kronenberg et al., 2010, p. 1244). This suggests that it is vital for practitioners who are screening for posttraumatic symptoms to be cognizant of the gender differences in psychological responses to trauma.

       Severity and Proximity of Disaster. Previous disaster research has shown that the degree of impact and level of exposure are the highest risk factors for poor mental health outcomes. Murphy’s (2010) review supports the “hierarchy of exposure” model (Tucker et al., 1999; Wright, Ursano, & Bartone, 1990), which has linked the most intense threats to self or family to the highest levels of PTSD, depression, and generalized anxiety in both adults and children. This model also describes lower levels of disaster impact and identifies social and material supports, such as access to schools and access to health care, as protective factors.

The Kronenberg et al. (2010) research outlines several studies that drew correlations between a higher level of exposure or proximity to an event and higher posttraumatic symptomatology, but suggests that the level of exposure has not been consistently and specifically linked to depression (p. 1242).

       History of Trauma. Kronenberg et al. (2010) also point to research suggesting that previous trauma, including war, domestic violence, and abuse, were linked to increased susceptibility to posttraumatic stress symptomatology (p. 1242). Becker-Blease et al.’s (2010) study described the complex web of lower SES, urbanity, and status as an ethnic or racial minority as “persistent predictors of vulnerability to disaster” (p. 1042). Those children who fit these categories experienced a higher rate of previous victimization, in part because of higher risk of exposure to traumatic situations and also due to fewer resources to prepare for and respond to adverse events. The authors also established that children experiencing victimization and disaster events had a higher level of anxiety and depression than those who experienced a disaster without history of victimization (Becker-Blease et al., 2010).

Along with Becker-Blease et al. (2010), Daughtery and Blome’s (2009) work supports the early research that found an increase in reports of child abuse post disaster. These authors additionally identify the increased vulnerability of those in the child welfare system, a large percentage of whom have experienced multiple traumas, which may further intensify posttraumatic stress symptoms in those with the disorder (Daughtery & Blome, 2009, p. 486).
 
Each of these articles suggests that when screening for psychological disorders following disasters, clinicians should ask children and their caregivers about previous trauma and victimization to better identify those most at risk for developing posttraumatic symptoms.

       Children with Disabilities. The final article reviewed for this bulletin focused on children with disabilities (Peek & Stough, 2010). The authors first assert how the myriad of social vulnerability factors (including gender, race, and SES), when clustered, can amplify risk and negative outcomes following a disaster, specifically for children with a disability. The research suggests that children with disabilities are the most vulnerable to death and injury, are less likely to receive or understand warning messages, and have less access to economic and social resources that provide a safe refuge in preparation for or in response to a disaster. Moreover, when communities must be evacuated, children with disabilities experience transportation difficulties and a lack of accessible shelters. The article also notes that even when evacuations were successful, medical care was significantly compromised and medical records were inaccessible. Clearly, this research tells us that children with disabilities are the subset within this category of high risk populations that would most benefit from pre-disaster planning and post-disaster psychological screening.

 
Exploring Patterns of Resilience and Recovery
 

The duration of symptoms varies in children following disasters, but most research finds that for ninety percent of children, their trauma response symptoms decrease over time. The research conducted by Kronenberg et al. (2010) generally concurs with this finding, but notes that some children’s recovery can follow a different pattern, most especially in cases where there is severe threat to life or long-term family or community disruption.
 
Kronenberg et al.’s (2010) review found that children who lived in highly impacted areas during Hurricane Katrina experienced a decrease in overall symptoms from the second to third year after the disaster. Despite this decline, three years after the disaster, over 25 percent of children continued to experience significant symptoms of posttraumatic stress and depression. The authors explain that when a neighborhood or family is severely impacted and there is slow environmental recovery, symptoms can persist or even increase over time. The Kronenberg et al. (2010) article outlines other studies where this increase in symptoms occurred, including the Buffalo Creek dam collapse (also described in Murphy’s review), where over a period of 17 years, the disaster survivors experienced a significant increase in alcohol and drug abuse as well as suicidal ideation (2010, p. 46).

The Kronenberg et al. (2010) article expands its discussion beyond symptomatology to explore other factors that affect children’s typical recovery patterns, such as their natural resilience. Resilience is defined here as the child’s ability to bounce back to their previous level of functioning, despite the significant impact of a disaster. The authors describe the complex pathways of both resilience and maladaptation explaining their evolutionary nature as influenced by previous experiences and coping abilities (Sroufe, 1997). The recovery pattern structure that was chosen for Kronenberg et al.’s study was adapted from Masten and Obradovic (2008). It outlines several possible outcomes including: (1) stress resistance, (2) normal response and recovery, (3) delayed breakdown, and (4) breakdown without recovery. The authors used these different outcome trajectories to categorize their study participants, and then conducted analyses to assess differences between the categories (p. 1245).

The research undertaken by Kronenberg et al. (2010) further supports previous studies’ findings that the vast majority of children (72 percent) display resilience following a disaster. In the study of Hurricane Katrina survivors, 45 percent of all children who lived in St. Bernard Parish were classified as “stress resistant,” displaying no significant psychological symptoms. Further, 27 percent displayed “normal” responses; that is, they displayed some struggles initially, followed by recovery to normal functioning. The authors substantiate these findings with several other studies of resilience and suggest that these patterns are correlated with “self-efficacy, positive coping and problem-solving skills, self-regulation, and supportive social systems” (Kronenberg et al., 2010, p. 1254).
 
Still, evidence warns that large-scale disasters and human-caused traumatic events such as terrorism can leave a long-lasting and significant negative psychological impact on some children and youth. Murphy’s (2010) literature review found that at least one-third of children exposed to a mass disaster or terrorist attack experienced mental health problems, described as “negative consequences of indefinite duration and severity” (Galea et al., 2007; Hoven et al., 2005; Norris et al., 2002; Pfefferbaum et al.,1999; Vernberg, LaGreca, Silverman, & Prinstein, 1996; as cited in Murphy, 2010, p. 45). The study conducted by Becker-Blease et al. (2010) adds to these conclusions by finding that symptoms such as substance abuse and suicidal ideation can increase over time post disaster. Over one-fourth of children in the 2010 Kronenberg et al. study reported significant posttraumatic stress and depressive symptoms, and the authors found that children who reported concern about the wellbeing of their family were more likely to have longer-term symptoms in the third year following Hurricane Katrina (p. 1255).

This variability of children’s responses to trauma and the potential for recovery supports current recommendations to screen and assess populations of children exposed to large scale disasters and mass violence.  Such variability also speaks to the need to incorporate additional factors in the screening process, particularly social and environmental effects. These influences are discussed in the following dedicated section, as a means of stressing their importance.


Social and Environmental Effects

       Family and Other Social Support Networks. Multiple studies provide evidence that the behavioral health of parents has a tremendous impact on children’s mental health outcomes (Kronenberg et al., 2010; Peek & Stough, 2010). The stress that parents feel as a result of a disaster can have detrimental effects on their ability to care for their children. Peek and Stough suggest that this impact may be felt quite acutely among children with disabilities (2010, p. 1264). The authors also emphasize that children with disabilities often rely on social networks for emotional support and medical care that are more fragile and complex than the networks of children without disabilities. When those social supports are threatened, it can more thoroughly disrupt the child’s safety net (Peek & Stough, 2010, p. 1264). Many children with disabilities rely on their caregivers for medical care or extra emotional or cognitive support to make sense of their experiences. If their caregivers’ sense of wellbeing or ability is impaired, these children may experience lasting negative impacts on their health and development (Peek & Stough, 2010).
 
       Schools and Peer Support. Another environmental factor that influences children’s recovery post disaster is the disruption to the school system. The loss of support from experienced teachers places many children at risk. Peek and Stough indicate this is especially true of children with disabilities, since these children tend to rely on more specialized educational plans and may have more difficulties in establishing social relationships (2010, p. 1266). Similarly, Kronenberg et al.’s study (2010) found that positive peer and school support was linked to better recovery patterns for children overall (p. 1255, 1257).

       Community Supports. Peek and Stough (2010) also argue that when community infrastructure is damaged during a disaster, the ability for children to adapt and recover may be linked with recovery of the community as a whole. Thus, the authors stress the importance of community recovery, including rebuilding schools, restoring a sense of normalcy, and the restoration of essential services to rebuild the social and environmental networks that are vital in supporting children, more so, children with disabilities.

A child’s demographics (age, gender, race, functional abilities and socioeconomic status), their history of trauma, their innate resilience and learned coping mechanisms, along with the proximity to and size, type and scope of a disaster create a complex set of variables that highly influence the development of negative psychological outcomes. The link between these variables and a child’s social and environmental supports strongly emphasizes the importance of reestablishing community and school system infrastructure as quickly as possible after a disaster. In addition, looking for ways to foster a child’s natural resilience and enhance their coping skills can mitigate the development of poor mental health outcomes and help move them towards recovery.


Implications for Practice

The articles reviewed reinforce current disaster behavioral health principles recommending that practical clinical interventions following potentially traumatic events should focus on “case finding, outreach, the identification of those at highest risk for adverse outcomes, and having well-trained providers to administer to those in need” (Murphy, 2010, p. 51). The findings support an additional understanding of disaster survivors, that those in need of services may not accept mental health referrals even in the aftermath of a disaster. In many of the studies that were reviewed, reports of successful referrals for treatment were low. In Becker-Blease et al.’s study (2010), only 2 out of 70 participants who had experienced a disaster within the past year had received counseling (p. 1049). Murphy cited a 2008 study by Goodman and Brown, whereby half of all parents either ignored recommendations to seek help or refused treatment for their children (Murphy, 2010, p. 51).

Disaster behavioral health responders would benefit from training to identify the needs of children and youth after disasters and to recognize common symptoms, such as children’s development of separation anxiety. It is crucial to build awareness of children’s experiences and emotions in reaction to disasters across various developmental stages, and to encourage response programs to provide public education for community members (Murphy, 2010, p. 52).

Daughtery and Blome (2009) bring to light a serious, often overlooked concern in provider agencies post-disaster: social workers and other child welfare staff will likely experience an increase in their workload. This may include attending to an influx of unaccompanied minors and an increase in communications with caregivers in an effort to assure safety (p. 493). Staff in these roles are already under considerable pressure due to high turnover and large caseloads. It is essential for provider agencies to consider that staff may need to be cross-trained should they need to fill in for displaced colleagues, as occurred in the Louisiana children’s service agencies after Hurricane Katrina.

The research suggests that health and mental health provider agencies should follow a broad based, trauma-informed perspective that focuses on strategies such as maximizing children’s sense of safety and self-efficacy, helping to calm children’s emotional distress and to facilitate an understanding of their experiences (Daughtery & Blome, 2009, p. 486). The authors also recommend strategies to address other impacts of the disaster on the child’s behavior and relationships, such as providing consultation to the family, and addressing the social worker’s professional and personal stress (2009, p. 486).

 
Implications for Policy and Planning

Translating research findings into effective disaster response plans and policies is vital to ensuring that communities are prepared for future disasters. Daughtery and Blome (2009, p. 487) describe the U.S. Government Accountability Office’s concerns regarding the impact of Hurricane Katrina on the child welfare system in Louisiana, where 5,000 foster children were dispersed to 19 different States. The child welfare system experienced many challenges, such as not having emergency contact information for foster families, loss of telephone service and case records, and the displacement of social workers (Daughtery & Blome, 2009, p. 487). Other communication issues were inhibited by the lack of coordinated communication channels between jurisdictions within counties and States.

Outlining a process case study based on Saleebey’s (2006) strengths-based perspective, Daughtery and Blome (2009) describe a consultation process which engaged seven public child welfare agencies in the Washington, DC metropolitan area, where they used a disaster planning template for incorporating emergency planning tasks. The challenges discovered included failure in coordination among agencies and workforce issues which served as a barrier for effective disaster response. The report noted that State and local communities could better protect children if they formed partnerships between child welfare and education agencies.

The Daughtery and Blome article states that the key to a strengths-based disaster planning approach is to focus on building upon the existing community capacity to deal with challenges and making connections between the resources and assets already in place. The disaster planning template was aimed at “translating tasks already mandated by law and policy into tasks essential for disaster planning” (Daughtery & Blome, 2009, p. 489). Throughout this process, the authors emphasized the importance of establishing agreements with providers before disasters occur, as well as focusing on the safety and accessibility of case records, which should be backed up in a different location than where paper records are stored. Furthermore, the authors suggest that child welfare agencies discuss disaster planning with foster families, social workers, and other involved parties to ensure key stakeholders are at the table during the planning process. The authors additionally call for increased interdisciplinary research among disaster planning, public safety, and child welfare officials.

 

 

 

CONCLUSION

 

 

The five articles chosen for this Research Bulletin provide information about the behavioral health effect of disasters on children and their caregivers as well as recommendations for future planning. Although most children demonstrate resilience following a disaster, behavioral health responders need to be able to identify the cohort of children who will experience long-lasting negative mental health effects, maladaptive coping mechanisms, and social support system disruptions. These articles support current knowledge indicating that higher degree of exposure, female gender, younger age, minority ethnicity, lower SES, and especially disability are known to increase the risk of experiencing poor mental health outcomes in children following a disaster. The articles also support emerging research that finds children’s support networks, including parents, caregivers, school systems, and providers, have a tremendous impact on behavioral health and recovery patterns. Although the body of research on children’s disaster reactions is ever growing, more studies are needed to identify risk and protective factors that have the greatest influence on resilience following a disaster. We recommend that the needs of children and youth are addressed in the disaster response policy and planning processes to maximize preparedness for future disasters.


Abstracts

Murphy, S. (2010). Women’s and children’s exposure to mass disaster and terrorist attacks. Issues in Mental Health Nursing, 31, 45–53. Published documents were used to identify women’s and children’s exposure experience following two mass disasters and two terrorist attacks that occurred in the United States. Research reports, clinical needs assessments, and a case study were analyzed to determine the type and severity of women’s and children’s exposure. Research reports were given priority if pre-event/post-event data were reported, if the study reported was longitudinal in design, and if samples were representative of the populations from which they were drawn. Clinical needs assessments were included because these documents provide evidence of need for mental health services by disaster victims. The case study selected was unique in the literature reviewed. The results showed that both women’s and children’s severity of exposure was related to posttraumatic stress disorder (PTSD), depression, separation anxiety, and generalized anxiety. In studies that made gender comparisons, data collected from women and girls showed more negative mental health outcomes than data collected from men and boys. Implications for clinical practice and traumatic event policy are addressed. Longitudinal, prospective studies of potentially traumatic events (PTE) are needed to better understand the longer-term plight of children, especially girls.

Becker-Blease, K. A., Turner, H. A., & Finkelhor, D. (2010). Disasters, Victimization, and Children’s Mental Health. Child Development, 81(4), 1040–1052. In a representative sample of 2,030 U.S. children aged 2–17, 14 percent reported lifetime exposure to disaster, and 4 percent reported experiencing a disaster in the past year. Disaster exposure was associated with some forms of victimization and adversity. Victimization was associated with depression among 2 to 9 year old disaster survivors, and with depression and aggression among 10 to 17 year old disaster survivors. Children exposed to either victimization only or both disaster and victimization had worse mental health compared to those who experienced neither. More research into the prevalence and effects of disasters and other stressful events among children is needed to better understand the interactive risks for and effects of multiple forms of trauma.

Daughtery, L. G., & Blome, W. W. (2009). Planning to Plan: A Process to Involve Child Welfare Agencies in Disaster Preparedness Planning. Journal of Community Practice, 17, 483–501. In the aftermath of Hurricane Katrina when child welfare officials in Louisiana reported they did not know the whereabouts of the foster children under their care, disaster planning in the public child welfare system became a new area of concern. This article reports on a process of engaging seven public child welfare agencies in disaster planning to address child safety and service delivery. The Washington Metropolitan Area Disaster Planning Project used a strengths-based approach to help agencies responsible for protecting and serving children in foster care and families at risk of abuse and neglect to develop plans to augment and continue service delivery and responsiveness in the aftermath of a natural or man-made disaster. The article details the process of gathering information on disaster responsiveness, interviewing community and professional informants, developing a template to guide disaster planning within the agencies, and implementing a tabletop exercise. As a result of this consultation effort, agencies became aware that disaster planning at the State and county levels had proceeded without child welfare at the table, that the increase in need for child welfare services during a disaster was not recognized by disaster professionals, and that practicing disaster responsiveness is necessary to address the welfare of children in foster care.

Peek, L., & Stough, L. M. (2010). Children with disabilities in the context of disaster: A social vulnerability perspective. Child Development, 81(4), 1260–1270. An estimated 200 million children worldwide experience various forms of disability. This critical review extrapolates from existing literature in two distinct areas of scholarship: one on individuals with disabilities in disaster, and the other on children in disaster. The extant literature suggests that various factors may contribute to the physical, psychological, and educational vulnerability of children with disabilities in disaster, including higher poverty rates, elevated risk exposure, greater vulnerability to traumatic loss or separation from caregivers, more strain on parents, and poor postdisaster outcomes, unless medical, familial, social, and educational protections are in place and vital social networks are quickly reestablished. Future research needs are outlined in the conclusion.

Kronenberg, M. E., Hansel, T. C., Brennan, A. M., Osofsky, H. J., Osofsky, J. D., & Lawrason, B. (2010). Children of Katrina: Lessons Learned About Postdisaster Symptoms and Recovery Patterns. Child Development, 81(4), 1241–1259. Trauma symptoms, recovery patterns, and life stressors of children between the ages of 9 and 18 (n = 387) following Hurricane Katrina were assessed using an adapted version of the National Child Traumatic Stress Network Hurricane Assessment and Referral Tool for Children and Adolescents (National Child Traumatic Stress Network, 2005). Based on assessments 2 and 3 years after the hurricane, most children showed a decrease in posttraumatic stress and depressive symptoms. Students were also classified into outcome trajectories of stress resistant, normal response and recovery, delayed breakdown, and breakdown without recovery (Masten & Obradovic, 2008). Age, gender, and life stressors were related to these recovery patterns. Overall, the findings highlight the importance of building and maintaining supportive relationships following disasters.


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SAMHSA DTAC Discussion Board
SAMHSA DTAC continues to offer this online forum for discussing disaster behavioral health issues, sharing lessons learned, and posting helpful resources. To become a member, please visit http://dtac-discussion.samhsa.gov/register.aspx and complete the brief registration process. Within 2 business days, you will receive your login ID and password via email, along with further instructions on how to access the board. Please contact SAMHSA DTAC with any technical questions by emailing DTAC@samhsa.hhs.gov or calling 1-800-308-3515.

The Dialogue–DTAC's Quarterly E–Communication to the Field
The Dialogue is SAMHSA DTAC's quarterly electronic newsletter that provides practical and down-to-earth information for DBH coordinators, local service providers, Federal agencies, and nongovernmental organizations. The Dialogue is distributed via SAMHSA's email updates, which can provide you with the latest news about grants, publications, campaigns, programs, statistics, and data reports. To receive The Dialogue, please go to SAMHSA's homepage (http://www.samhsa.gov), enter your email address in the “Mailing List” box on the right, and select the box for “SAMHSA's Disaster Technical Assistance newsletter, The Dialogue.” To volunteer to author an article or submit a feature for an upcoming issue, please contact SAMHSA DTAC by emailing DTAC@samhsa.hhs.gov or calling 1-800-308-3515.

 

 

 

 

 

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SAMHSA is not responsible for the information provided by any of the Web pages, materials, or organizations referenced in this communication. Although the DTAC Bulletin includes valuable updates and links, SAMHSA does not necessarily endorse any specific products, services, or meetings provided by public or private organizations unless expressly stated. In addition, SAMHSA does not necessarily endorse the views expressed by such sites or organizations, nor does SAMHSA warrant the validity of any information or its fitness for any particular purpose.