We know children were adversely affected by the events of Sept. 11. But are their fears abnormal? Or is worrying just part of a kid's job? [Times art: Rossie Newson]

By BILL DURYEA
© St. Petersburg Times
published June 17, 2002

Parents began worrying about how Sept. 11 would affect their children almost immediately.

How can we assuage our children's fears, adults seemed to say during those first anxious days, when we're having such a hard time managing our own?

It made sense that the first generation of stories tended to focus on prescriptive measures -- don't let young children watch too much grisly footage on TV, or better yet, don't let them watch at all.

Recent stories have lent some scientific support to our original dire speculation: the events of Sept. 11 and the relentless coverage of the aftermath have overwhelmed our ability to mitigate the impact on our children.

Six months after the attacks, 90 percent of New York City children in grades 4-12 showed at least one symptom of post-traumatic stress disorder (PTSD), according to the study commissioned by the Centers for Disease Control and Prevention. Ten percent of the city's 1.1-million students suffered at least six symptoms and could be diagnosed with PTSD.

Some public health officials have linked a mysterious skin rash afflicting school children in cities far beyond Ground Zero to mass hysteria induced by lingering fears of terrorism.

Parents, whose most approximate experience was growing up in the Cold War era of "duck and cover" drills, might reasonably worry that their children have been scarred permanently.

After all, " 'duck and cover' alluded to something that might happen," St. Petersburg therapist Bob Greene said. "This did happen. These kids have seen something we never saw. I'm sure it's 100-fold worse than 'duck and cover'."

To be sure, the trauma has been greatest for those children directly connected to the destruction, children who lost a loved one, who went to school near Ground Zero or who witnessed the planes crashing into the buildings.

Billy Kelley, a fourth grader at Melrose Elementary, fits none of those descriptions, yet seven months after the attacks he refuses to fly to Ohio to visit his father. "The plane is going to crash," he said.

Has Sept. 11 really made children across America abnormally fearful of the world they live in? Or is worrying about things they cannot control just something that children do?

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[Times photo: Dirk Shadd] Gathered in the media center at St. Petersburg’s Melrose Elementary, students discussed their post Sept. 11 fears: from left, Ariana Rivera, 7; Xavier Williams, 10; Billy Kelley, 12 (in back); Kim McEntegart, 7; and Linda Nhon, 10.

Melrose Elementary is a magnet school for communications and mass media. It would be hard to find a school in which Sept. 11 was not somehow incorporated ad hoc into the curriculum, but Melrose may have been more immersed than most.

For several months, the school's hallways were adorned with 4-by-8-foot posters of front pages from the St. Petersburg Times. One of them was the edition of Sept. 12 that showed the now infamous photograph of a plane flying into the second tower of the World Trade Center as the first tower burned ominously.

Several teachers expressed concern that young children didn't need such a graphic reminder of the attacks, said principal Sue Graham, but none of the students complained. The school's guidance counselor hadn't reported any children "displaying problems," she said.

Graham wasn't suggesting the students didn't think about Sept. 11 or even worry about it privately, only that there was nothing to indicate they were in crisis. She invited me to talk with a group of students to learn specifically how the attacks had affected them.

In early April, I met with 14 children in two age groups, kindergarten through second grade and third grade through fifth. The kids sat in purple and green bean bags on the floor of the library. My first questions were general; I asked them about things they liked and disliked.

Ariana Rivera, 7, was eager to talk about how much she likes math. But Kim McEntegart, 7, was more interested in discussing her fear of dying.

"If I have to go in the dirt, that's scary because you can't do a lot of stuff," she said, creasing her forehead.

The subject of "bad men" came up without prompting. That was followed closely by Ariana's concern that her dog was a terrorist because he had frightened her bunny and the bunny had had a fatal heart attack.

This, in turn, led one boy to explain that he thought almost equal amounts about "all the people dying" and his two goldfish, John and Jonathan.

If there was a common denominator in the recollections of these 5- to 7-year-olds, it was that they comprehended the deaths of people they didn't know in terms of the only deaths they did know -- those of elderly relatives and pets. For the most part, if they expressed worry, it was not directly connected to Sept. 11.

The older children, as might be expected, were more conversant with the details of the attacks. They had asked questions of their parents as events were unfolding. They remembered clearly their parents' responses, whether soothing or fearful. Five of the seven had watched the documentary 9/11 and recalled the sound of bodies hitting the sidewalk.

Perhaps because of that familiarity, these kids seemed more likely to express continuing anxiety.

Billy Kelley, 12, was worried "that it might happen again. My parents said it probably will and it's probably going to kill more people."

Linda Nhon's father assured her that St. Petersburg didn't have any tall buildings. Consequently, Linda, a fourth-grader, was "stressing out" over a report she had to write on Daytona Beach rather than over the possibility of future terrorism.

Several of the children said that troublesome thoughts often surprise them. For Billy it's when he is playing with his Game Boy. For Xavier Williams, 10, these moments tend to occur on weekends when he has more free time.

Nearly all of them expressed a mixture of confusion and anger that a handful of men would deliberately kill thousands of innocent people. It continued to bother them that they did not have a satisfactory answer.

"I want to think about school," DeShauna Henry, a fourth grader, said. "I want to think about the best and not the worst."

Fourteen children, of course, do not meet the threshold of a scientific sample. Still, it is remarkable how their comments reflect the current research on how children acquire fears as well as the way those fears develop with age.

Experts in the field of fears and phobias generally agree with the theories of Canadian psychologist S.J. Rachman that fears are acquired through three pathways: direct conditioning (dog bites you, you become afraid of dogs), vicarious or observational learning (witnessing someone else's experience, for example) and information gathered from photographs or books.

None of the children at Melrose, with the exception of one boy whose aunt lived four blocks from Ground Zero, had a direct experience with the attacks. Yet the ubiquity and persistence of the images and information stemming from Sept. 11 made it possible for the children to develop high individual worries.

Kim told me later in a one-on-one interview that she thinks every day about "the bad guy who killed our people." She knows he lives in Afghanistan, which is far away ("really close to Tennessee," she said), but she worries sometimes that he might harm her.

Recently, though, she "figured it out that he can't just come down here and kill me. He doesn't know where I live."

Xavier, the thoughtful co-editor of the Manatee Messenger, reads the newspaper every day. This keeps him up to date, but also makes him worried. "I'm hearing rumors that it might happen again." Welcome to the club, Xavier.

After the Oklahoma City bombing, psychologists studied children's long-term reactions to the traumatic event.

"From our research, how much TV they were watching was a pretty positive predictor of post-trauma stress," said Robin Gurwitch, a clinical psychologist in the Department of Pediatrics at the University of Oklahoma Health Sciences Center.

Just as important, Gurwitch said, is how the images are being processed. "Are they watching with family who are putting the images in context? Or are they watching alone?" she said.

That emphasis on the role of guardians to mitigate and interpret the raw data is supported by research done at the University of Sussex in England. Dr. Andy Field wanted to determine whether indirect experience is as viable a "pathway to fear" as direct experience.

In Field's study, children were given negative information about a monster from adults and from videos. They discovered that if you really want to embed fear in a child, a scary story from an adult is nearly twice as effective as the same information delivered by video.

And it is important to understand that preteens are particularly susceptible to fears about external threats.

"The age between 8 and 12 years seems to be an age at which many children suffer from fears and anxiety due to mental changes," said Peter Muris, a psychology professor at the University of Maastricht in the Netherlands. "They are able at that age to worry about things which are not in their direct environment."

As children get older they become more able to anticipate future events. Moreover, as they pass into middle childhood their deductive reasoning permits them to contemplate multiple outcomes, some of them catastrophic, Muris writes.

Most children worry every now and then (60 percent -- 70 percent), Muris says. Only 5 percent of them exhibit symptoms that would be described as pathological. Worry tends to increase with age; half of 3- to 6-year-olds worry, but three-quarters of 10- to 14-year-olds worry. Little children are most likely to worry about imaginary creatures, but the older a child gets the more likely he is to fear social failure.

In the Netherlands at least, schoolwork and dying represent equal prevalent concerns. Being separated from one's parents is not as likely to worry a child as the prospect of being teased.

The persistence of phobias into adulthood may depend on whether the child has overprotective parents, or whether the child is simply inclined to worry, according to Muris.

Annette M. La Greca, University of Miami professor of psychology and pediatrics, tracked children after Hurricane Andrew in 1992. "Children who before the event were more anxious tended to be more affected after the event," she said.

This may explain why Linda Nhon, 10, who says she would rather be happy than sad, says she is occasionally afraid of ghosts, but chooses not to focus anymore on Afghanistan.

"Hello, that's in the past. I'm moving on," she says. "The president has to stick to the same subject every day. Poor president."

Time passes, and worries, even ones sparked by events of staggering enormity, dissipate.

That's the double-edged sword of cognitive development. At first it gives children the fodder to worry about more things, but it also provides the perspective that enables children to put their fears into the context of daily living.

Take Billy Kelley, for example.

"My mom asked me if I wanted to fly. I told her, 'Not really'," he said. "The next day I woke up and I said to her, 'I guess I'll fly'."

He's got a flight to Ohio on July 2.

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