"It makes a big difference. I don’t want you to get overwhelmed by all that could – and unfortunately does – happen, and the long-lasting and profound impact these violent events can have on children. Instead, I challenge you ... to commit to at least one strategy to advocate for violence prevention and/or readiness for your practice or your community to support those who have been impacted by these events," he said.
Such strategies can include:
• Working to decrease violence crisis and loss, and advocating for meaningful change.
• Giving voice to children impacted by these events, allowing them to tell their stories, and forcing a dialogue that can help move the agenda forward.
• Advocating for better systems and services for children affected by these events, and other adverse events in the lives of children, including poverty, exposure to urban violence, and food insecurity, for example.
• Becoming more skilled in supporting children who are grieving and traumatized.
• Ensuring that other professionals in positions to support children – such as teachers and other school staff – are better prepared, more skilled, and more effectively supported in helping children after these events (and introducing information that can help before such events occur).
• Inquiring about exposures and experiences routinely in the practice setting. (The Medical Home for Children Exposed to Violence project [MHCEV] is working to provide resources for identifying, treating, and referring affected children and youth.)
• Promptly identifying affected children at the time of an event, and facilitating discussion about the impact of the event, and offering "psychological first aid and psychoeducation." Attend to basic needs, provide triage and referral, and remember that services will be needed throughout the recovery period, which may be weeks, months, or years.
• Helping in one’s own community when events happen elsewhere, as communities struggle to understand and cope with the events, and deal with distress that can surface as a result of concerns and personal experience.
• Becoming aware of the resources and support efforts of the AAP with respect to disaster preparedness and response. The academy’s department of federal affairs has helped make the AAP one of the leading forces for positive change at the federal level, Dr. Schonfeld said.
"The [AAP] Friends of Children’s Fund in general, and specifically the disaster relief part of that fund, helps not only children, families, and communities recover, but also assists professionals with self-care after these events," he said, noting that it is important to recognize that "it is distressing to be with children in distress."
"Events that are troubling our patients and their families are troubling to us as pediatric health care providers, as well," he said.
Dr. Schonfeld recommended the following resources for additional information:
• The AAP Children and Disasters site.
• The AAP Children and Disasters site, Coping and Adjustment.
• The AAP Medical Home for Children Exposed to Violence.
• The National Center for School Crisis and Bereavement.
Dr. Schonfeld reported having no relevant financial disclosures.