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Vivid Images of Temblor Still Haunt Many Children

TIMES STAFF WRITER

The youngest draw pictures to describe feelings they lack the words to express, depicting tents, sad people camped out in cars and houses marred by angry, scrawled crack lines.

Older children meet in groups to talk about how they feel and to find comfort in the discovery that their nightmares, sleeplessness, continuing sadness and insecurities are not unique.

Still others, with more serious behavioral or emotional problems, spend hours with therapists, describing how the problems of out-of-work parents, homelessness and other earthquake-spawned ills torture them--the most vulnerable victims of the Northridge earthquake.

And in Los Angeles schools Tuesday, therapists reported that the anniversary of the Northridge quake, and haunting images of seismic trauma in Japan, triggered again the fear, panic and helplessness many children thought they had left behind.

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“At the moment the earthquake happened, there was an immediate experience of life threat and a real physiological response to that,” said Dr. Robert S. Pynoos, the director of UCLA’s Trauma Psychiatry Service and a leading expert on disasters and the mental health of children. “We know that can become chronic over time, especially when they are faced with numerous reminders and aftershocks.”

There have been tremendous successes over the past year, children who lost everything and who are moving on stronger, better prepared and emotionally toughened.

But others, experts and therapists say, still have a long way to go.

According to a Los Angeles Times poll taken Jan. 7-9, one-quarter of the parents in Los Angeles County--and about two in five parents in the San Fernando and Santa Clarita valleys--report that their children are still suffering nightmares and other problems.

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At Woodland Hills Elementary School, children took turns Tuesday proving those statistics true, telling their teacher and a visiting social worker that they are still afraid.

Publicity about the quake anniversary was enough to send some of them scurrying to sleep in their parents’ beds again, they said. Fresh images from Kobe, Japan--and worries about how the children there are faring--sealed for some students the idea that they might never be safe.

“It reawakens fears that may have been beginning to heal,” said JoAnne Tuell, a psychiatric social worker who spoke to the children Tuesday. “For so many of the children, last year was their first traumatic experience. Now they know that it can happen again.”

One child asked if the Kobe temblor meant that there would be an earthquake every Jan. 17.

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Other principals, fearing those discussions would revive old pains, decided not to have any commemorative events Tuesday.

“I don’t think we need to continue to re-traumatize the children,” said Larry Gonzales, the principal at Pacoima Elementary School. “I think the anniversary was dramatized enough by Japan.”

More than 241,000 children received crisis counseling from Jan. 17 to mid-November through the county’s Project Rebound, a mental health recovery program funded by the Federal Emergency Management Agency, said Risa Palley Flynn, who coordinates the project’s services for school-age children. That number includes everything from onetime rap sessions to continuing therapy, Flynn said.

One year later, the number of referrals and inquiries by students, teachers and parents has not significantly tapered off, Flynn said.

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“Recovery is a long process,” said Kim Boyer, the Los Angeles Unified School District’s coordinator for quake-related mental health recovery efforts. “It’s just like child development. Every child walks at a different age and they will also recover at their own rate based on their coping skills, their support system and their emotional health.”

Flynn, leafing through recent reports from the Project Rebound therapists, said the children’s own descriptions of their fears best explain the continuing problems:

* A 6-year-old girl assured a clinician that she was no longer afraid. But then she drew a picture of a tilted house, with a very bright light and a butterfly. “That’s the light that I keep on in the bathroom ever since the earthquake,” she explained to the counselor, pointing to her drawing. “And the butterfly is flying away because it is scared.”

* One boy told counselors he did not want to move back into his family’s newly repaired home. The elementary school student said he felt safer in the mobile home his family has been living in since the quake.

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* Just after moving back into her house, an elementary school-age girl told counselors that she is still frightened, and that she has not told her parents because they are busy trying to get resettled.

* Months after the quake, another young girl told counselors her sadness continued. Her best friend, she said, was forced to move away after the temblor. “She was my best friend for four years,” she said. “Now she’s gone and I didn’t even get a chance to say goodby.”

* One boy summed up his feelings to a counselor this way: “I am scared because there are more aftershocks,” he said. “I am also sad because the house I had was very, very nice, big, had a pool, and the neighbors (were) very nice. Before, I lived in Granada Hills. I would stay outside until 10 at night and wouldn’t worry about anything. I was never scared of an earthquake until now.”

* A high school senior in a wheelchair expressed fears about attending Cal State Northridge in the fall because that campus was badly hit by the quake. She worried that her disabilities would no longer be accommodated and that any additional earthquakes would trap her on a campus no longer suited to wheelchair navigation.

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As part of a study five months after the quake, Pynoos, in conjunction with FEMA and the LAUSD, examined how children were affected by the quake initially, and tracked how they were reacting to it several months later.

What the researchers found was that a significant number of children had been physically threatened during the quake: They reported being trapped, hit by falling objects and cut. Many also witnessed injuries to members of their families.

One in seven LAUSD children said they had been hurt. Forty percent said they thought they were going to die. These children were more likely to show signs of significant mental trauma, Pynoos said.

Other indicators of mental distress are children who were displaced, live in visibly damaged homes or who lost a pet during the quake.

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Children who suffered secondary effects of the quake--relocation, or parents losing jobs--showed increased signs of depression, Pynoos said.

That an earthquake is not a onetime trauma compounds the problem; aftershocks and other earthquakes elsewhere mean continuing mental stresses.

“It’s just like a prod,” said social worker Joyce Wexler-Ballard, a clinical art therapist with the Cedars-Sinai Trauma Center who has been working in the schools. “It makes them feel helpless again.”

Dr. Lynn Ponton, a professor of psychiatry at UC San Francisco and an expert in how children respond to disaster, said it is a myth that children are resilient and able to overcome trauma on their own.

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“Parents say, ‘Kids are resilient, my kids will recover,’ but that’s not what we see,” said Ponton, who has worked with children who experienced the 1989 Loma Prieta earthquake, the 1993 Midwest floods and the Northridge quake. “To hide behind that phrase really deprives a whole group of children of the proper assessment and treatment they need.”

Children who are still experiencing sleeping problems, nightmares or obsession with or avoidance of anything earthquake related could be experiencing symptoms of Post Traumatic Stress Disorder, she said. The condition involves recollections of a disastrous event so vivid that victims feel as though they are experiencing the trauma again.

Those children who are not old enough to verbalize their fears find other ways to express them. In all three disasters she studied, Ponton said, she found evidence of trauma on the playgrounds.

“You could see incorporated into their play aspects of the traumatic experience,” Ponton said. “You could hear them say, ‘This little bird doesn’t want to leave the mama bird and the mama bird wants to stay with the little bird in case another earthquake happens.’ ”

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Even before the disaster in Japan, some of the children who worked through their quake-related fears became aware of the publicity surrounding the anniversary and again experienced sleeping problems or other regressive behavior, their therapists said.

Suzanne Silverstein, the president of Cedars-Sinai Medical Center’s Psychological Trauma Center, suggested asking children what they remember about the quake and if the quake seems as scary now as it was then.

If children are frightened, Silverstein tells parents to reassure them and work with them to make them feel safe. Let them help “quake-proof” their rooms by bolting bookshelves and making earthquake kits, then walk through home emergency and evacuation plans.

As much as students might need help, the clock is ticking on the programs that have allowed the county’s Department of Mental Health to hire additional counselors and send them into the schools.

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Flynn said FEMA’s most recent nine-month grant, which has funneled $844,670 directly to the LAUSD on top of the money given to other agencies that serve children, runs out in February and is unlikely to be renewed. The regular school-based counseling services, overworked and understaffed, are unlikely to adequately fill the gap.

Pynoos said that the study of disasters and mental health is being recognized worldwide as an important specialty. Particularly in areas afflicted by war and natural disasters, there is an increasing awareness of the need for prompt screening and treatment.

Additionally, he said, professionals such as police officers, firefighters and doctors who are at high risk of traumatic stress are regularly screened.

“Children deserve the same kind of access to those kinds of psychological interventions,” he said.

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Those children who are not given proper treatment, he said, can be permanently affected, becoming anxious, aggressive and wary of new situations.

“By learning how to cope with this disaster, the children will be able to take those coping skills they’ve learned and apply them to other situations,” Silverstein said. “They’ve been given skills they didn’t have before.”

Times staff writer Beth Shuster contributed to this report.


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