In the wake of the Indian Ocean tsunami (search), we Americans pray for the survivors — particularly the injured, ill and orphaned children. And we hug our own kids a little tighter.

They were spared, of course, from the tsunami's devastating direct effects. But few children have been spared from the graphic and disturbing images that every hour stream across the airwaves.

And those images do affect them, says Glenn G. Sparks, PhD, communications professor at Purdue University in Indiana. Sparks is an expert in children's reactions to frightening media images.

"We must acknowledge that the people who experienced the tsunami first-hand are the first to worry about," Sparks tells WebMD. "In comparison, it seems silly to worry about the emotional trauma in kids who are fine but watching TV. But there are issues in terms of children's exposure to these kinds of images."

TV Images Traumatic for Young Children

Media coverage of the tsunami can be tough on children aged 5 and younger, says Clarice Kestenbaum, MD. Kestenbaum is a child psychiatrist at the New York State Psychiatric Institute.

"Unlike the genocides in Darfur and Rwanda, the tsunami deaths are being reported in graphic images that are repeatedly in front of you," Kestenbaum tells WebMD. "The images are very traumatic for young kids. Now they are all going to know something about this, so I am not saying we should pretend nothing is happening. It is important for them to know something bad happened, but far away — and they are safe."

Parents, Kestenbaum stresses, should be careful not to express great anxiety in front of small children. If small children show concern about the tsunami, they should be reassured.

Extremely young children who have not yet learned of the tsunami need not be told, says Randall D. Marshall, MD, director of trauma studies and services for the New York State Psychiatric Institute.

"I have a 2-and-one-half-year-old girl we've shielded from this. But a 4- or 5-year-old will pick this up. You can't shield kids from this kind of thing," Marshall tells WebMD. "For very small children, keep it extremely simple. Emphasize their safety. Tell them that they are safe, that momma and poppa are going to keep you safe; that they will not let this happen to you."

But don't lie. Kids need the truth — just not gruesome details.

"You can't say this is something that would never happen," Kestenbaum says. "I would tell them that we would be better prepared — that we have lots of firemen and rescue workers and people who can help us if there is a disaster."

Parents' Common Mistake

Parents tend to make a mistake, Sparks says. They suppose that the older the child is, the less they have to be concerned about what they see in the media. This turns out not to be a good rule.

"It is likely that older children, aged 6 to 12, will suffer from these images more than preschoolers," Sparks says. "Once a kid hits the age of 6 or 7, they realize there are people really suffering out there."

Children at the earlier end of this age range may become confused. When they see repeated images of waves pounding over the shore, they may think this is happening continually. And they may not understand that the Indian Ocean is far away — and that their chances of being swept up in a wave are remote.

"In these disasters, it is really the kids aged 9, 10, 11, and 12, who are more likely to be at risk," Sparks says. "They are still children, and the media can be fairly harsh in what it shows. So you have kids who can understand that something terrible is happening, but who don't have much experience dealing with their emotional response to it. They are the more vulnerable group compared to preschool kids who don't really understand the realities of the event."

Kestenbaum and Shields both advise parents to limit kids TV viewing.

"Parents ought to be very careful about kids' exposure to news up to the age of 12," Shields says. "It is not a good idea to push news consumption on kids younger than 12 in an unregimented manner. What they will encounter is very unpredictable. So I recommend that if parents are going to have kids watch news, they ought to make sure they are there when it is happening, and talk with them about what they see and talk about their emotional reaction to it."

What You — and Your Kids — Can Do About Tsunami Coverage

Talk with your kids, all these experts advise. And listen to what they have to say.

"It is very important to listen to the children's thoughts and ideas and take whatever is in their minds very seriously," Kestenbaum says. "Maybe they will say something like, 'If Superman were here he could change the plates at the bottom of the sea and stop the tsunami.' Let them do this. Listen to their questions and talk sensibly and truthfully. If they encounter an image of bodies on a beach, don't say they are sleeping. Tell them yes, it is a terrible tragedy. It is important for parents to be calm, to explain the situation, and then to do something helpful. It is really important for them to be a part of it."

What can your child do to help? They might want to break open their piggy banks and give money to tsunami victims. They might call their friends and collect relief money. They might simply write letters or emails to the victims.

"After the World Trade Center disaster, lot of New York kids aged 3 and 4 and 5 went to fire stations with their parents and gave flowers to the firemen," Kestenbaum says. "It was extremely helpful. Children are very capable. They may not know things in the way a parent does, but they certainly have ideas. Not all of their reaction is negative and fearful."

While children are more vulnerable than adults, they are also more resilient, says Bernhard Kempler, PhD, an Atlanta psychotherapist who, as a child, survived the Holocaust.

"So much is made of children's vulnerability, and that is true," Kempler told WebMD in a recent interview. "But a point is missed in that often what is traumatic is the sense that our world is coming apart. Something is happening that is completely impossible. The world we took for granted is gone. But young children do not as yet have such fully formed impressions of the world. In a way, they can certainly be frightened, feel insecure, but it is not quite on that level that this is not supposed to be happening."

When to Get Help

Some children — particularly those who have themselves survived a trauma or disaster — may be at higher risk than other kids. Graphic images of the tsunami and its aftermath may serve as a trigger for them to re-experience their trauma.

Signs of trouble may include:


—Waking up frequently

—Children used to sleeping on their own insisting on sleeping in their parents' bed

—Being afraid of water in the bath, or afraid to go to the beach.

—Being afraid to go to school

"If symptoms develop and are there for more than a month, you should see a professional," Kestenbaum says. "If this persists, they really need help — psychotherapy or perhaps even drug therapy."

By Daniel J. DeNoon, reviewed by Michael W. Smith, MD

SOURCES: Clarice Kestenbaum, MD, child psychiatrist, New York State Psychiatric Institute; and professor and director of child and adolescent psychiatric training,Columbia University College of Physicians and Surgeons; and past president, American Academy of Child and Adolescent Psychiatry. Glenn G. Sparks, PhD, professor and assistant head of communications department, Purdue University, West Lafayette, Ind. Randall D. Marshall, MD, director of trauma studies and services for the New York State Psychiatric Institute, New York State Office of Mental Health; and associate professor of clinical psychiatry, Columbia University College of Physicians and Surgeons, N.Y. Bernhard Kempler, PhD, clinical psychologist, Atlanta.