In the latest installment of our occasional conversations with Fort Worth newsmakers, Dr. Debra Atkisson, a child psychiatrist and associate professor at the TCU School of Medicine, explains how to help kids navigate in the aftermath of a massive school shooting in Uvalde that claimed the lives of 21 people.

This conversation has been edited for length and clarity. For a longer conversation, please listen to the audio file attached to this article.

Dr. Debra Atkisson. (Courtesy | TCU School of Medicine)

Alexis Allison: If you have a relationship with a child, how do you navigate the aftermath of the school shooting with them? What’s helpful? What’s healthy?

Dr. Debra Atkisson: I’m glad that we’re talking about this today, even though it’s a very sad topic to be discussing. This is a very abnormal situation for us to have to deal with. It is an abnormal situation where we have to worry about children, small children who are attending school being killed in the school. 

This is not just a horrific situation – it’s abnormal. And the way that we as people react to that, it’s going to cause all sorts of reactions in us. So just be aware of that yourself, whatever age you are. 

If you have a relationship with a child, the very first thing you have to do before you talk to any child about this, is to look at yourself and think about how this is impacting you. Acknowledge that this is abnormal, acknowledge this is horrific, and just validate yourself, and try to ground yourself a little bit before you talk to a child about this. 

I bet that everyone listening to this has talked to family members or friends, or people who are close to them about the situation, because all of us are grieving this tragedy. And that this is a horrible trauma. It’s a horrible tragedy, and we’re all grieving it. And it’s OK to acknowledge that and to discuss it. By doing that, it will help us then be able to do what we need to do to have those conversations with children. 

You see, we have some frame of reference to know whether this is a horrible thing. And to know what it means. They don’t — especially the young ones, they don’t have a frame of reference, so this is beyond confusing for them. It turns their whole world upside down. 

As an adult, once you get yourself grounded, where you can be calm, I think the first thing I would suggest for parents to do, or people who have close relationships with young children, is check in with them like you probably normally would when you see them. 

Say, ‘Hey, how did your day go? How are you doing?’

Get them to tell you about their internal world at the moment, the world through their eyes. And then you may ask them, ‘Have you heard anything today? Or has anyone said anything that has bothered you or made you scared?’ 

And so that is how you open the door to find out if they even know about this. My guess is that many of them will have heard something and know something about this. And so when they talk with you about that, it’s important to ask them what they heard, and what they think it means. You’re actually spending time as a calm adult who’s interested in what they know, and interested in what it means and hearing their replies. 

You will hear some replies that will probably make you feel very sad. It’s OK to show sadness as you’re talking to the children. But remember, they’re looking to you for security and safety right now. So one thing you can do as a grown-up is provide that sense of security for them by remaining calm while you’re in the conversation. 

I had a conversation with someone this morning about the conversation she had had with her 9-year-old child who had heard about this. One of the things that she discussed with her child was: How then did it make them feel? And so I think that’s really important: ‘How do you feel about this?’ Don’t give suggestive words. Let them tell you. They’ll tell you if they’re scared, they’ll tell you if they’re sad. Validate their feelings. Tell them that that’s exactly normal, and that you have those feelings too.

Then, ask them what helps them feel safe. One of the things I would suggest for parents to do, and it makes me sad even have to say, but ask: ‘Do the teachers or the school ever talk to you about what to do if something scary or frightening happens at school?’ 

Ask them to tell you about it, hear what they tell you, and then try to help them understand that their teachers are the people who will try to keep them safe. And they need to truly trust the teacher to help them. And you also want them to know they can always talk to you about anything, and you’re going to talk to them about it. That’s the way to begin those conversations with your child.

Allison: It sounds like best practices involve asking the kids a lot of questions. So inviting them to share, as you said, their inner world. What happens if the child maybe doesn’t know what happened? Or maybe shares some inaccurate information? How do you respond? 

Atkisson: The thing that you have to think about is, is there a good chance that your child will be exposed to this information if they don’t already have it? So the first thing: Do not let your children watch the news about this. I cannot tell you how many children in my practice I’ve seen who started having anxiety disorders and panic attacks and nightmares because of watching the news about traumatic events. The news is for adults, it’s not for young children. 

I have a 26-year-old daughter. I think if this had happened when she was this age, when she came home from school, I would ask her what she had heard about it, if she had heard anything that day that was scary or frightening — make it a general question. If she said no, she had not, I would probably ask her to sit down with me. And I would say ‘I want to talk to you about something sad, because I want you to hear it from mommy, so that you know what happened.’ 

And then I would tell her that there had been a school where a lot of little children were hurt, because somebody came in and shot people in the school. So I would be factual. I wouldn’t embellish a lot of things. And if she started asking me, ‘Were kids killed?’ I would say some kids have died. But I would not get into details about how many kids died. 

I would then ask her, ‘How does that make you feel?’ And I would get her to talk about it. And then I would say, ‘Do they ever talk to you at your school about what to do if something like that happens?’ And then I would get her to talk about that. And then I would ask her, ‘What helps you feel safe? And what are things you can do to try to feel safe?’ And that’s the way that I would approach that conversation. 

Parents, I just want to say this to you – not just as a child psychiatrist, but as someone who is a parent – one of the most valuable things you can do for your child is to stay calm when you’re having these conversations and somewhat matter-of-fact. It’s OK to be sad. It’s OK to tell them you’re sad, to look sad, but calmness goes a long way with helping them be able to understand things, helping them continue to feel secure. 

You also ask the question about best practices. I’m going to suggest some things are going to sound really basic, but they will go a long ways:

Every evening, try to sit down and have dinner with your children. I don’t care if it’s a McDonald’s Happy Meal. Sit down and have dinner with them where you’re talking to them, you’re not just doing it in the car. Sit and look at each other. Talk to them. Ask them how their day went. Ask them about something good that happened. Ask them if there was anything that happened, that was a challenge for them. And if it was, how did they deal with it, ask them if there’s anything they need help with. Make that a safe space, where people can be conversational, about what’s going on with your day and talk about real things. That way, you have a daily connection or touch point with your child where you’re looking at them, and you’re interacting.

That’s so important. Because if you do that, that becomes a cornerstone for them knowing they have that time every day, they can have these discussions. It’s like putting money in the bank you’re putting, you’re putting positivity in their emotional piggy bank, so to speak. You’re just putting in a little bit every day. With those interactions, it also opens the door for them to feel free to come to you whenever there is an issue, problem or concern. 

The other thing I suggest to parents, make sure that you’re connected with other parents, so that you can talk with each other about these things that happen. I talked about needing to feel grounded. You can get that often by sharing things with each other, sharing resources, discussing how your children are reacting. Two heads are better than one with brainstorming and coming up with ideas. It’s just really important, too, that you reach out to other adults who will have some understanding of what you’re going through. 

And I guess the other thing: If you are someone who does own guns, and many, many people do, please make sure they’re well secure. That they’re locked, so someone cannot gain access to them, especially children. Please make certain of that.

Allison: Thank you for sharing. How can adults also model healthy grieving? 

Atkisson: Oh, that is a great question. It’s not an easy question. There is no such thing as grieving the exact right way. Grief is different for everyone in terms of how we grieve. But there are common elements to however we grieve that I think we can model for our children. And one of those is being able to verbally express, ‘This makes me really sad. Mommy is sad about this,’ or ‘Daddy is sad about this.’ And it’s OK to say that. It’s OK to say, ‘I wish this hadn’t happened.’ It’s OK to say, ‘I think about the people this happened to.’ And if you are a person of faith, you can say, ‘I pray for these people.’ 

If you’re someone who’s a helper, say something like, ‘I’m going to try to do something to help the people who are struggling with this because it has to be really, really sad for them if it’s making me sad.’ So that’s a way to model it. 

What is an unhealthy thing to do is to pretend it never happened or act like, ‘Well, it didn’t happen to you, so it’s not that important.’ That’s not a healthy thing to do, even though I know parents do that sometimes out of good intentions. But it’s important to acknowledge what’s going on in the moment.

Allison: Thank you for sharing, and, and going back to best practices in conversation with kids. What about kids who may be differently abled? How would a family go about navigating these conversations with those kids? 

Atkisson: OK, so I’ve actually worked a lot with kids on the spectrum and a lot of them are extremely intelligent. And they’re very factual, very fact-oriented. They listen to specific details and conversation, and they are not good at interpreting emotional reaction. 

You start off in the similar manner. You ask them how their day went, you ask them if they’ve heard anything about anything scary that’s happened? It wouldn’t be an unusual thing for a kid on the spectrum to say, ‘Oh, yes, I heard there was a shooting somewhere.’ And for them to say it without a lot of emotion or affect. That doesn’t mean they don’t have emotion about it. You ask them, ‘OK, what do you think about it?’ So you get them to talk about it from a thinking standpoint. And then you ask them, ‘How do you feel inside about this?’ 

I actually think it can be a teaching moment for kids who are on the spectrum. I think you can say to them, ‘You know, when this kind of thing happens, it makes people very sad. It makes me very sad. It makes me worry about those children, it makes me worry about the families.’ So you help them learn to connect the emotion and the words that express the emotion to the event. 

I’ve known a lot of children with Down Syndrome, too. And really, they’re pretty lovable. I’m going to start with that, and they have a lot more ability to understand things, I think sometimes than we realize. And I found that a number of them often pick up on emotions, even though they can’t express what they’re picking up on. They can pick up on emotional states, a lot of them have some fairly good empathic skills. And so I think you ask them the same questions, but you just make it very direct. So I think you take a similar approach knowing you’re the parent of that child, you know how that child will react and approach it in that way with the same principles.

Allison: Thank you. How does an adult end the conversation in a healthy way?

Atkisson: The first thing you need to do is make sure you give the child opportunities to talk, and if you get a sense that the child doesn’t know how to talk about it, you can then ask them this question: ‘How do you feel when something sad or bad happens to somebody you know?’ And sometimes that’s a way to help them be able to open the door to talk about it. So you give them a couple of opportunities. And, when they have expressed some things about that, as you’re moving toward the conclusion of your conversation, ask them: ‘How can I help you feel safe? What can other people do to help you feel safe? What are the things you can do to help yourself feel calmer and safe when you need to feel that way?’ And respond to those things. And then make sure your child knows that they can always talk to you about anything, and that you’ll try to help them with it.

Allison: Thank you for modeling these conversations. I know you also mentioned that you recommend that parents don’t let their kids watch the news. Are there any other actions that you recommend that parents or caregivers take in these next few days and weeks?

Atkisson: Yes. We all use the internet. We all have let our children sit and watch different things on the internet. We’ve pulled up movies and let them watch TV and do other things. It’s not bad to use things, if you know what they’re watching and doing. So one thing I want to say is, especially in the next few days, if your child is going to be watching something, please make sure you’re viewing that with your child, so you can interact with that as needed. 

I’m not suggesting that we raise our children in a cocoon. But I am saying there are certain things that cognitively and emotionally they cannot handle at this young of an age. And it is our responsibility as adults to be the buffer for them until they’re ready to be able to handle that kind of information. So please monitor any type of media exposure that your child is getting these next few days. You should really do that all the time anyway. If the children are spending time with friends or other relatives, make sure that they are also doing the same thing for your child. 

And now I want to talk about what you can be doing daily: Keep a structure and a routine everyday in your home. It needs to be somewhat predictable. The child needs to know, ‘I’m going to expect this will happen around this time.’ Stay with your structure, stay with your routine. Continue to encourage them to let you know how their day was, touch base with them if they bring this up. And they probably are going to. Be aware that children take a while to process things like this. And there might be more questions. They may ask the same questions two or three days in a row. Go ahead and just respond to it in that same calm, even way every day.

Allison: Is there anything else that you’d like to share or add?

Atkisson: Yes, there’s some resources I had listed where it’s the American Academy of Child and Adolescent Psychiatry. It’s aacap.org. If you go to that website and you click on, at the top, Facts for Families, you can put any word in, such as ‘trauma,’ etc. 

The other website I would recommend is the American Academy of Pediatrics.

Pediatricians, child psychiatrists are people who work exclusively with children. And so they are going to be the ones that are probably going to provide the most resources. Your family doctor will provide those resources, churches and other organizations will provide them as well. 

One final thing I want to say to parents, and I just got to be really direct here: It’s hard being a parent. I’ve been one. I am one. I know. It’s hard. I’ve been known to say to more than one person I think the most difficult thing I’ve ever done in my entire life is raise a child, because they don’t come with a manual or handbook. 

I want to say to you: Please, please reach out to other people, reach out to your friends and your family of faith organization you belong to — have these conversations, talk about this, don’t try to deal with this all by yourself. 

Alexis Allison is the health reporter at the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her by email or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.

Creative Commons License

Republish our articles for free, online or in print, under a Creative Commons license.

Alexis Allison

Alexis Allison covers health for the Fort Worth Report. When she can, she'll slip in an illustration or two. Allison is a former high school English teacher and hopes her journalism is likewise educational....