August 2009

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Raising a Mensch

After the Injury
Helping Parents Help Their Children Recover from Injury

-- Flaura Koplin Winston, MD PhD (with support from Charles Vaihinger)

Injuries are the leading cause of death and acquired disability for children. Of course, the best medicine is prevention and there are many ways that families can reduce the risk that their child will be injured. But even with the most attentive and careful parent, injuries will still happen. Right now, over 100,000 children in the United States are recovering from injury. How should a parent respond? What is the parent’s role in the recovery process?

The short answer: parents are vital to a child’s recovery. With all the doctors, nurses, and therapists who will treat your child’s injury, remember that no one is more important than parents in their child’s recovery.

The Jewish tradition has long recognized that healing occurs on two dimensions – the body and the spirit. The Mi Sheberakh prayer “prays for physical cure as well as spiritual healing, asking for blessing, compassion, restoration, and strength.” Building on this wisdom, we recognize that for injured children, doctors and other medical providers help heal the body; parents, relatives and friends help heal the spirit.

In my years of studying injuries to children, many parents told me that they feel alone and lost after an injury. They are not sure how to respond and help their injured child and they do not know where to turn for help. The Children’s Hospital of Philadelphia just launched a website, for all of these parents. You are no longer alone! The new site takes the best from science and practice to allow parents to watch brief videos, download tip sheets and create a personalized care plan based on their child’s individual situation. The website was developed by a team of behavioral researchers, pediatricians, trauma surgeons and trauma nurses. We designed www.AfterTheInjury.org to help parents know what to expect, get tips for how to help their child, and how to find additional help if they need it. Here is a summary of a few of the tips on the site.

Tip one: Don’t forget to take care of yourself

It is natural for parents to want to give 110% of themselves to their injured child. But most parents experience their own reactions to their child’s injury and these reactions may get in the way of helping the child. A parent is most effective when he takes care of himself, too. Remember what they say on the plane during the pre-flight safety demonstration: “In the event of an emergency, make sure to secure your own oxygen masks before assisting your children.” In the same way, parents need to get the help and support they need first so that they can give help and support to their injured child. For more, see Self-Care for Parents.

Step two: Accurately assess your child’s symptoms and needs

One of the most important things parents can do to help their child is to recognize their child’s reactions to the injury. Many reactions are normal and common; some are more worrisome. The first step in helping your child recover is to learn what reactions to look for and what you can do to help your child respond in a healthy way.

In the first few days after an injury:

  • Nearly all children feel upset, jumpy, or worried at times.
  • Parents and other family members can have similar reactions.
  • Nearly everyone feels symptoms of stress, headache, tense muscles, knots in your stomach, sweaty palms, feeling that life is a bit out of control
  • Parents and children may argue more.
  • Children may be more clingy or have trouble sleeping.

With a little time and extra support, most children, and parents, feel better. But when an accident or injury causes overwhelming feelings of fear, helplessness and horror, it can lead to more than just everyday stress reactions -- it can lead to traumatic stress. There are three main types of traumatic stress reactions:

  • Re-experiencing: Reliving what happened
  • Avoidance: Staying away from reminders
  • Hyper-arousal: Feeling anxious or jumpy

For many children and their parents early traumatic stress reactions get better over the first month. But about 1 in 6 still have traumatic stress reactions that bother them even six months after an injury. These symptoms might get in the way of getting back to normal and prevent full recovery. In these cases, sometimes outside help is needed.

www.aftertheinjury.org has a quick quiz to help you measure traumatic stress symptoms in your child with lots of videos and text on what traumatic stress symptoms are and how to recognize them.

Tip 3: Provide the right support to match your child’s needs

The most important things a parent can do is to let her child know he or she is safe now and to be patient. More specific strategies depend upon their child’s exact injury, age, and reactions. Some things parents might need to consider:

  • Pain management
  • Cast care
  • Managing a head injury
  • Talking with their child about the injury
  • Dealing with their child’s new fears and worries.

www.AfterTheInjury.org serves as a comprehensive and free resource. It provides parents with easy access to credible information, tips, and practical tools to help support their children’s emotional recovery. Parents can even create a personalized care plan matched to their child’s needs.

For all the injured children and their parents, I wish you full recovery – body, mind, and soul. Please know that you are not alone. If you are reading this article and know someone who is recovering from injury, please let them know that you are there and so is www.AfterTheInjury.org 24 hours a day, 7 days a week.

Dr. Flaura Koplin Winston is Associate Professor of Pediatrics at the University of Pennsylvania and the Scientific Director of the Center for Injury Research and Prevention at The Children's Hospital of Philadelphia.

To view previous editions of "Raising a Mensch", please click here.

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