Helping children heal from tragedy

A mother hugs her children after paying tribute to the victims in Newtown, Connecticut, on Saturday.Adults must find some support for themselves, experts sayIt's key for children to know their parents can protect themParents' response should vary by the age of a childBehavior such as bed-wetting or sleep disturbances can signal a problemEditor's note: Former CNN correspondent Pat Etheridge is a journalist specializing in children's health and family issues. She previously hosted CNN's "Parenting Today."

(CNN) -- The anguish is unimaginable. In the midst of their own loss, grief-stricken parents in Newtown, Connecticut, now struggle for ways to comfort their children: What to say? How to react? What to watch for in the child?

"The first thing adults need to do is find some reinforcement for themselves because the best people to help these children are the people who take care of them in their daily lives, especially parents," says Dr. Lewis Leavitt, professor emeritus of pediatrics at University of Wisconsin-Madison.

"The analogy I use is one you hear on an airplane: Put the mask on yourself first, so you can then attend to your child," says Dr. John B. Lochridge, an Atlanta-based child and family psychiatrist. "After that, it is minute by minute, case by case. It's really a matter of listening and responding in a way that fits the framework of their understanding."

Civic and church groups as well as individual counselors and pediatricians can offer crucial support for parents. "The divorce rate is incredibly high following the death of a child, especially a tragic death. One of the most important things you can do is focus on communicating with your spouse and getting the help you need to keep the family unit intact," Lochridge says.

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To help kids with tragedy, slow down, listen

Children have different emotional needs than adults. Also, at different ages and stages of development, they react in different ways. Leavitt and Lochridge offer age-specific advice for children directly affected -- or indirectly traumatized by exposure through conversation or media.

Infants and toddlers (0-3 years)

Infants and toddlers cannot comprehend how a tragedy might change their environment. But they can recognize and respond to changes in adult behavior. What they need most after a loss is their parents' loving care. Focus on the familiar and resume normal activities. "The games you played and the stories you read before are still appropriate afterwards," advises Leavitt.

Preschool children (3-5 years)

Preschoolers may not talk about their feelings even when asked. They require reassurance from parents and family members about their care and safety. Playing music or doing arts and crafts may help children open up.

It's best to respond with answers that are simple and direct. For example, if your child asks, "Do people wake up after they die?" You could answer, "People do not wake up after they die, but it's OK to think about people we like even when they are not with us anymore." Also, it is important to avoid television viewing. "Young children may think a disaster is happening again and again if they see repeated images," cautions Lochridge.

School shooting: Shattering the sense of safety

School-age children (5-12 years)

Children at this stage have more interest and understanding of how and why things happen. Parents can help by talking, listening and answering their questions. Honest, direct responses coupled with reassurance are best.

For instance, if your child asks, "Mom, are you sad?" You could say, "I'm sad about what happened, but I'm happy we are together." Again, it is best to limit TV or watch together and discuss what has happened. School-age children benefit by returning to their normal activities and routines.

Behavior to watch

Changes in your child's behavior may signal anxiety. Contact a health professional if problems such as these persist more than a few weeks:

-- Preschoolers: bedwetting, thumb-sucking or increased clinginess

-- School-age children: sleep disturbances, nightmares, poor concentration, aches and pains

-- Teenagers: expressions of anger or sadness, problems with eating and sleeping, loss of interest in activities, new difficulties at school

Therapy

For children under stress after a traumatic event, various forms of therapy can help, including art.

"Anything that's available -- clay, crayons, music -- children can use to express themselves," says Susan Anderson, founder of the ArtReach Foundation. Her nonprofit group was on the ground in Tuzla, Bosnia, following a massacre that killed 71 -- many of them schoolchildren.

"This is a time when we are at a loss for words. Parents should understand and share with their children that sometimes, there is no simply explanation," Lochridge offers.

"In an event of this scope, it's important for parents, police, even the president to convey that this is a terrible but rare event and our institutions are there to keep them safe," says Leavitt.

He suggests creating opportunities that enable youngsters to look "beyond the memorials for the lost children -- which are important -- to more long-term activities that aim for solutions and a secure future."

So what of the magic of Christmas in Newtown? The magic is not lost, says Leavitt. "Part of that magic is exactly what will help these children heal: togetherness, unity and the spirit of goodness in the world."

Watch CNN's LIVE TV coverage of the Connecticut elementary school shooting as the story continues to unfold.December 17, 2012 -- Updated 0420 GMT (1220 HKT) In a town still numb from an inexplicable massacre of children, relatives of the victims will meet with President Barack Obama on Sunday when the president visits. An interactive tribute to the victims of the Sandy Hook Elementary School shooting. Details continue to emerge about what precisely happened at Sandy Hook Elementary School. Here is a timeline of events that compiles the latest reporting.December 17, 2012 -- Updated 1045 GMT (1845 HKT) Robbie Parker has a message for the family of the gunman who killed his 6-year-old daughter and 19 of her school mates. December 17, 2012 -- Updated 1905 GMT (0305 HKT) The suspect in the Sandy Hook Elementary School shooting took to his grave the reasons that compelled him to mow down more than two dozen people before taking his own life.December 15, 2012 -- Updated 1649 GMT (0049 HKT) The 5-year-olds in Janet Vollmer's kindergarten class heard the noise: Pop. Pop. Pop. December 18, 2012 -- Updated 0152 GMT (0952 HKT) The deaths of 16 children aged five and six together with their teacher in the Scottish town of Dunblane in 1996 was one of Britain's worst incidents of gun-related violence.December 17, 2012 -- Updated 1312 GMT (2112 HKT) In some cases around the world, mass shootings have been a catalyst for changes in gun control laws.December 15, 2012 -- Updated 1656 GMT (0056 HKT) The sound of gunfire, confusion, a lockdown and then an evacuation. Witnesses, students and parents told frightening stories after the shooting.December 17, 2012 -- Updated 1949 GMT (0349 HKT) Security experts predict what comes next: A strong reaction -- maybe an overreaction -- to school safety. And within months, it'll be back to cuttign security budgets.December 15, 2012 -- Updated 1644 GMT (0044 HKT) Principal Dawn Hochsprung, killed in Friday's shooting at her Connecticut elementary school, recently installed a new security system to ensure student safety.December 14, 2012 -- Updated 2347 GMT (0747 HKT) CNN's Susan Candiotti reports on how the Connecticut school shooting happened, leaving dozens of people dead. December 15, 2012 -- Updated 1849 GMT (0249 HKT) Family members give their accounts of the school shooting in Newtown, Connecticut.December 14, 2012 -- Updated 1711 GMT (0111 HKT) Learn more about school violence in the U.S. with our interactive timeline of incidents of random violence at elementary, middle and high schools since 1927. Click through our interactive timeline to learn more about the worst mass shootings in the United States since World War II.December 17, 2012 -- Updated 2111 GMT (0511 HKT) Learn how to help the victims and families affected by the Connecticut school shooting tragedy.Today's five most popular stories

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Street children found dead in bin

The dumpster where the bodies of the five boys were found by a trash collector in Bijie City on Friday, November 16.Eight officials sacked or suspended over deaths of five boys in dumpsterChildren died from carbon monoxide poisoning after burning charcoal for heatAged between 9 and 13, the boys came from one extended familyUNICEF says one of China's biggest challenges is caring for "left behind children"

Hong Kong (CNN) -- Eight Chinese officials have been fired or suspended after five boys died in a rubbish bin after suffocating on fumes from charcoal they burned to stay warm, according to state-run media.

The bodies of the boys, aged between 9 and 13, were found by a trash collector on Friday in Bijie in China's southwestern Guizhou province, Xinhua reported.

They are believed to have died the night before, as rain fell and temperatures plunged to as low as six degrees Celsius (43 degrees Fahrenheit).

Six officials have lost their jobs, including the principals of two local schools and four government officials in charge of education and civil affairs in Qixingguan district where Bijie is located. Two deputy heads from the same departments were also suspended pending an investigation.

Users on China's social media platforms expressed shock and disgust, with some questioning how society could have allowed such young children to fall through the cracks.

It's not uncommon to see several children living in a household with an elderly couple in rural China. These are the left behind children.
Dale Rutstein, UNICEF ChinaOne user on Sina Weibo, China's version of Twitter, wrote: "China is supposedly an intermediate developed country but still can't protect its own children. At the age when they should be enjoying a happy childhood these poor kids are wandering and dying on the streets." (@Datounaonao)

Another said: "I just can't believe this is a story happening in my country today...where are the "relevant departments" doing on this? And "where are the kids' parents? Why give birth to children and then abandon them?" (@Dongsir)

Days after their deaths, details of the boys' lives emerged in local press. They all belonged to the same extended family, the sons of three brothers.

Two of the fathers, Tao Yuanwu and Tao Xueyuan, were rural migrants, who had moved from Guizhou to the special economic zone of Shenzhen near the Hong Kong border, where they worked as rubbish collectors.

The other father, Tao Jinyou, a poor man who was said to work long hours tending fields, told Xinhua that he and his wife paid little attention to their own son, let alone their nephews.

"Sometimes they didn't even come home at night," he said. Persistent truants, the boys were said to have been missing for three weeks before they were found dead. "At first, I sent (my son) back to school by force," Tao said. "But every time he'd run away again, so I knew it was hopeless."

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Rutstein says the presence of street children is obvious in some cities, but it's safe to assume that many remain in rural towns, the byproduct of a huge demographic shift in China, as parents move to booming cities for work.

"It's not uncommon to see several children living in a household with an elderly couple in rural China. These are the left behind children. Right now people are coping the best they can," Rutstein said.

It's estimated there are 55 million "left behind" children in China, the sons and daughters of 200 million migrant workers who have moved to the cities for a better life.

"We would say in UNICEF that that's one of the most significant challenges for China right now, because all the data shows these children have lower nutrition, suffer a higher rate of accidents and injuries and are at greater risk of abuse and exploitation," Rutstein said.

State media reported that four of the five boys found dead in the dumpster were being cared for by their aging, blind grandmother who had difficulty caring for herself.

A local resident told CCTV that neighbors had noticed the boys wandering the streets. "They took a shabby shed in a construction site near the dumpster and ate some discarded vegetables in the market and played football that they had picked up," he said.

Last year, China's Ministry of Civil Affairs launched a nationwide campaign to return "vagrant" children to their homes. Once sent back, the children would be placed in government-run shelters, according to Xinhua.

This tragedy is a wake-up call that something needs to be done to improve the working and living conditions of migrant workers.
China Daily"Street orphans should be placed in the care of welfare institutions or foster families if their guardians cannot be found," the article said, quoting the vice minister of civil affairs.

Despite efforts to pull millions out of poverty in China over recent decades, the country still lacks modern child welfare systems seen in the West, Rutstein said.

"The concept of social workers, for instance, which is quite well known in Europe and North America, is very, very new in China. China's aware of this and there are many efforts in place right now to professionalize the whole system of social workers, to introduce alternatives to institutionalization, or just sending children to a state orphanage, which traditionally has been the main response to these kinds of situations," he said.

An opinion piece published Wednesday in China Daily asked whether authorities were too quick to lay the blame on local officials and suggested that major changes were needed to reduce the number of "left behind children."

"This tragedy is a wake-up call that something needs to be done to improve the working and living conditions of migrant workers, so they can settle in the cities where they work and enjoy the same rights as their urban counterparts. This would enable them to have their children live with them," it said.

The plight of the dead children in Guizhou has been compared on social media to the tale of the Little Match Girl, a Hans Christian Anderson story of a girl ignored by the rich who froze to death after trying to warm herself with a lit match.

On Wednesday, messages of condolences for the five boys were still being posted on Weibo.

"Hope they won't feel cold anymore in heaven," @Qingyu_aneya said.

@KongXia added: "Rest in peace, don't reincarnate in China..."

Referring to Beijing's decision to turn on the city's heating system two weeks early this year due to colder temperatures, one of China's most popular fairy tale writers, Zheng Yuanjie, posted: "Beijing spent 800 million [yuan] to start the heating system 15 days ahead of time, but you're out of the reach. Hope the 'The Little Match Boys' can forgive us in heaven."

The boys were Tao Zhongjing, 12; Tao Zhonghong, 11; Tao Zhonglin, 13; Tao Chong, 12; and Tao Bo, 9.

Wei Yuan Wen Min contributed to this report.

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