Home > Research > Sesame Workshop - 12 December 2002

Sesame Workshop and Project Liberty Advisory Report

Introduction

Sesame Workshop in collaboration with Project Liberty and funding provided by a grant from the Federal Emergency Management Agency (FEMA), convened a day-long Advisory meeting on December 12th 2002. The Advisory meeting was held to discuss the development of a multiple media project and resources to help children ages 3 to 8 years and the adults who care for them, address and deal effectively with the situations and changes they have encountered in their world post-9/11. In addition, the materials will be produced in three languages: English, Spanish and Chinese.

Advisors

The meeting brought together a group of Advisors comprised of mental health experts with diverse specialties and experience with the care of children, families and other caregivers in the aftermath of 9/11 events. Jeanette Betancourt, Ed. D., Assistant Vice President, Education and Research, Sesame Workshop moderated the meeting. The Advisory Panel included the following individuals:

• Abraham S. Bartell, M.D., Medical Director, Children After Trauma Care and Health Program, The Mount Sinai Medical Center
• Michael Cohen, Ph.D., Principal, Michael Cohen Group LLC
• Marian Tan Johnson, Project Director, The Coalition for Asian American
  Children and Families
• Charles Lai, Director, Programs & Planning, Asian American Federation
• John D. O’Brien, M.D., Medical Director, Therapeutic Nursery, The Mount Sinai Medical Center
• Nora Alarifi Pharaon, Ed.D., Arab American Family Support Center, Inc., Consulting Psychologist
• Dinelia Rosa, Ph.D., Director, Center for Educational and Psychological Services, Teachers College, Columbia University
• Donna Sotolongo, Psy.D., CEO, Sotolongo Consulting Associates
• Nicci Anne Spinozzola, Ed.S., Director, ALLIES Adolescent and Family Services, Richard Hall Community Mental Health Center
  

Discussion Points

The Advisors based their discussion on an agenda sent prior to the meeting. The meeting was designed to discuss needs and objectives, key messages, strategies and activities that would be most salient to incorporate within the overall project goals and materials. The following is a synopsis of the Advisors’ observations and recommendations divided into four sections, (1) Overall Focus, (2) Specifics for Adults, (3) Specifics for Children, and (4) Resources.

Overall Focus

The Advisory meeting included a general discussion on the purpose and overall need for this type of project. All the Panelists agreed that it was essential to have a project that would effectively meet the needs of children and adults in the areas of coping and resilience in a time whereby there are uncontrollable events or circumstances surrounding them. The Panelist strongly indicated that the project should not be based solely on the trauma of 9/11 events, rather it should address the general concepts of “coping”, “resilience” and “acceptance”. The key messages should emphasize how to “raise mentally healthy children within these times” and take a “strength-based approach”. This type of approach is one that will emphasize the abilities of children and adults to cope with such situations with simple and positive strategies that can be incorporated into every day routines.

The project should also focus on the general population of children ages 3 to 8 years, their families and caregivers, not those directly and specifically impacted by a direct loss, as these individuals require more comprehensive services. There was a sense that in having Sesame Workshop create multiple media tools to discuss these issues, it would provide a foundation for “normalizing” these discussions between children and adults in ways that would be non-threatening, supportive and effective.

Other discussion points included:

• In dealing with traumatic events or experiences, different models or approaches may come into play. One is a “recovery model” whereby a traumatic event may occur with a strong likelihood it will not reoccur. The focus is on coping and recovering from such an event, as well as losses that may have occurred. Examples are assisting children and adults to deal with the Columbine shootings or the Oklahoma City bombing. Another is a “coping model” whereby the event or circumstances are ongoing and individuals must cope with loss, as well as the uncertainties that such traumatic events may occur again. It is dealing with loss of safety or a secure future. The Panelists indicated a general consensus that based on events of the past 1 ½ years, children, families and caregivers are responding to both, but the general population is most affected by dealing with the uncertainty of the future, thus a “coping model”.
• Key is assisting both adults and children with feelings of “helplessness”. For parents, it is often dealing with the inability to assure their children such trauma will not occur again or the inability to control events. This is difficult for parents as they see this as their role and being unable to provide this support causes a sense of “helplessness”.
• From the children’s perspective, a way to counteract this sense of “helplessness” may come from a sense of reassurance that the people who care for them are okay. Information should provide ways that children feel that they can do something positive and are not totally helpless or dependent on circumstances surrounding them.
• Recommended strategies are ways that both adults and children can establish a sense of stability and proceed with their lives. Assisting children, particularly children ages 5 to 8, to gain or regain a sense of control over their environment. Assisting adults to recognize and possibly accept, their own feelings of fear, anxiety, insecurity or uncertainty by providing strategies that will guide adults to stay calm and reassuring. Most important, encouraging fundamental and honest communication between children and adults about these issues.
• Although the focus of the project is one that should address and impact the general population of children ages 3 to 8 years, their families and caregivers, it is also important to acknowledge that certain communities may be experiencing even a greater sense of loss, helplessness and even hopelessness. Examples provided included the Arab-American community which is experiencing a backlash in their daily lives—fear of deportation, attacks based simply on the way they look, dress or their religious beliefs. The Asian community (particularly the Chinese community based in Chinatown, New York which is in direct proximity of the 9/11 attacks) which hope to come to the United States for a better way of life and after such events are unable to respond to the everyday needs of their families—economic destitution.
• There is a significant difference between a sense of “helplessness” (the inability to feel in control) which is more in the moment and a sense of “hopelessness” (total lack of hope) which is more focused on the future. Certain communities or groups hardest hit by 9/11 and post-9/11 events may be experiencing a total sense of “hopelessness”—this is much more difficult to deal with as it affects their ability to look and hope for a positive future. Most often, this “lack of hope” requires significant intervention—therapeutically, financially, etc. On the other hand, many adults and children post-9/11 are experiencing a sense of “helplessness” because they feel unsafe, unsure or not in full control. The focus of this project should be more on “helplessness” rather than on “hopelessness”.
• Despite differences in certain communities, the project’s content should focus on “commonalties” such as the desire of all parents wanting to protect their children, the general sense of fear, concern and confusion parents and other adults have in responding to these times of uncertainties. The key information or strategies should avoid any message that would cause individuals to “cast blame” on the reason or cause for such events.

Specifics for Adults

• Provide recommendations so adults can acknowledge their fears, anxieties and sense of helplessness while assuring them that these feelings are all right and appropriate for the situation. Most important, help adults to acknowledge these feelings openly; this is essential before they can address the needs of the children they care for.
• Offer acknowledgement and support that adults have the capacity to help their children even within uncertain circumstances—support parents as resources for their children. Provide similar messages for other adult caregivers so messages are consistent for a variety of adults within children’s lives.
• Assist in empowering parents by validating their experiences and identifying successes in similar circumstances. Help adults recognize and build on past strategies they may have used in times of distress.
• Provide ways that adults (parents or caregivers) can recognize signs of distress in children as indicated by feelings of helplessness, lack of coping skills, general anxiety, fears, changes in behavior or sleep patterns, etc. Very often, preschoolers and school-age children “act out” and these may be signs of depression and/or distress. Adults are often unaware of these symptoms as signs of distress as they do not reflect the adult symptomatology of depression or distress.
• Offer specific information on how parents can ‘listen to” and “communicate with” children in developmentally appropriate ways—allowing for greater flexibility and openness. Encourage adults to be sensitive to when children actually want to communicate and how much they may want to say at one time—it may require several discussions over time to effectively decipher children’s feelings and emotions. Prepare parents to expect the unexpected as children often express feelings of concern at different times—sometimes in the most unusual places or circumstances.
• Provide guidance on how parents and caregivers can take advantage of “teachable moments” to discuss issues both positive and ones that may be more difficult to discuss openly. Offer recommendations on how adults can identify these moments, when do they occur and how they can take advantage of “teachable opportunities.”
• Offer recommendations on how parents and other caregivers can communicate and share information or activities—make the activities compatible so that they can reinforce key messages at home, as well as in school or child care. Encourage parents and caregivers to share observations about the children in their care.
• Indicate ways adults can assist in controlling and explaining media exposure.
• Either provide specific resources whereby parents or other caregivers can find networks to support them and/or provide suggestions on ways that parents or caregivers can create networks. This is essential for adults caring for children and will assist in regaining a sense of stability and control within their lives.

Specifics for Children

• Approaches need to be distinguished between younger children (preschoolers—ages 3 to 5) and older children (school age—ages 6 to 8). Preschoolers are significantly more concrete and need assurance that is often physical, as well as verbal. Often for younger children, adults need to assist them in expressing their feelings or emotions. Older children require more specific discussions, acknowledgment of their feelings and a sense “of talking it out”. They also may respond better to peer groups rather than to adults.
• Consider that children will continue to experience trauma due to post-9/11 events because the world has changed forever. Children will be reminded of these events by anniversary remembrances, continued uncertainty due to changes in government, processes during every day routines, e.g., traveling, school drills and new information in history books, etc. It is an event that will not be forgotten and will be experienced over and over for some time.
• Preschoolers are significantly dependent on information and guidance from the adults who care for them, particularly parents and extended family members. They are more concrete and often express their concerns physically rather than verbally. Children at this stage may regress developmentally, particularly because there are so many milestones that children have just reached during this period of time. Children may act out, start bed-wetting again, become restless or have nightmares, etc. They may bring up issues of concern far beyond the time of the traumatic event and at what may seem to adults, at unrelated or inopportune times. Preschoolers require routine and all too often uncertainty or trauma disrupts this routine. They also integrate adults’ feelings—if adults are unsure or sad, children will become uneasy and confused. Children at this age may benefit from play activities (including dramatic play) or using the arts to express their feelings or anxieties.
• Offer children, particularly younger children, reassurance. In order to do so, children need concrete answers to questions, though adults should avoid always giving a “fixed answer”.
• For both age groups, preschool and school age, maintaining a routine is important, especially within their daily lives.
• Within the school-age group, there may be a need to be specific about age ranges. For example, dividing the age ranges so they are from 6 to 7 years and from 7 to 8 years. Children in the 6 to 7 years are more likely to make distinctions that are on one side or another—it is either “right” or “wrong” and there are no alternatives or in-betweens. Children in this age group still rely on adults for information and a sense of safety; they also need assistance in planning—for their day, for events, etc. They are however, starting to link with peers at a fundamental level and starting to rely on both peers and adults other than their parents as sources of information.
• Children in the age range from 7 to 8 years are entering a stage of developing “moral reasoning”. At this age, children need to explore and discuss “right” versus “wrong” or “good” versus “bad” but there is more flexibility and alternatives to making these decisions. This is the start of mastering “moral reasoning”. In addition, at this age children are learning to rely on themselves more often, as well as with peers as sources of information and ways of gaining a sense of safety. It is important to provide children activities and strategies that would offer them a guide to accomplish this on their own as well as with peers and adults.
• Effective use of ways to build resilience should be stressed. Offer strategies that encourage children to recognize their own uniqueness, establish and maintain an internal locus of control, seek and maintain open communication with peers and adults, sustain a sense of routine and order, link with positive role models and express a sense of caring for others.
• Help children establish a sense of belonging despite differences. Assist children to accept differences, but leverage the concept of similarities between a variety of ideas, groups and/or customs. Provide a way for children to celebrate their uniqueness, build their self-esteem but within the context that they also have many similarities with others around them.
• As children get older, there is a strong need to belong especially among peers. This may cause separation from the adults who care for them, often resulting in lack of communication. For children who are experiencing a sense of helplessness, anxiety and/or hopelessness, this lack of communication is detrimental—they have no one to turn to. Often these children will demonstrate their anxieties by experimenting with increased risk behaviors—a key sign of distress. Post-9/11 studies reveal evidence that children are engaging in greater numbers of risk behaviors at younger ages. We should encourage and model positive communication among children and with adults even when the issues or topics are not positive.
• Provide activities or recommendations whereby children can actively take some action that is positive—community activities, contributions, etc.

Specifics for Materials

• Materials should be adult-focused with strategies specifically for parents and caregivers stated first. The materials need to distinguish between strategies for parents versus caregivers, as they are not the same approach. Caregivers also need to be divided between those adult providers caring for preschoolers versus school-age children, once again the strategies and recommendations are different.
• Once the material information clearly delineates the need for adults to care for themselves first, it should follow with strategies, recommendations and activities to do with children. It is important to differentiate clearly between suggestions or activities for young children (ages 3 to 5) versus older children (ages 6 to 8), as these age groups require different approaches.
• Design the materials and their content so that they meet a wide range of socio-economic and literacy levels. Include strategies that are not always dependent on writing or reading, for example oral story telling, acting out, the arts, etc.
• Consider developing activities that adults can do at home versus school. These require different approaches. School activities may be more group focused and/or peer-to-peer while family activities are more parent to child.
• Offer materials that children and parents can read together.
• Include a poster with developmental information. Materials should include materials that are reproducible, as well as copies of these materials that can be given away as not everyone can easily make a copy.
• Online information should provide more information, activities, resources and links than are included in the “package” of materials as well as what is included within the “kit” of materials. Online information may have a slightly more limited access because of language limitations.
• It would be a good idea to include a CD-ROM that includes additional materials than what is included within print or video materials.
• Strongly consider having a video or using existing Sesame Street segment material as a video to use as a discussion piece with children.
• Distribution of materials should be as wide as possible, inclusive of mental health programs, as well as schools, child care programs, after-school programs, youth programs, etc. Consider national distribution of materials as everyone, regardless of how near or far; has been impacted by the 9/11 events.

Resources

• The entire Advisory Meeting was videotaped and is available on tape.
• Nicci Anne Spinozzola, Ed.S., Director, ALLIES Adolescent and Family Services, Richard Hall Community Mental Health Center provided a videotape, Beyond 9.11, and print materials, Helping School Staff Prepare for the 9/11 Anniversary, she developed.