March 8, 2000 (New York) -- Young children who have witnessed acts of violence, even if they were not directly involved, can be deeply affected, a new study shows. But because these kids often show no obvious symptoms of harm, it's easy for parents, educators, and doctors to overlook the damage done to them.
Further, parents are not always aware that their preschoolers have been exposed to violence -- either because it happened when the child was away from home, or because the parents are repressing such information, says the study, published in a recent issue of the American Journal of Orthopsychiatry.
Preschoolers who had witnessed violence tended to internalize their problems and were often depressed, anxious, and withdrawn, the study says. In contrast, victims of mild violence were apt to engage in aggressive and disruptive behaviors.
"We often pay attention to kids with obvious symptoms of exposure to violence, like aggression," says study author Ariana Shahinfar, PhD. "This highlights the importance of paying attention to children who are witnesses and who may not show on the outside that they are being affected by violence, but are certainly showing symptoms on the inside." Shahinfar is a psychologist at La Salle University in Philadelphia.
The study looked at 155 families with children 3 1/2 to 4 1/2 years old who were enrolled in a Head Start program in a "moderately violent" neighborhood near Washington, D.C. It found that three-quarters of the children reported that they had witnessed or been a victim of at least one violent incident, but only two-thirds of the parents said this had happened to their children.
"We've been more concerned about adolescents and violence because that's where we see a lot of dangerous behavior occurring," Shahinfar tells WebMD. "Our findings show that violence is significant in young children's lives as well as in older children's lives. We need to recognize that we need to move down the age groups we consider being at risk ... and we need to move down in age the kids we are offering intervention and prevention programs to."
The study interviewed the children and their parents separately about each child's exposure to violence. For the children, researchers used cartoon depictions of such acts as shooting, robbery, beating, and shoving to determine how much violence they had been exposed to.
Parents and children were also asked whether the children showed any behavior problems. Again using cartoon figures, children were asked whether they had feelings of sadness, a lack of appetite, a fear of going outside because of possible violence, upsetting memories, or nightmares.
On almost all measures, the children reported higher levels of exposure than the parents reported. For example, 37% of the children said they had witnessed severe violence, but only 7.7% of the parents reported this. Similarly, 31% of the children said they were victims of severe violence, but only 0.8% of parents said their children were victims.
Shahinfar believes this may be because parents are unaware of their children's exposure to violence -- for instance, if the child spends part of his day in child care -- or because the parents may repress such information.
"We need to be sensitive to the idea that kids may not perceive violence in the same way as adults do," Shahinfar tells WebMD. "We need to let kids tell us what has been traumatic for them and to help them work through those feelings."
The investigators realized that not all children were able to give accurate answers when questioned, and some often mixed fantasy with reality. However, close to half of the children were thought to have shown a high level of understanding.
"It's time to move beyond saying that young children are not affected by witnessing violence. In fact, they are affected by witnessing violence and it can impact them in very significant ways," Joy Osofsky PhD, tells WebMD. Osofsky, a professor of public health, psychiatry, and pediatrics at Louisiana State University Health Sciences Center in New Orleans, reviewed the study for WebMD.
She says that both the public and physicians must recognize that witnessing violence is a problem and that something can be done.
Osofsky, who works with a program that educates New Orleans police officers on how to handle children confronted with violence, says that when dealing with traumatized preschoolers, the traumatized family must be dealt with as well.
Shahinfar says that children who are exposed to violence tend do much worse if parents are unavailable to them afterward.
"Parents must remember they are the first resource for their child," Shahinfar says. "For a child to function well in a dangerous and difficult society, parents need to be functioning well."
- In a study of preschoolers enrolled in a Head Start program, three-fourths reported witnessing or being a victim of at least one violent incident.
- Kids who witnessed violence tended to internalize their problems and were depressed, anxious, and withdrawn, while those who were victims of violence externalized their problems with aggressive and disruptive behavior.
- One researcher says that interventions should be offered at an early age and that the age of those who are considered at risk should be lowered.