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Fear and young minds

Children's responses to tragedy may shed light on human anxiety and resiliency

By Ellen Barry, Globe Staff, 9/4/2002

Strong feelings
Lisa Burgess of Norton was struck by her autistic son Dakota's powerful reaction to the Sept. 11 attacks. (Globe Staff Photo / Essdras M. Suarez)

A marked change
James Sandman of Spencer, who is autistic, refused to go to Boston after the Sept. 11 attacks because of the tall buildings. (Globe Staff Photo / Dominic Chavez)

Vague memories
Many children have reshaped the attack into something more digestible. Sydnee King-Owens (above) said only one person died, while Justina Colon Jean-Francois (below) recalled that she watched SpongeBob SquarePants that day. (Globe Staff Photos / Wendy Maeda)

NORTON - As his mother gasped at the news from Manhattan, Dakota Burgess softly clucked and flapped, unaffected.

For six years, the boy had inhabited a sealed world with its own rules: Yellow is scary, and railroad crossings are good, and emotions are foreign signals that have to be explained to him. When he finally began to speak two years ago, his thoughts spilled out unedited. ''A cakewalk,'' he explained recently in a sing-song voice. ''Hulk Hogan crashed the ambulance. Dakota is autistic.''

Dakota was born with a brain disorder that has made the beehive of human society a mystery to him. Yet it was a few weeks after the attacks on New York when Dakota began doing something that made his mother freeze where she stood: Wordlessly, he had dragged his fire truck up to the pot-bellied stove and buried it in ashes. When she tried to retrieve it, Dakota threw a tantrum: ''Crashed, crashed,'' he said.

That morning of Sept. 11, in safe living rooms far from Manhattan, the adult carnage had etched itself in the minds of children. A year later, the nightmares and even the memories have subsided; no epidemic of traumatic shock has been reported outside New York. But it is difficult for even the most attentive parents to know how their children made sense of the falling bodies. It was impossible - as Dakota's mother realized - to stop them from knowing.

''It's haunting, because it's even reaching these kids who are not reached by much,'' said Edward Hallowell, a Sudbury child psychiatrist. ''It is so powerful. They can be like little seismographs. They can pick up vibrations in the atmosphere. They are aware of what is going on.''

Children such as Dakota are not at all typical, but in their cryptic responses we may learn something about the birth of fear in our nation. Across the state, caregivers tell stories about certain children who had no direct exposure to the attacks, but for reasons of their own, fixated on them: a hearing-impaired boy in East Boston who built models of the towers so intricate that goosebumps covered his teacher's arms; a 13-year-old with Asperger's syndrome, a developmental disorder related to autism, who has plastered a wall in his parents' house with pictures of skyscrapers. And their parents, like the parents of children across the country, are left wondering whether something changed permanently inside their childrens' heads on the day the towers went down.

In Dakota's case, his mother had no choice but to wait and watch. Through Halloween, through Thanksgiving and Christmas, he left his toy buried in ashes. She stopped trying to convince him, and finally forgot about it. Then one day in January, he came to her with his blackened toy. She washed it off in the bathtub and watched, incredulous, as he padded off to play with it again.

"When he unearthed it, I thought, 'OK, he wants it back now.'" she said. "It was the way he expressed himself. I think he was upset about the firefighters. I always wonder if that's something he'll explain to me 20 years from now."

Grim rituals

As late as the 1970s, psychiatrists were taught that children were too immature to be imprinted by terrible events. By then, posttraumatic stress disorder had been documented in soldiers, refugees, rape victims, torture victims, Holocaust survivors, and the residents of Hiroshima and Nagasaki. But psychiatrists believed that preadolescents were protected by incomprehension and egocentrism, just as young children can emerge from war zones without so much as a memory.

That assumption went largely unchallenged until the mid-1970s, when researchers began to look closer at children who had survived ordeals. In 1976, 23 children were kidnapped in a school bus in Chowchilla, Calif., crammed into two vans for 11 hours, and, when night had fallen, removed one by one and forced into a hiding place - a moving van that had been buried in a nearby quarry. When they dug themselves out, they were greeted by a crowd of reporters, briefly examined by a pediatrician, and sent home. No one thought to contact a mental health professional.

A psychiatrist named Lenore Terr met the children five months later, when many were suffering from terrible nightmares. The studies that she wrote - first in 1979, then in 1981 - described children stuck in grim, repetitive rituals: one girl played bus driver, calling out the names of every child who had been kidnapped. Another girl ate compulsively and threatened to starve her kidnappers.

Over the next 20 years, the children of Chowchilla reported long-lasting, debilitating fears. Terr documented a litany of disappointment - one was incarcerated at 15, three girls dropped out of high school to get married, and the "hero" of the group had "drifted into a marginal existence on the run." Terr wrote that she could ";follow the Chowchilla kidnapping like a fine metallic thread through the fabric of many of these developing, young lives."

The "lessons of Chowchilla," as trauma specialists have come to see them, have been brought to bear in the disasters that followed. Mental health professionals have researched the children who saw the space shuttle explode, the children who saw classmates murdered in school shootings, and the children who saw and heard the explosion in Oklahoma City.

The airplane hijackings that took place last year were unlike any of those events because, as Dr. William Schlenger, author of the first national study of posttraumatic affects, put it, "the choice of the World Trade Center as a target maximizes indirect exposure." In the real-time moment when the towers collapsed, he explained, Americans watching television in Omaha experienced the kind of horror that has been reserved for eyewitnesses. Fear was established in the most unlikely people.

'Listening to his brain'

Cathy Boyle of Winchester has learned the danger that words pose to her son. On a recent morning, when the verb ";kill"; was spoken in his presence, Terry, who is severely autistic, began growling ominously, and his mother rapidly rearranged the afternoon. Bathing suits were dug out, adult topics were relocated to the back porch, and, at least this time, an episode of fear was averted.

The fear, when it happens, is profound. Once, she took the chance of reading a book to him - "The Cat in the Hat Comes Back," in which Dr. Suess's troublemaking cat wreaks havoc on two children who have been left home alone. Terry cried hysterically for 30 minutes.

With that in mind, Boyle has patrolled his world for almost 12 years. Terry has never seen the evening news, as far as his mother knows. She flicks off movie trailers and folds over newspaper pages if there is death in the picture.

"The bottom line is, I'm not sure at any given moment how much he understands," she said. ";He's like the blind men and the elephant - he collects the facts, and every now and then he figures out an elephant. I've learned the hard way, you can't assume he doesn't understand."

On the morning of Sept. 11, Boyle made a series of quick decisions. Waves of emotion were rolling over her: A foreign service officer who had been posted to Nigeria in the 1980s, she found herself reverting to an old compulsion to check under her car for a bomb. But as far as Terry was concerned, her policy was a total blackout. There would be no television, and no one in the house was to utter such words as "kill" or "dead" around Terry. No mention of the crashes was made in the school he attends, and only twice did Terry see footage of the rubble.

But a week later, after a fire drill in his school, he came to her and said a word she had never taught him.

"Frightened, frightened, frightened," he said, and when she asked him why, he said, "Frightened, frightened, frightened, TV, bomb," and brought his hands together into the shape of a globe.

It was, she said, "like listening to his brain."

Boyle was stunned. She has spent so many years trying to decode her child's signals that she compares herself to a graduate student she remembers who wrote his doctoral thesis about one square meter of turf. But she looks back today on that conversation as an indication her child understands much more about the world than she knew he could. She has begun to look at him a little differently.

'Poor little grownups'

A year after Sept. 11, children in New York show symptoms that have been documented in children in war zones. And yet the national picture is much sunnier. In such communities as Boston, most children - those without disabilities such as autism, those without firsthand experience of missing or dead family members from the attacks - appear to have moved on, reshaping the attack into something more digestible. A group of children at the Roxbury YMCA, for instance, had only vague memories of what happened.

Although she remembers her mother crying - "poor little grownups" - Sydnee King-Owens, a 6-year-old, brightly explains that only one person really died. ";The people that was in the building all left. There was only more person there, and he jumped out,"; she said. "I saw the guy on the top of the building, and he jumped off the cliff. Then the plane made a very big hole."

Her friend at the YMCA, Malik Garrett, said terrorism poses him no danger. "When I jumped out there would be a big bouncy bed at the bottom and people would just carry me away," Garrett said. What Justina Colon Jean-Francois, 6, remembers is that she watched "SpongeBob SquarePants" that day. The relevant information came from her brother: "Osama bin Laden was, like, in the plane, and he, like, told them to crash. He's bad. He has a long beard."

For the most part, even children with preexisting problems do not show clinical aftereffects, despite the warnings that were issued that week from trauma professionals. A year later, the same experts are citing old wisdom about children's capacity for resilience. Like the children who lived through the Holocaust and those who witnessed the bombing of Hiroshima, they could grow up to be industrious and full of purpose.

"We all got caught up in it, too. The textbook answer" - that children bounce back remarkably well - "is the right one," said Dr. John Walkup, a specialist in children's anxiety disorders at Johns Hopkins University. "Human beings bury their fears and concerns. . . . That's the story of human beings."

But this is also true: Once seen, the images often do not go away. At Children's Hospital, where she works with autistic children, Janice Ware began to notice a powerful effect the attacks had among her patients. It was not a huge number - maybe 10 to 20 percent - but their responses were "just very sharp," she said.

"We have seen and are seeing a number of children who are extremely anxious and somewhat obsessed," said Ware, assistant director of the hopital's Developmental Medicine Center. "That event is the focus of their anxiety. That image is just so powerful that it's imprinting on their visual memory."

And we do know this, Ware said: Children, so lacking in analytical skills, often surpass adults in their ability to recall traumatic moments. The first permanent memory an infant creates is often attached to fear. For that reason, Ware has closely observed the autistic children, and she is spellbound by their reaction.

"For both myself and other parents, it's such a profound experience to think that the world contained this, and to observe how it is impacting the next generation," she said. "What are they going to carry with them?"

In a distant town, fear is born

James Sandman's family members knew he was a peculiar boy long before they knew why. At 7, spindly and blond-eyelashed, he has a computerlike ability to list dead rock stars, a morbid litany that embarrasses his mother. James, who has autism, is so fond of regulations that he begs his mother to take him to the playground and makes her read the posted rules to him. Then he is ready to come home.

But he fails to mention it when he is in pain, and he remains strangely remote from humans outside his immediate family. He refers to them by the pronoun ";it"; and is so passive with other children that "if we don't watch him like a hawk, he'll be in line for the slide for 45 minutes," said his mother, Ellen.

It was that detachment that surfaced on the morning of Sept. 11. When the second plane hit the south tower, Sandman and her son were at Children's Hospital, huddled around a computer monitor. Ellen Sandman describes the crumpling of the nurses' and doctors' faces around her, and the dash out of the buildings with her mother. On the street, pedestrians with cell phones waited on the sidewalk to hear the voices of their loved ones.

The only person who seemed unaffected was James. "Why are we running in the hospital?" he asked his mother, again and again. Developmental disabilities can serve as insulation at those moments, and Dr. Daniel Rosenn, who treats people with Asperger's Syndrome, said most of his patients reacted to the national spasm of grief with puzzlement. Only one patient became suicidal, and it was for a strange reason: He wasn't sad enough.

James, too, was the only member of his family not overwhelmed. Protected from newspaper or television depictions of the disaster, he played quietly all week and did not mention the attacks.

But a month later, when his mother was making an appointment to return to Children's Hospital, James surprised her by declaring that he would never go back there. He said the buildings were bad. Sandman did a double-take.

"It was a haunting experience for all of us," she said. "I've never seen him react with fear before.";

And he still won't return to the city - not Boston, where he has been treated at Children's Hospital for a year and a half, and only reluctantly to Worcester, whose buildings are squatter and fewer. Before recently accompanying his mother on a shopping trip to Paxton, population 4,000, he asked his mother with urgent gravity if the town had tall buildings. The few people who fall inside his comfort zone have made an effort to comfort him.

"Planes don't usually crash into buildings," his grandmother, Debby McNamara, told him. "The people in charge of the government are making sure this is never going to happen again."

But Ellen Sandman looks at her son, who can remember the exact time of day when he started preschool three years ago, and that it was a Wednesday when he first used lined paper. She wonders whether James will ever go back to town.

Ellen Barry can be reached at barry@globe.com.

This story ran on page A1 of the Boston Globe on 9/4/2002.
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