For Many of Katrina's Young Victims, The Scars Are More Than Skin Deep

Many children are having difficulties adjusting after Katrina. The screening by LSU found that more than 30 percent of them showed symptoms of depression or post-traumatic stress disorder.

In a study by Columbia University and the Children's Health Fund of 665 displaced families, nearly half of the parents reported that at least one child in their household had emotional or behavioral difficulties that were not present before the hurricane. Symptoms involve feeling sad or depressed, being nervous or afraid, and having problems sleeping or getting along with others. Compared with children surveyed in Louisiana in 2003, Katrina's victims were more than twice as likely to have behavioral or conduct problems; the same was true of depression and anxiety, the survey found.

Patterns are beginning to emerge. "The younger children lack the cognitive ability to grasp the idea of a once-in-a-hundred-year storm," said Elmore Rigamer, a psychiatrist who is medical director of Catholic Charities Archdiocese of New Orleans. "For them, if it happened once, the world is an unsafe place."

Elementary and middle school children can be both more withdrawn and more aggressive, and their anxiety often comes out in physical symptoms such as headaches and stomachaches. Rigamer described a 6-year-old boy from hurricane-devastated St. Bernard Parish. "He's a meticulous boy who'd started to collect stamps and toy soldiers. Now, they're all gone," she said. "His mother brought him to me because he's punching kids at school, he quit learning to read and he's hoarding food."

Rainy days frighten the weather-obsessed children at Gautier Academy Child Development Center in Gautier, near Pascagoula. "When it's cloudy, they don't want to go outside," said Cynthia Matthews, the academy's owner. "It's as if they're afraid of the sky."

Teenagers seem affected most by social isolation. Joy Osofsky, an LSU professor of pediatrics and psychiatry, said that when she worked with a group of young people in a shelter in rural Louisiana about a week after the storm, she expected to hear stories of terrible experiences; some of them had been in the Superdome or were rescued from rooftops.

"Some talked about that, but what they talked about more was missing friends," she said. "They used to be in constant touch by e-mail or cellphones, and they felt very isolated."

The older children, while suffering, often show strength, said Howard Osofsky, chairman of LSU's psychiatry department, who with his wife is leading the university's screening of Katrina children.

"One reason our clinicians work around the clock and are so dedicated is how inspiring these kids can be. They really do have symptoms of mental distress," he said. "Yet when you ask their first concerns, so many say they want to help their parents or help in the rebuilding."

Younger children can be especially resilient, Joy Osofsky said. "If their parents are able to give them support and stability, most will bounce back and do what children do -- play," she said.

For this reason, experts say that efforts to help Katrina children should focus not just on them but on their families. A number of charities and nonprofit organizations have established or are raising money for programs such as free family mental health screening, trauma counseling in schools, and summer programs for children who have fallen behind in school or who live in Federal Emergency Management Agency trailer parks, which have no playgrounds.

Some advocates, including the Children's Health Fund, have called on the federal government to allocate $100 million to send a force of pediatricians, family doctors, specially trained mental health workers and mobile medical vans to the Gulf Coast. The Children's Defense Fund, another advocacy group, likewise is calling for emergency health and mental health services.

For parents, their children's well-being has become one of their biggest concerns in trying to return to a normal life.

Joy Green hasn't yet returned to her job at the Zatarain's plant, which packages rice, because of her worries about her three sons. "I can't hardly focus. It's depressing. The only thing that keeps me going are my kids," she said. "I'm afraid for them."