Case Vignettes P ART 4

S TACY Stacy, a 10-year-old girl, was in her fourth grade classroom when the planes struck the World Trade Center. Another student alerted the class to the black smoke that consumed the sky well after both buildings had already been hit. A teacher from another class came into their room in tears, spoke softly with Stacy’s teacher, and left. Stacy’s teacher then told the children that something horrible had happened; planes had flown into the Towers and they would have to talk to their parents and watch the news to find out more. School was dismissed early that day.

No one in Stacy’s family was injured or killed in the attacks; however, one of her classmates lost his father. Stacy asked many questions about the attacks and about what happened to her friend’s father. Stacy spent much time watching television coverage with her family in the days following the attacks. She now watches the news every evening with her father. Stacy has continued to ask questions related to current events and has expressed concern about the War on Terrorism. She has experienced bad dreams intermittently and these have increased over the last several weeks. Although Stacy continues to participate in her dance class, she does not seem to enjoy practicing at home. On a positive note, her grades have steadily improved. S TACY

It so happens that Stacy’s maternal grandmother died in a car accident two months before September 11. Stacy’s mother has been tearful and quiet since then and has limited patience with Stacy. Stacy stays in her room when her mother is upset. Stacy complains that her father, who works long hours, does not spend time with her. Stacy has become irritable with her friends at school and angry that “no one will do what I want.” During a recent fire drill at school, Stacy cried inconsolably and her mother had to come to school to take her home. Stacy's mother told her that she did not have time for such behavior. S TACY

D EREK Derek is a 6 year old first grader. His grandmother was killed in the September 11 attacks. Derek and his family (mother and 5 year old brother) had lived with his grandmother since Derek was 2 years old. Derek asked a few questions immediately after the attacks, but not after that. Derek enjoys playing with his fire engines, police cars, and construction toys, which according to his mother he can do for “hours at a time.” Squabbling between Derek and his brother has increased in the last year. Derek’s mother reported that his temper tantrums over little things are becoming difficult to ignore.

This is Derek’s first year at his school. He has few school friends. His teacher noted that he has problems with attention and difficulty staying in his seat. He often interrupts her or classmates during discussions. His teacher has expressed concerns about Derek’s learning and worries that he may need to repeat first grade. Derek prefers being near the teacher on the play ground and continually seeks her approval. In his neighborhood, Derek has only one friend. He spends much time inside as his mother is concerned about gang activity. The family is active in their church. D EREK

Grandmother was the primary caregiver for Derek and his younger brother while mother worked. Since the attacks, money has been tight as his mother now pays for after school care. Recently, Derek’s mother began dating a man from their church. In the past few weeks, Derek has complained about stomachaches and not wanting to go to school. The family doctor found nothing wrong and suggested his mother contact a therapist to help with his difficulties. D EREK

A LLISON Allison is 15 years old and in the 10 th grade. Her high school was distant from New York City but she saw coverage of the attacks on the television news and Internet. She also learned about the attacks in her social studies class. The class was assigned to watch coverage in the weeks following September 11 and to keep a journal of what they saw and read about the attacks. Allison is fairly popular at school and performs well in her classes. She organized a cookie drive for the September 11 rescue workers. Although she seemed to handle the September 11 attacks with little distress, she asked repeated questions about the anthrax scare.

Allison continued writing in her Social Studies journal over the last year. She states that she has a running record of “alert colors” and information about terrorist events from around the world. She recently told a friend, “Why bother worrying about grades for college? They say the world will probably go up in smoke after we bomb Iraq.” Her parents have noticed that Allison is spending more time in her room and less time on the phone with old friends. Her grades dropped a little, but her parents attributed it to greater difficulty of her homework assignments. Allison has begun drawing and mother recently found pictures of graveyards and angels in her pockets. When she does go out, it is with a new group of friends and she comes home after curfew. When her parents expressed concerns, Allison told them to “chill.” A LLISON

Allison’s teacher called you this week to report she was highly concerned about Allison. A classmate reported overhearing Allison talking about “how cool death would be because there are no wars in heaven.” Allison’s mother found a joint in her daughter’s backpack. Her parents were at a loss, and guilt- ridden that they had not been aware of Allison’s distress. They have contacted you for consultation. A LLISON