Why we need to support infants and children before, during and after disasters

What is this resource about?

Australian families and communities are experiencing more disasters than ever before. Infants and children rely on the adults around them to meet their needs, keep them safe and help them to make sense of their world. This puts them at greater risk of adverse impacts during and after a disaster.

Experiencing a disaster can disrupt children’s sense of safety and development and impact on their mental health and wellbeing in the short- or long-term. Individual outcomes are influenced by a range of risk and protective factors.

This practice paper explains why it’s important to focus on the unique needs of infants, children and families in the context of disasters. It introduces the foundational knowledge and skills needed to support children and families at all stages of a disaster (preparedness, response and recovery). It is informed by a growing body of academic evidence in Australia, along with the experiences of families and practitioners in preparing for, responding to and recovering from severe and impactful weather-related disasters.

Key messages

• Infants and children in Australia are increasingly exposed to disasters.
• Disasters are stressful and potentially traumatic events that can disrupt infants’ and children’s development and impact on their mental health and overall wellbeing.
• Everyone, regardless of their professional background, has a role to play in supporting infants, children and families before, during and after disasters.
• By understanding and integrating child-centred practice strategies into your work, you can contribute to the safety, mental health and resilience of children and families in the context of disasters, laying a foundation for future generations.
• Every child’s experience of, and reactions to, a disaster is unique. It depends on a range of personal, family, community and societal risk and protective factors.
• Following a disaster, many infants and children experience minimal and short-lived distress that lessens over time with support from their parents and other trusted adults. However, some children experience more significant reactions that can contribute to the development of mental health difficulties.​
• Children’s reactions are shaped not only by their exposure to a disaster, but by any adverse consequences that impact their family or community following the event.
• It is important to understand how children react and respond to potentially traumatic experiences, the value of seeing the ‘whole child’ and their ecology, and why it is essential to match support to children and families’ needs. These are critical steps towards mitigating disaster-related distress and enhancing the wellbeing of infants and children in the short and long term.
• Effective support for infants, children and families requires a coordinated and integrated approach across multiple service sectors that embraces a range of child and family-centred practice strategies.

Who is this resource for?

This practice paper is for anyone who is currently supporting, or could support, infants, children, parents and/or families – before, during or after a disaster. This includes practitioners, workers, leaders and volunteers in:

• health services
• social and community services
• education
• first response and emergency services
• government (policymaking and agencies)
• non-government organisations
• community-led initiatives.

For ease of reading, we will refer to individuals in all these roles as ‘practitioners’.

Definitions

The terms ‘children’, ‘parents’ and ‘practitioners’ are used throughout this resource and we define them in the following ways:

Children: includes newborn infants, babies and children up to 12 years old.

Parents: the biological, adoptive, foster and kinship carers of a child, as well as individuals who have chosen to take up primary or shared responsibility in raising that child.

Practitioners: all individuals with a role that involves or might involve supporting infants, children, parents, families and/or communities in the context of a disaster of any kind.

While experiencing and recovering from weather-related disasters has been part of life for many Australians, our exposure to disasters is changing. Weather-related disasters are becoming more frequent and severe, with significant impacts and costs for individuals, communities and the environment (CSIRO and the Bureau of Meteorology, 2022). In the past 10 years we have seen increasingly frequent and intense bushfires, floods and droughts occurring across the country, with cyclones developing further south than they have previously. Communities are increasingly likely to experience multiple disasters, either concurrently (around the same time) or consecutively (one shortly after another) (CSIRO and the Bureau of Meteorology, 2022).

Emergencies and disasters related to other hazards, such as terrorism, toxic waste, violence and epidemics, have also affected or could impact Australian communities. This means more Australian communities, families and children are at risk of experiencing a disaster than ever before.

Estimates suggest around one million children (aged six to 18 years) experience a disaster in an average year (Deloitte Access Economics, 2024). Many more are experiencing heightened fear or concerns about the current and future threat of hazards through their exposure to media (e.g. social media, TV, books and movies).

Hazards (and their impacts) can be unpredictable and devastating. They have the potential to affect anyone, anywhere, at any time. But some population groups are at greater risk, including infants, children and young people (Phoenix, 2020).

Without adequate protection and support, the experience and impacts of a disaster can disrupt children’s sense of safety and development, cause significant distress, and lead to long-term mental health difficulties (Royal Far West & UNICEF Australia, 2021). But with the right preparation, responses and support, infants and children who experience a disaster can recover and adapt well (Phoenix, 2020).

This is why it is essential that everyone who works with infants, children, parents and families is prepared to support them in planning and preparing for disasters, as well as responding and recovering afterwards.

In the following video (5 minutes) practitioners and a parent with lived experience describe potential impacts of disasters on the development and wellbeing of infants and children and the importance of responding to their unique needs.

Disasters (of all types) are not equal in their impacts. Research shows certain population groups, including infants, children and young people, are at greater risk of experiencing mental health difficulties related to a disaster (Chen et al., 2020; NEMA, 2023).

Despite this, the mental health needs of infants and children are often overlooked in the context of disasters and emergencies (Chen et al., 2020; Danese et al., 2020). This is partly due to the now debunked belief that infants and children are too young to understand or be negatively impacted by disasters (NEMA, 2023).

Children are not small adults, so their experience of disasters is different to that of adults. Infants and children have particular emotional, social and physical capabilities and needs that place them at greater risk of mental health difficulties following a potentially traumatic experience (Chen et al., 2020).

As their brains, bodies and social behaviours are undergoing rapid development, everything an infant or child experiences shapes their mental health. The increased risk for infants and children is due to multiple factors, including:

• their earlier stage of physical, cognitive and emotional development – making them less experienced and equipped to deal with the physical and psychological stress of a disaster
• their reliance on adults for protection as well as for support to cope and ‘make meaning’ of disaster events. Infants and children are hard-wired to engage with others, to look at and respond to faces, and to trust and rely on adults for their safety
• differences in threat perceptions and values – for example, their increased fear of separation from loved ones, or the loss of pets or possessions such as favourite toys
• the disruptions a disaster causes in communities, such as loss of access to education, health services and spaces for sport and play
• the secondary impacts of a disaster on their family and/or community (explored further in the section ‘What shapes an infant’s or child’s mental health in a disaster context?’); and
• the possibility that they will experience multiple disaster events and climate-related risks during childhood, with accumulating impacts.

It is also important to be aware of the potential impacts of disasters on expectant parents and their unborn children (Parayiwa et al., 2022; O’Donnell & Behie, 2013; McLean et al., 2021). In addition to a higher risk of pre-term births, lower birth weight and pregnancy loss, research suggests the stress for pregnant people who experience a disaster is linked to adverse child development and a higher risk of postnatal depression, with potential consequences for the mental health and wellbeing of infants (McLean et al., 2021; Simcock et al., 2017).

Mental health is an integral part of overall health and wellbeing for children, just as it is for adults. It starts developing before birth and keeps developing and changing over a lifetime.

To effectively support infants, children and families who are exposed to a disaster, it’s essential to understand what infant and child mental health is and the multiple factors that interact with and shape it.

Infant and child mental health refers to the emotional, psychological and social wellbeing of infants and children from birth. It encompasses how infants and children think, feel, behave, form relationships, and learn and play in their daily lives. For Aboriginal and Torres Strait Islander peoples, social and emotional wellbeing is the foundation for physical and mental health. This is a holistic concept that results from a network of relationships between individuals, family, kin and community, and recognises the centrality of Land, culture and environment to wellbeing (Commonwealth of Australia, 2017).

Positive mental health is foundational to infants’ and children’s emotional and physical development. It helps them learn to express and regulate a range of emotions, form other close and secure relationships, and confidently begin to explore the world around them.

An infant’s or child’s mental health is not fixed. It occurs along a continuum that can range from positive mental health, ‘going OK’ or experiencing some challenges, to diagnosed mental health difficulties that significantly impact their daily life. A child’s mental health is shaped by their experiences and the interaction between many different internal and external factors (as explained in the following section).

In this video (2 minutes, 51 seconds), Emerging Minds Director Brad Morgan discusses what adults need to know about children’s mental health.

Learn more about infant and child mental health in these Emerging Minds online courses and resources:

The mental health of infants and children, more than any other age group, is shaped and influenced by a range of intersecting social, biological, relational and environmental factors.

These include:

• their individual characteristics – their age, development, genetics, temperament, physical health, neurodivergence and any disabilities they may have
• their relationships with their family members and other significant adults in their life (like grandparents and educators)
• their interactions in the places they live, learn and play
• events in their local neighbourhood, community and the wider world.

No single factor or experience contributes to mental health in isolation. Throughout childhood, most children have experiences that are nurturing and some that are stressful. The impact of any experience – including a disaster – on a child’s wellbeing depends on their ecology and the support they receive before, during and after. Consistent, nurturing relationships and safe, supportive environments foster the mental health and wellbeing of infants from conception to birth, throughout childhood and as they transition into adulthood (Merrick et al., 2020).

The environment in which children live and grow has a direct link to their mental health, especially with the increased risk of climate-related disasters.

A disaster that impacts a child’s community can disrupt all, or many of, the different areas of their life, including their:

• safety
• physical and mental health
• development
• learning and play
• sleep
• routines
• relationships
• environments (the places where they live, learn and play).

The way their disaster experience impacts on each of those different areas of a child’s world, and intersects with existing risk and protective factors, influences the child’s response and ultimately their mental health.

To support infants, children and families who have experienced a disaster, it’s essential to see the ‘whole child’ within their ecology – which means considering the infant or child in the broader context of their relationships and environment. Children, families, communities and the environments in which we live are all interdependent.

The following video (2 minutes, 25 seconds) explores the concept of the ‘whole child’ – a holistic view of a child’s wellbeing.

Being curious about a child’s ecology helps you look beyond the current situation or presenting concerns to better understand:

• the intricate interplay between various contextual factors influencing their development and wellbeing
• how they have personally experienced and processed the effects of the disaster
• their unique needs, strengths and hopes; and
• the important relationships in their life, including family, friends, educators and other sources of support.

By adopting this holistic perspective, you can tailor your approach, support or referrals to effectively address the needs of the individual child and their family.

This video (1 minute, 5 seconds) explores some of the things that can support a child’s mental health and recovery following a disaster.

Every child’s experience of, and reactions to, a disaster will be unique, depending on a range of risk and protective factors within their ecology.

Select the following headings to learn more about each factor.

It is important to know that infants and children can experience distress or mental health difficulties that are related to a disaster that they have not directly experienced. These may be related to:

• their perception of threat – for example, seeing coverage of disaster impacts in a nearby town on TV may lead a child to believe that their safety is also threatened; or
• secondary impacts, such as a parent losing their job in an affected region, or housing insecurity or homelessness due to a lack of available housing in their area following a disaster.

In the following video (6 minutes, 14 seconds) practitioners and a parent whose family has experienced several disasters describe various factors that shape a child’s experience of, and recovery after, a disaster.

Disasters are often unexpected and overwhelming events that typically cause adversity, so reactions are to be expected – for infants and children, as well as adults.

Every infant and child’s reaction to a disaster is unique. It will be influenced by their exposure to the disaster, potential stressors and adversities resulting from the disaster, or both, as well as other factors (described in the previous section).

Infants and children exposed to a disaster show a wide spectrum of common reactions, depending on their pre-existing risk and protective factors. These reactions are also influenced by the service responses and support available to them and their family during and after the disaster.

As the following graphic shows:

• In most cases, infants and children experience mild and short-lived distress that lessens over time with support from parents and others.
• Some infants and children experience immediate emotional/behavioural reactions that can persist over time. These reactions may intensify or develop into mental health difficulties.​
• ​Others may initially appear unaffected, but then display signs of mental health difficulties and/or traumatic stress responses.
• Some children even report positive changes following a disaster, such as feeling more confident to help in a crisis (Royal Far West & UNICEF Australia, 2021).​

The common trajectories for infants and children after a disaster may change in the future, given the predictions of increased frequency, severity, duration and accumulation of disasters during a child’s lifetime. For instance, we may see an increase in the number of children who experience emotional/behavioural reactions, traumatic stress responses or mental health difficulties, as a result of compounding disaster experiences.

This highlights the importance of developing and using strategies to support infants, children and families to adapt to these potentially difficult or challenging life experiences. For practitioners supporting children and families, a baseline understanding of how children’s brains develop and respond to adversity and potentially traumatic events is crucial.

Our bodies instinctively react to perceived threats to keep us safe. When we are exposed to the actual or perceived stress and threat caused by disasters, a physiological and psychological response is activated. This triggers the release of stress hormones that increase our alertness, energy levels, heart rate and senses. This is sometimes referred to as the ‘stress response’ or ‘fight, flight, freeze or fawn’, and is experienced by infants and children as well as adults (Mohammadi et al., 2024).

However, if the stress response doesn’t stop once the threat has passed, it can disrupt the development and functioning, and potentially the mental health, of infants and children. This can be seen in many different aspects of a child’s daily life, including their physical, social, emotional, behavioural, cognitive (thinking) and communication skills. For example:

• It is common for infants and toddlers to regress in some developmental milestones following a disaster. They might experience sleep or feeding problems, increased irritability and extreme distress when separated from a parent or primary carer, or regress in physical skills such as sitting, crawling or walking.
• Preschoolers often become very ‘clingy’ with parents or other primary caregivers and might regress in toileting or sleep. They may become withdrawn and not enjoy or engage in things they used to love.
• Primary school-aged children commonly experience anxiety and sleep problems, complain of bodily aches and pains, and may exhibit regressive behaviours like wanting to be dressed or fed. Changes in appetite or sleep (not wanting to go to bed at night, difficulties staying asleep or nightmares) are common. Not wanting to go to school or be separated from family and having difficulties (e.g. struggling to concentrate) at school is also common.

For most infants and children, these reactions are minimal and short-lived. Temporary regression in skills, behaviour and development is typical in infants and children who have experienced severe stress or an adverse or potentially traumatic event (Lai et al., 2020). This is how children communicate their distress and unmet needs – they are letting the adults around them know that they need more support. With the right support for the infant or child and their parents, the child’s development, learning and functioning is more likely to get back on track.

While children’s reactions may be observed through changes in their behaviour and other forms of communication, it’s also important to know that children’s psychological distress may not be obvious, even to the adults closest to them. Also, children’s reactions can change over time. They may appear to be recovering and adapting well immediately and shortly after the disaster and may not show signs of difficulties until months or even years after the event.

For some infants and children, their reactions to a disaster can adversely affect their long-term health and wellbeing. When the stressors and adversities a child has experienced outweigh the factors in their life that are protective – like a strong parent-child relationship and access to support – it can negatively impact the development of their physical, neurological and emotional systems. This can lead to social, emotional, behavioural and cognitive difficulties and the potential of mental health difficulties into adulthood.

In these circumstances, children will benefit from more targeted and timely support. Therefore, all the adults in an infant’s or child’s life need to understand and be able to recognise signs the child is not coping or may be experiencing mental health challenges – in both the short and longer term – and know where to seek more information and support.

Disasters such as floods, bushfires, storms and drought can be traumatic for children, as they can impact entire communities, involve significant damage and destruction, and may result in loss of property or life. If an experience is overwhelming for a child (i.e. too frightening, too painful, or has too many accumulating stressors), it can lead to a traumatic stress response.

Children who experience a disaster can recover with support. However, a significant number develop a diagnosable mental health condition such as anxiety, depression or post-traumatic stress disorder (PTSD) (Alisic et al., 2014).

The following animation (2 minutes, 30 seconds) gives you an overview of trauma and adversity.

It is important to understand that disasters are a potentially traumatic event. Not all infants and children who experience a disaster will have traumatic stress responses or develop PTSD. The risk of a traumatic stress response is greater for infants and children who experience multiple adverse experiences (continuing and/or cumulative) during childhood. Children who have a previous history of adverse childhood experiences, or experience further family adversity following a disaster – such as the loss of a family home, financial stress or a parental relationship breakdown – are at higher risk of mental health difficulties.

When children experience an accumulation of stressors and adversity, it can negatively affect their mental health, with potentially life-long impacts. Yet, going through tough times can sometimes lead to developing new strengths, stronger relationships and resilience. Resilience is the ability to recover, adjust to or grow in response to changes including adverse or challenging life experiences, like those brought about by a disaster. It is a process, rather than an outcome, which ebbs and flows throughout a person’s life.

For children, building resilience hinges on whether they have strong relationships with important adults in their family and their community. These relationships help children to navigate through challenges and stressful situations. Children exposed to disasters develop resilience through their connection with at least one caring adult who can:

• help them to feel safe, secure and valued
• ensure their basic needs are met
• help them access psychosocial support; and
• learn skills to cope with life’s difficulties.

The process of building resilience through a disaster can help children through future disasters and difficult times.

It is also common for people to experience post-traumatic growth following a disaster. Post-traumatic growth is a concept that suggests people can experience positive changes and personal growth as a result of overcoming challenging or traumatic events, including disasters (Bernstein & Pfefferbaum, 2018). Experiencing and navigating through a disaster can lead to unexpected positive outcomes for infants, children, parents and communities.

With the right support at the right time, infants and children can recover, adapt and even thrive following a disaster. This requires a coordinated and integrated approach, involving a range of child-centred and family-focused practice strategies that respond to the needs of infants, children and families over time.

Embracing a child-centred and family-focused approach

Child-centred practice in disaster contexts prioritises the unique needs, vulnerabilities and voices of infants and children to support their safety, wellbeing and resilience throughout all phases of a disaster. This approach recognises that children have different developmental journeys, capacities and coping skills that must be understood and addressed by practitioners.

Child-centred practice involves actively engaging with children, families and communities to gather insights into children’s experiences, preferences and concerns, thereby supporting them to actively participate in decision-making processes that affect their lives. It also involves advocating for policies, environments and services that promote children’s rights and facilitate their recovery and adaptation in the aftermath of disasters. By placing infants and children at the forefront of disaster preparedness, response and recovery efforts, child-centred practice ensures their holistic needs are met and they are supported to thrive, even during adversity.

In addition to the impacts on an infant or child, a disaster affects parents and other family members. Mental health and wellbeing outcomes for children, parents and other adults in the family are interrelated and interdependent, particularly in the context of a disaster. Therefore, engaging and supporting parents is critical to improving outcomes for infants and children. Parents and other family members need information and support to develop the skills and strategies necessary to support their children’s mental health and wellbeing, as well as deal with their own stress responses and challenges.

It is important to understand that disasters can affect individuals within the family differently and can disrupt and adversely affect the whole family ‘unit’. Families are the foundation of children’s resilience and recovery, so we need to adopt a family-focused approach that prioritises engaging and supporting families in disaster preparedness, response and recovery.

In the context of disasters, a family-focused approach involves a collaborative and supportive partnership between practitioners and families. The aim is to empower families to identify their needs, co-create solutions and participate in decision-making. This approach acknowledges the unique dynamics and diversity within families and extends beyond nuclear units to encompass extended family members and support networks. It also includes supporting expectant parents who may need to prepare for or recover from disasters while their baby is in utero.

By prioritising the strengths, values and cultural contexts of each family, practitioners can tailor interventions and services to meet a family’s specific circumstances and preferences effectively across all phases of disaster response. Through open communication, active listening and mutual respect, a family-focused approach fosters a sense of control and agency within families, enabling them to navigate challenges, build resilience and achieve positive outcomes together.

Practice strategies for supporting families through disasters

Offering child-centred and family-focused practice strategies in the context of disasters includes the following elements:

You don’t have to be a mental health specialist to effectively support infants and children following a disaster. Everyone can play a role in mitigating the impacts of disasters on infants, children and families and fostering resilience through adversity.

To reduce the risks of adverse outcomes for children who experience a disaster, it’s important that all practitioners working with infants, children, parents and/or communities understand and consider support for children’s mental health as part of their work.

Many practitioners are concerned about potential mental health impacts for infants and children, but unsure how best to respond to the needs of infants, children and families in a disaster context. Often practitioners – across various disciplines – discover that strategies they’re already using in everyday work are protective or nurturing of children’s mental health. Taking steps to learn more about how to support infants, children and families using practice strategies within your work context is a great place to start.

By embracing opportunities to enhance your capacity for supporting infants, children and families, you can positively impact their lives both immediately after a disaster and in the long term.

Whether you work in adult-focused services, with families, or with infants and children, you can make a significant difference to the lives of Australians who experience a disaster.

Supporting infants and children in disasters: A practice guide has been created to help you support the wellbeing of the children, parents and/or families you work with at any stage of a disaster. It includes resources about many different aspects of child-centred and family-focused disaster preparedness, response and recovery. It also explores essential knowledge and strategies for working in disaster contexts and looking after your own wellbeing when supporting others.

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