Following the children of September 11

October 1, 2004

It is three years now since the calamity of September 11. Three years is long enough for researchers to count the number of children orphaned on that dreadful day and launch the earliest studies of how children react to what these experts call "traumatic bereavement."

It is three years now since the calamity of September 11. Three years is a long time in the life of a child-long enough for the younger ones to work out a provisional concept of death, like the 5-year-old quoted in The New York Times who, when one of his dead father's bones was identified, asked: "Can we get all the pieces and put them together, so he could be alive?" Long enough for older children to act out their rage, retreat from activities that once engaged them, and then-the more resilient ones-begin to reintegrate into their forever-changed world.

Three years is also long enough for researchers to count the number of children orphaned on that dreadful day and launch the earliest studies of how children react to what these experts call "traumatic bereavement." Preliminary data compiled by Claude M. Chemtob, clinical professor of psychiatry and pediatrics at Mount Sinai School of Medicine, account for 2,990 children whose parents died in the attack, more than 100 of them born after their father died. Most were grade-school age. Of those who have received a diagnosis, the most prevalent psychiatric problems were disruptive disorders and problems with mood and conduct. Posttraumatic stress disorder appears relatively rare, affecting only 12%.

Another study, headed by Dr. Marylene Cloitre, director of the Institute for Trauma and Stress at New York University's Child Study Center, is following 203 children whose parents killed in the attacks were firefighters, police, or paramedics. The early findings show that the children who have undergone psychotherapy are doing much better than those who have not. According to Dr. Cynthia Preffer, a professor of psychiatry at Cornell University's Weill Medical College, the children's most pervasive fear is that something will happen to their surviving parent-a fear that breeds intense separation anxiety.