By Linda Carroll, NBC News contributor
In a particularly wrenching irony, a gunman in Colorado chose to shoot up a movie theater packed with an audience that included children who’d come to see a film about a hero who was supposed to save everyone from danger.
Whether that will make any difference to the children who were injured or witnessed the shootings early Friday at a screening of "The Dark Knight Returns," no one can say. Reports say that those among the wounded are an infant and a 6 year old.
What experts can say is that the children who survived the attack that left 12 dead and 59 injured will most likely suffer the symptoms of acute stress disorder and that some might eventually develop PTSD. Children who weren’t at the theater may also be very frightened when they hear about the tragedy, but they are unlikely to develop any lasting problems, experts say. The suspect, James Eagan Holmes, told police he was the villian named the Joker.
The children most likely to end up needing therapy for longer term problems are those who were injured, lost a loved one or witnessed horrific sights, said David Yusko, a psychologist and associate director of the Center for the Treatment and Study of Anxiety at the University of Pennsylvania. “Seeing body parts or gore, stuff like that,” Yusko said.
And that’s what many kids at the theatre saw. Tanner Coon, 17, went to the movie with a friend who brought his 12-year-old brother. Coon, obviously stunned by what he’d witnessed, described the little boy’s horror to Matt Lauer on TODAY Friday morning.
“When he realized what was going on …all the gunfire and stuff like that … he didn’t take it too well,” Coon said. “He was freaking out. I was trying to calm him down. He just wanted to go home afterward. He was really upset about this.”
Parents should expect that children who were exposed to the violence will suffer symptoms for a month or so. “They may be upset and anxious,” Yusko said. “They may have some sleep problems, possibly nightmares. They might have intrusive thoughts about what happened. They might have difficulty concentrating and be agitated. They may be hyper-vigilant about their surroundings. They might be a little nervous to be out in public again. That’s all part of the normal response to something like this.”
The vast majority of people – young and old - will recover within a month, Yusko said, adding that children don’t seem to be affected any differently than adults.
“The way children express themselves is different, but I think their lives are affected in the same way as adults. There’s no reason to suggest they’re going to be scarred for life. Just like adults, they can have a traumatic experience and they can recover.”
The time to get help is when kids are still suffering symptoms like nightmares or intrusive thoughts three months after the traumatic event, Yusko said. “If you see symptoms around three months from now, then we’re talking about a chronic PTSD, something they’re not likely to recover from without help.”
The best thing to do for people who were in the theatre is to make sure they feel supported, Yusko said. “I wouldn’t try to force someone into talking about it or going over what happened unless they volunteer to,” he added. “There’s some evidence from debriefing groups that this forced longer symptoms when people didn’t want to be in them.”
Whether it’s a child or an adult, it’s best to let them decide when, and if, they want to talk, Yusko said.
If symptoms go on for longer than a month then it’s best to seek professional help. “There are some very effective treatments,” Yusko said.
As for kids who become frightened when they learn about the shootings from the TV or the Internet, they will need to be reassured, Yusko said.
Yusko said he wouldn’t bring the shooting to a child’s attention, but if a child finds out about it, then you may have to try to calm his fears.
“I think kids will wonder if that can happen to them,” Yusko said. “They might ask, ‘If we go to the movies could that happen?’”
If the child is older – say 18 or 19 – then you might have an honest conversation, Yusko said. But for younger kids, the best approach is to make them feel safe.
“You can say that there are people who do bad things but they aren’t very frequent and for the most part the world is a safe place,” Yusko said. “You can say, ‘we’re going to have fun the next time we go to the movies. Emphasize that. Try not to emphasize the fact that there are people out there who do horrible things – and that they can do horrible things at any time.”
Related content from NBCNews.com:
- Parents say shootings won't make them keep kids from Batman movie
- Colo. ER doc: 'Oh, my heart sank'
- Theater shooter believed to be ex-graduate student at Colorado medical school
- Police: 'Sophisticated' booby-trap in Colorado shooting suspect's apartment
- Woman who died in Colo. movie rampage narrowly escaped being shot last month
- Witnesses react online to 'Dark Knight' theater shooting