As school shootings sadly become more commonplace, it’s hard not to wonder how they affect the children attending school. Do kids today worry more about maintaining their own safety than their math homework? Are they unable to focus, looking at pictures of victims of recent school shootings that remind them of themselves? Are they nervous towards and hyper-observant of other children that they consider to be possibly dangerous?

Whether you are a parent, relative, coach, teacher, or community member who works with and cares about students, it’s important to understand the fears and feelings children today may be struggling with. We asked experts about the effects that school shootings have on the developing brains of America’s youth. Here’s what they want you to know.

“Mass shootings are a first-line traumatic event that can potentially trigger post-traumatic stress disorder (PTSD) in people who are directly exposed, as life and limb are under direct and violent threat. Children, in particular, are even more vulnerable; multiple studies have shown that childhood trauma has more lifelong and pervasive effects on young developing psyches, both in terms of their psychological worldview, and their physiological systems that handle stress and anxiety.

On a secondary level, the threat of mass shootings throughout schools is also damaging to mental health; safety and security are always paramount to a child’s healthy psychological development, and this constant anxiety and sense of danger will disrupt that sense of security, and put all children at risk of developing anxiety and mood disorders.”

—Jean Kim, MD, Clinical Assistant Professor of Psychiatry at George Washington University, Medical Officer at the FDA

“It is common for those affected directly and indirectly to have increased anxiety, nightmares, difficulty sleeping, resistance to school, inability to trust, uneasiness, depression, fear, decline in academic performance, inability to fully express their thoughts and feelings, why questions, absence of feelings of safety and security, changes in eating habits, increased anger, hyper-vigilance, grief, loss, guilt, etc. These symptoms and behavior may result in Acute Stress Disorder, Post-Traumatic Stress Disorder (PTSD), and even delayed Post-Traumatic Stress Disorder. Mental health clinicians trained in trauma and grief can assist and support children and families during this time of healing.”

–Melissa Dumaz, MS, LMFT, founder of uhelpyou.com

“While it’s already challenging to cope with loss, the impact can be significantly more when the loss occurs due to violence and is unexpected. It can strip away the sense of control and comfort of the families and the people left behind, leaving them feeling angry and vulnerable…Mass shootings do leave not only physical injuries but also psychological injuries that require healing. For survivors who make it without any physical injuries, it takes a few months to assess the impact on their mental health adequately, but the trauma of a mass shooting can potentially result in post-traumatic stress disorder (PTSD), depression or other mental health issues that can continue to affect a person’s life drastically.

Providing help to these people and their loved ones can ensure they recover successfully and significantly decrease the psychophysiological consequence…While a lot of survivors may suffer from symptoms of trauma that include flashbacks, anxiety, sadness, insomnia, fear, and anger, these signs will start to fade over time as they start re-engaging in activities. However, for some, it may get worse leading to depression or PTSD. It takes at least one month after the event to diagnose for PTSD. Effective treatment options include psychotherapy such as Cognitive Behavior Therapy (CBT) and medications.

It is important to remember that we do not only need to support the affected people but also find a way to prevent future incidents. Assessing the cause of the events and how a person can harm so many people so easily proves the urgent need for gun reform. Our children—the voices and minds of the future—have risen and voiced their demands for “stricter gun control laws” working in conjunction with mental health checks (psychosocial evaluations), background checks are necessary to reduce future shootings. ”

–Henry Montero, LMHC, CASAC, Alquimedez Mental Health Counseling, New York, New York

“Children, like adults, often cycle through feelings of shock, anger, sadness, fear, and helplessness when they learn that people are dying unexpectedly and brutally at the hands of someone wielding guns. However, due to less-developed communication and emotional processing skills, children express their thoughts and feelings differently from adults. Children may have increased nightmares, intrusive thoughts, abrupt changes in their mood, and changes in their play behavior (i.e., acting out shootings, mimicking dying, or other aspects of the school shooting, etc.) . They may also report aches and pain in their bodies following a traumatic experience. Children who are especially distressed or anxious may exhibit regressions in their development, such as increases in bedwetting, clinginess, and tantrums.

It is important to look for any changes in a child’s emotional and behavioral presentation after exposure to traumatic experiences across multiple and different contexts. How a child presents at home may not be how the child presents at daycare, the supermarket, or the playground. It would be helpful to talk to teachers about any changes in the child’s grades, ability to concentrate, or degree of engagement in social activities.”

–Kathy Wu, PhD, licensed psychologist, assistant professor of psychology at Delaware Valley University in Doylestown, Pennsylvania

“Mass shootings certainly contribute to heightened societal anxiety. And in a state of heightened anxiety, it becomes much harder to focus on the facts and create effective solutions. When we’re afraid, we tend to distract ourselves, fight with each other, or avoid the problem all together. Therefore the challenge of every community is to figure out how to keep communicating with each other and create reality-based solutions to prevent mass shootings.”

–Kathleen Smith, PhD

“Mass Shootings effect all of us, young and old. It’s so very important that we talk about these shootings openly and honestly with each other, and make sure that our children know they can come to us with any fears or concerns that they may be having as well. When schools have safety drills, make sure your children talk to you about them afterward, as these can be very scary as well. If you or your children are feeling anxious and panicked throughout the day, therapy can be a helpful, safe place to talk about these fears and to learn ways to stay more present and grounded in your everyday life.”

–Heidi McBain, MA, LMFT, LPC, RPT