Published online December 31, 2007
PEDIATRICS Vol. 121 No. 1 January 2008, pp. 46-53 (doi:10.1542/peds.2007-1348)
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ARTICLE

Young Children's Reactions to War-Related Stress: A Survey and Assessment of an Innovative Intervention

Avi Sadeh, DSc, Shai Hen-Gal, PhD and Liat Tikotzky, MA

Adler Center for Research in Child Development and Psychopathology, Department of Psychology, Tel Aviv University, Ramat Aviv, Israel

OBJECTIVE. The goal was to assess stress reactions in young children during and after war and the effects of a new brief intervention.

METHODS. Two separate studies were conducted. In study I, we assessed war exposure and stress reactions of 74 children (2–7 years of age) in a sheltered camp during the second Israel-Lebanon war (July to August 2006). Their exposure to war experiences and their stress reactions were assessed through parental reports during the last week of the war. In addition to standard care, 35 children received a brief intervention (Huggy-Puppy intervention) aimed at encouraging them to care for a needy Huggy-Puppy doll that was given to them as a gift. The effects of the Huggy-Puppy intervention were assessed in a follow-up interview 3 weeks after the war. Study II assessed the efficacy of group administration of the Huggy-Puppy intervention to 191 young children, compared with 101 control subjects. The effects of the intervention on stress-related symptoms after the war were assessed in telephone interviews with the parents.

RESULTS. Study I indicated that, during the war, most children had significant exposure to war-related experiences and had severe stress reactions. The Huggy-Puppy intervention was associated with significant reductions in stress reactions in the postwar assessment. A higher level of attachment and involvement with the doll was associated with better outcomes. The results of study II indicated that group administration of the Huggy-Puppy intervention was associated with significant reductions in stress reactions.

CONCLUSION. These studies suggest that the Huggy-Puppy intervention may offer pediatricians and other child health care professionals a promising, cost-effective intervention for children during stressful times.

Key Words: stress • posttraumatic stress disorder • war • intervention • child

Abbreviations: PTSD—posttraumatic stress disorder • HPI—Huggy-Puppy intervention • SRCL—stress reaction checklist

Accepted Jun 25, 2007.


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