After The Disaster: A Children's Mental Health Checklist

Add up the pluses and minuses to obtain a final score. If the child scores more than 35, it is suggested you seek a mental health consultation.

1. Has the child had more than one major stress within a year BEFORE this disaster, such as a death in the family, a molestation, a major physical illness or divorce? If yes: +5
2. Does the child have a network of supportive, caring persons who continue to relate to him daily? If yes: -10
3. Has the child had to move out of his house because of the disaster? If yes: +5
4. Was there reliable housing within one week of the earthquake with resumption of the usual household members living together? If yes: -10
5. Is the child showing severe disobedience or delinquency? If yes: +5

Is the child showing any of the following as NEW behaviors for more than three weeks after the disaster?

6. Nightly states of terror? +5
7. Waking from dreams confused or in a sweat? +5
8. Difficulty concentrating? +5
9. Extreme irritability? +5
10. Loss of previous achievements in toilet or speech? +5
11. Onset of stuttering or lisping? +5
12. Persistent severe anxiety or phobias? +5
13. Obstinacy? +5
14. New or exaggerated fears? +5
15. Rituals or compulsions? +5
16. Severe clinging to adults? +5
17. Inability to fall asleep or stay asleep? +5
18. Startling at any reminder of the disaster? +5
19. Loss of ambition for the future? +5
20. Loss of pleasure in usual activities? +5
21. Loss of curiosity? +5
22. Persistent sadness or crying? +5
23. Persistent headaches or stomach aches? +5
24. Hypochondria? +5
25. Has anyone in the child’s immediate family been killed or severely injured in the disaster (including severe injury to the child)? +15

Note: Preoccupation with death, unusual accident proneness or suicidal threats are reasons for immediate consultations. It is also recommended that any child who has been seriously injured or who has lost a parent, sibling or caregiver by death, have a psychological evaluation and/or brief therapy.

This checklist was developed under the auspices of Project COPE, a federal funded (FEMA) crisis counseling program activated in Santa Cruz, California, in response to the October 17, 1989 Loma Prieta Earthquake. The project provided individual, family and group counseling, agency debriefing services and a school intervention program. Over the course of 16 months, the project provided services to more than 25,000 individuals. Peter J. Spofford, M.S. served as Project COPE Director.