07/23/2018 16:15 EDT | Updated 07/23/2018 16:17 EDT

How Public Shootings Can Affect Kids: 'They Think They're Going To Be Next'

There are ways to help them cope with the anxiety and fear.

Frank Gunn/Canadian Press
Police escort civilians away from the scene of a mass casualty incident in Toronto on Sunday, July 22, 2018.

The story recounted by an eyewitness is nightmarish for children and adults alike: a little girl is sitting in a restaurant. In the next moment, she's lying on the ground, a victim of the Sunday night shooting on one of Toronto's busiest streets.

Tragic incidents such as the Danforth-Logan shooting can strike fear into the hearts of kids who have become all too exposed to seemingly random acts of gun violence close to home recently. And the effect is especially heightened when children are involved — shootings can happen at the playground, riding in your parents' car, or when you're out for a late-night summer outing.

"It affects kids on every psychological level," Rev. Sky Starr, a minister, therapist, and the founder and executive director of Toronto's Out of Bounds Grief and Trauma Support, told HuffPost Canada in a phone interview. And kids who live in neighbourhoods where gun violence is more common often live in a constant state of hyper-vigilance.

"They feel they're going to be next," said Starr, who specializes in grief and trauma after incidents of gun violence. Starr works out of the Jane and Finch neighbourhood in Toronto, where residents have been fighting to end a history of gun violence in the area.

Sunday's shooting in the bustling downtown area left three people dead (including the shooter) and 13 injured. On Monday, police confirmed that a 10-year-old girl and 18-year-old woman were killed.

On Sunday, a server told CP24 she was serving a table of four people near the front of Caffe Demetre when the gunman shot through the patio doors. Later, she said she saw the girl from the group she was serving lying on the ground.

Chris Helgren / Reuters
A police officer guards the scene of a mass shooting in Toronto, July 22, 2018.

In the aftermath of these incidents — whether it happened in your neighbourhood or your child is learning about it on the news — it's important not to minimize your child's fears, Dr. Michelle Ponti, a community pediatrician in London, Ont., and member of the Canadian Paediatric Society's Digital Health Taskforce, told HuffPost Canada in a phone interview.

"Parents may sometimes think it doesn't impact their child if they're not showing any physical symptoms or asking questions. Don't assume they're not impacted," Ponti said.

A younger child may express worry and anxiety with more physical symptoms such as problems sleeping or eating, bed wetting, throwing more tantrums, complaints of aches and pains, and wanting to be closer to their parents or guardian, Ponti explained. An older child has more emotional vocabulary to express themselves (and may ask a lot of questions), but can also experience these physical symptoms.

Teens may pretend not to be concerned, but "don't let this fool you," The Canadian Paediatric Society (CPS) notes in a handout about helping kids cope with stressful public events. A teenager reacting to these events may become moody, less patient, argumentative and sad, CPS explained. They, too, can experience physical symptoms such as troubles sleeping, eating, and stomachaches.

Take cues from your kids

Ponti encourages parents to express some of their own emotions, as it can be helpful for children to know adults have feelings of fear, anxiety, and worry as well. Reassure them, and let them know you're going to get through it together.

At the same time, parents should be careful not to over-dramatize the events above and beyond their child's developmental level, Ponti said. Takes cues from your children, she added, and determine if you think they're ready to talk about what happened.

Chris Helgren / Reuters
People leave an area taped off by the police near the scene of a mass shooting in Toronto, July 22, 2018.

"Parents are the number one source of providing reassurance for their children because they know their kids the best."

Among their recommendations, CPS also suggests checking in on how your child is feeling (but not forcing them to talk until they're ready), making sure your child understands what happened (at their developmental level) and giving them a sense of where it happened in relation to them, maintaining family routines, spending family time together, and limiting screen time and social media.

Any parents concerned about their child's reactions to a traumatic event should seek professional help, Ponti said, and any signs of self harm or suicidal thoughts should be addressed immediately.

A loss of safety and security

When violence happens close to home, some parents will be tempted to place more restrictions on their children and teens, or check in on them constantly, but Starr cautions against that as it can add to a child's anxiety.

"They need a certain level of calm," Starr said.

When Starr works with kids who have been affected by gun violence, she tries to help them know that at that moment, in that room, with her, they are safe. She works on their breathing, and tries to normalize their fears, she added.

Cole Burston/Getty Images
Toronto Police officers stand watch at Danforth St. at the scene of a shooting in Toronto on July 23, 2018.

After being exposed to or affected by a shooting, kids experience fear and a loss of safety and security, Starr said. But when that violence continues in their own neighbourhoods, youth can experience nightmares, flashbacks, emotional disturbances, problems at school, problems with how they relate to others, can be volatile or aggressive, and even have suicidal tendencies, she added.

"They're re-traumatized. Like with this shooting, anybody who has experienced one ... they are just continuously scared," Starr said.

"Some youth are saying they hope they live to 20. When you hear a young person saying something like that, it really is distressing. It's beyond distressing."