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Seeking to Remove Scars of Violence

Aftermath: A national network has been set up to treat children whose post-traumatic stress often goes undiagnosed.


Taking a walk to the corner store is a luxury that Anthony does not have anymore. He's too afraid to leave his house alone. He hasn't been able to make it through the night in months without nightmares piercing his sleep. The 16-year-old can't even concentrate on his schoolwork because the same gruesome scene keeps invading his brain.

Anthony--whose name and some others in this story have been changed to protect them--was sitting outside his Long Beach home several months ago, not far from where some guys were talking to a friend of his. He says he recognized the other boys as gang members. But that's no big deal in his--boom, boom, boom. Gunfire.

His friend fell down, shot right in front of him. "Run!" Anthony told himself. But he was in shock; his body wouldn't move.

His friend died the next day. And Anthony, although not physically harmed, can't seem to get over his fear.

Many youths like Anthony who grow up in the country's most crime-ridden neighborhoods experience such terror that psychological and physiological trauma can continue long after the shooting stops, medical experts say.

The problem often goes undiagnosed and, with a shortage of specialized counseling, untreated. Now, however, that may change, with a recent increase in money and attention being devoted to the study and treatment of such child trauma.

Late last year, $10 million in federal funds helped establish a national network of 18 universities and medical centers to study child trauma from violence and other causes, improve its treatment and expand the availability of counseling. The National Child Traumatic Stress Network includes three centers in the Los Angeles area and one in San Francisco. Still, doctors say more can be done.

The network's research effort is headed by a collaboration between UCLA and Duke University in North Carolina. Grants of $340,000 were awarded to Children's Institute International in the Wilshire District to create a community-based center to treat the city's immigrant populations and to Miller Children's Hospital Abuse and Violence Intervention Center in Long Beach.

"It's a major national commitment to improving the care of traumatized children across all different types of trauma," said Dr. Alan Steinberg, associate director of the National Center for Child Traumatic Stress at UCLA, which also will study children exposed to natural disasters, war, terrorism, abuse and serious accidents.

After the Sept. 11 terrorist attacks, many Americans temporarily experienced post-traumatic stress, evidenced by fear of airplanes and public gatherings. But the trauma suffered by children in gang neighborhoods is especially powerful, psychologists say, because the violence is continuing, it's in their own communities and sometimes it's right before their eyes.

"The impact on the child goes well beyond their post-traumatic reactions, which themselves are pretty bad," Steinberg said. "A lot of this violence has a pernicious effect on their daily lives."

Anthony, for example, was so afraid of the gang that he didn't go to school for two weeks after the shooting. "I just want to stay in the house," he said, "because I feel like they're coming to get me."

The feeling is normal, said Anthony's therapist, Sara Dickes, a psychologist at Miller Children's Hospital. Its Abuse and Violence Intervention Center provides treatment, individually and in groups at some Long Beach Unified elementary schools, to children traumatized by violence.

Dr. Cheryl Lanktree, director of the center, said adolescents scarred by violence react by becoming more aggressive or withdrawn. They can be more irritable, show a numbness toward activities, be disruptive in class, get into fights at school or let their grades slide, she said.

"A lot of the time, the teachers just think it's a bad kid," Dickes said. "It's just one of those kids who need to be sent to the principal's office."

Trauma can even affect a child's nervous system, making it more sensitive to stimuli, UCLA's Steinberg said. Anthony cringes whenever he hears a dog bark.

Techniques to Help Children Open Up

In therapy, psychologists use different techniques, including having children draw pictures or write letters, to get them to open up. Since Anthony began his weekly sessions at the center, he has felt a little better. "I get to come out of the house every once in a while," he said. "And I get to have someone to talk to about it."

Whenever he told his mother that he feared for his life, she said gang members would have killed him already if they were really after him. But Anthony wasn't convinced. After all, violence seemed to follow him.

The shooting on his block occurred shortly after he moved there from downtown Long Beach, where someone threw a brick through his neighbor's window, then proceeded to shoot up the place. "I was scared because it was just so close," Anthony said.

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