In Schools, a Hidden Toll of Sept. 11
By JOYCE PURNICK
KRISTEN AND ERIC LEINUNG were very close to their older brother, Paul Battaglia, so close
that Kristen's first word was "brother," and she was furious when a teacher insisted that she
indicate he was a half brother on her family tree.
After Paul, 22, who worked for Marsh & McLennan in the World Trade Center, died on Sept. 11,
10-year-old Eric acted out in school, got into trouble, and was quickly sent to therapy by his
parents. But the depth of Kristen's pain did not surface until January, when she broke down after
her Sweet 16 party. "She repressed her emotions, still doesn't want to talk about her brother,"
said her mother, Elaine Leinung, a nurse-practitioner. "She had to hit bottom before we could
reach out to her."
Eric and Kristen exemplify the findings of a newly released study by the city's Board of
Education that about 75,000 of the more than 710,000 public school students in grades 4 through
12 are suffering symptoms of post-traumatic stress disorder, and as many as 190,000 have mental
health problems, both related and unrelated to 9/11.
The study and the underlying reality have spurred an intense debate about how to proceed.
Psychologists who specialize in trauma want the Board of Education to screen students and find
those with emotional problems — especially those suffering in silence, crying themselves to
sleep, like Kristen did, or having nightmares or getting psychosomatic aches and pains.
The board studied children anonymously, and several mental health professionals contend that
the schools should now try to identify those who need help. Even if the numbers are not as large
as projected in the study, experience with other disasters suggests they are considerable.
"We know children don't ask for help on their own, and we know that parents and teachers are
not particularly good at knowing which kids are hurting when they hurt silently," said Claude M.
Chemtob, a visiting professor of psychiatry and pediatrics at Mount Sinai School of Medicine
who specializes in trauma. "We also know with children that when their problems are not
detected they can continue to have problems from a disaster for more than 20 years after."
Dr. Chemtob, who has been working with students in some schools near the trade center site,
urges the screening of all students, with their names coded; those whose answers betray serious
problems would be identified and offered help.
Dr. Spencer Eth, professor of psychiatry at New York Medical College, agrees. "Those kids
affected and untreated will go on to have potentially lifelong difficulties directly related to 9/11,
in the form of educational handicaps, substance abuse, antisocial behavior," he said.
After Hurricane Iniki hit the Hawaiian island of Kauai — on Sept. 11, 1992 — a study two years
later showed that teachers had missed the symptoms of the more withdrawn students. "The
teachers had reported students who acted out and caused disruptive trouble, but the report helped
us see those suffering quietly," said Joanne P. Nakashima, an education specialist with the Kauai
school district at the time.
The screening on Kauai helped school officials identify about 200 students (out of 10,000) in
need of treatment. A similar undertaking in New York City would be ambitious and costly, but
the experts say it could be done. School officials are unenthusiastic, however. "We don't want
our kids to be guinea pigs," said Francine Goldstein, who oversees the schools' mental health
outreach program. "We're not totally ruling out screening, but I'm not sure that's the route the
system is going. I am more concerned about what that might do to kids than I am about money."
Those who favor screening say that exploitative research can be prevented, but Ms. Goldstein
has other doubts. She notes that superintendents, principals and teachers have been instructed
about the warning signs of trauma, and that concerned parents can call several programs and
consult the board's Web site.
Several schools are providing counseling, some with help from nonprofit groups, but the
numbers of students getting therapy is small compared with the need. And few would contend
that the system has any experience at finding students like Kristen. Ms. Leinung said that when
she called her daughter's high school asking for help, the school counselor said that she could not
do anything until Kristen herself asked. And both brother and sister encountered some unfeeling
teachers, Ms. Leinung said.
Today, Eric and Kristen are still hurting, but getting the attention they need. "I just wish I had
realized sooner," Ms. Leinung said. "I wish the teachers had been more sensitive."
"Copyright (c) [2002] by The New York Times. Reprinted by permission."