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ST. LOUIS — Local health experts offered guidance for families embarking on an overwhelming task: counseling St. Louis-area students through the aftermath of Monday’s shooting at Central Visual and Performing Arts High School.

Pediatricians and counselors advised parents and guardians to acknowledge their own emotions and recognize that they can be be affected even if they’re not directly connected to CVPA.

“I think all parents in the St. Louis area, today, are feeling kind of rattled and scared,� said Dr. T. Eric Spiegel, an associate professor of psychiatry at Washington University.

Spiegel advised parents to begin by expressing their emotions freely to a partner or other trusted adult. That will help them work through some of their own pain and figure out a plan for talking about it with their child. Parents don’t want to be so overwhelmed with their own distress that their child feels like they can’t express their own feelings.

“We, as parents, may not know the extent that we’ve been affected by something until we start talking about it,� said Spiegel, who is also the medical director for inpatient behavioral health services at BJC HealthCare Children’s Hospital. “Then you can say, ‘OK, I’ve gotten that out of my system in a way, or I’ve taken care of myself. And now I can feel competent to take care of my kids and do that in a way that is thoughtful.’�

For very young kids, in kindergarten or earlier, Spiegel said, caregivers might decide to say nothing or to say something “very simple.� For example, they could say that a dangerous person was at a high school, people were hurt, and police and other helpers stopped it.

It’s natural for people who take care of kids to tend toward calming and reassuring them, which is good, said Dr. Ken Haller, a professor of pediatrics at St. Louis University School of Medicine and a pediatrician at SSM Health Cardinal Glennon.

“But it’s also important for us to even let kids know that we are scared, we are angry, we are sad,� Haller said. “Sometimes when we comfort kids, it can come across as, ‘Don’t feel bad.’�

In times of tragedy, Haller said, it is “normal, natural and healthy� to feel terrible. Adults’ overarching message to their children should be: I will be here for you.

Some children and adults might feel motivated to take action, Haller said. For children and caregivers, that could mean getting involved in advocacy around school and gun safety. For teachers and students, that could mean making cards for people affected by the incident at the school.

Some children might be curious and want to find out as much information as possible about the shooting, Spiegel said. Parents might want to explain that they need to know a certain amount but that learning more will likely make them upset and won’t be helpful.

Debra Emery, a psychologist at Cardinal Glennon, said parents shouldn’t make any assumptions about what their child has or hasn’t heard about the events.

“This information spreads pretty quickly,� Emery said. “Kids are pretty perceptive, too. All it takes is a television being on somewhere or overhearing a conversation.�

Emery said it can be helpful to ask children and teenagers questions like: How much information is helpful to hear about this? How do you know? How do you stay connected to your friends without getting too much detail about these upsetting topics?

“A lot of teens really respect being asked,� Emery said.

Adults can counsel their children against learning about these events from social media, where they will be more likely to encounter misinformation and extreme emotions and opinions.

Parents might also plan to have these discussions earlier — such as over dinner, rather than right before bedtime — so that the children can switch to a lighter activity afterward.

Parents should keep closer track of their children after the incident, experts said, and look for signs of depression such as nightmares, changes in eating habits, social isolation or other changes in behavior.

Children involved in such traumatic situations sometimes have physical complaints, like headaches or stomach aches. Some may experience changes in their academic habits, like difficulty concentrating. They may have strong reactions to reminders, like loud noises, friends who were present during the incident or the school itself.

St. Louis-area school officials might strategize for how they want to communicate to students about Monday’s events. The topic will almost certainly come up organically in area classrooms, and it is a good idea for teachers to give students space to express their emotions and talk about how they feel about being at school.

“Taking a break from the instruction of the day in the St. Louis area, today or tomorrow, in high schools, seems like a really good idea to me,� Spiegel said.

If you’re experiencing behavior that isn’t typical for you, such as sleeplessness or loss of appetite — or notice it in someone else, that’s a signal to ask for help.

To speak with a clinician free of charge, call Behavioral Health Response’s 24/7/365 Crisis Line and Youth Connection Helpline. Call 988, 314-469-6644 or 314-819-8802 (youth). Youth can also chat online at or text BHEARD to 31658.