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Melanie Cole (Host): With the spring comes rain, thunderstorms and possible tornadoes. For children who are afraid of storms and tornadoes, the unpredictability of severe weather can really be especially unsettling.

Welcome to Mom Docs, the podcast from St. Louis children's hospital. I'm Melanie Cole. And. joining me is Dr. Jonathan Nauser. He's a psychology fellow at St. Louis Children's Hospital. Dr. Nauser, it's a pleasure to have you with us today and as a mom and when my kids were little, I remember those days when they were afraid of storms. I love storms. So I know they didn't get the anxiety from me. Tell us a little bit about this. Is it normal for kids to be afraid of storms and severe weather?

Dr Jonathan Nauser: Well, first of all, thank you for having me, Melanie. It's great to be on Mom Docs. And regarding your question as far as whether this is normal for children to have this fear, this anxiety, if you will, about storms, absolutely. I think, throughout childhood, as we develop, and this is everyone, I think there comes with it certain sensitivities. And for a lot of children, that includes specifically storms. The reason why that being as I'm sure you could imagine within storms comes a lot of moving pieces, if you will. One of which being thunder, which with thunder of course comes the loud volume, the shakiness possibly of houses depending on the level of thunder that's experienced, as well as lightning. Lightning can be very bright, overstimulating if you will. Not to mention, I think whenever children first learn about lightning, it's communicated to them that this is electricity and that electricity can actually hurt someone if you come into contact with it. So I think there are a lot of moving pieces that contribute to this fear, this level of anxiety with storms, that it is absolutely developmentally appropriate for children to experience this as they grow up.

Melanie Cole (Host): When I was little, my parents used to set chairs up in front of the door and then open the door, but leave the screen door closed so that we could watch the storm that way. So it was always such a happy memory for me. But for some children, as you say, and this is pretty normal, how do we know if they have anxiety? Is it always glaring? They run in their room and hide. How do we know?

Dr Jonathan Nauser: Not necessarily. I think it can Be presented differently across different children. From what I've seen in my own clinical practice, as well as my own personal life, this can absolutely just, as you said, Melanie, be presented itself as the child retreating and running back into the room, almost hiding under their bed. I've certainly seen that in my own professional practice. But I've also seen children who become very tearful, very short of breath and have difficulty breathing, maybe clinging on to mom and dad a little closer than what they usually would. And additionally, there all can be very intelligent children who just want to absorb all of the information, have all of the new developments as storms progress, and be glued to almost the weather channel or YouTube or whatever kind of electronic device to where they're receiving the latest and greatest news about, storms and the development of those storms. So it can be presented quite differently from child to child.

Melanie Cole (Host): I think for teenagers, their fear of the storm is just that the power might go out and they'll lose charge in their phones. But for the littler kids, what do we do at the time of the storm? I mean, there's things like weighted blankets that now they even sell for dogs that are afraid of storms that give this sense of comfort. What do we do for our children right during the storm to help ease that anxiety?

Dr Jonathan Nauser: Well, there's a couple of things. There's a couple of things that parents can do, a couple things that the children themselves can do during these circumstances. So one of which from the parent's side of things, I think first of all, validating, validating these worries, validating these anxieties related to storms because, certainly, I'm not the most relaxed whenever I'm under a severe thunderstorm watch or a severe thunderstorm warning. So I think it's important for us to validate the fear, validate the worry associated with storms, but with caution. And what I mean by that is, Melanie, not to overreact and make the worry, the fear worse. And that takes a delicate balance. But there's a couple of ways in which you can do this.

One is just ensuring from the parent's side of things, ensuring that everyone is safe, that you are in shelter, that you're within house, that if you have this kind of accommodation with you in your home, as far as the storm shelter or a basement, that you're in the safest place that you can be during the storm. I think that is two very essential key things that can be done from the parent's side of things in terms of facilitating a conversation between you and the child who has the storm anxiety.

Another thing is that might be a little bit more fun for the parent to help with the child is actually making these storms kind of a fun time. And what mean by that is maybe restricting your child, who, for instance, as I mentioned earlier, may be glued to the laptop, glued to the tablet, glued to the TV and watching the Weather Channel or any kind of developments related to the weather. And the reason why I say that is, is unfortunately with media, of course, you're going to get the worst of the worst with the storm, especially on the weather channel. So they're going to show things like blown-over trees, blown down power lines, flooding, tornadoes, which are all very real, no doubt about it, but they're only showing the most extreme circumstances. So possibly restricting their access to that during those specific times, whenever you're noticing your child exhibit this worry.

Another thing is that during this time, during the period of the storm, making this more of a fun time. And what I mean by that is, is almost whenever you start to notice that your child is maybe a little bit more clingy, a little bit more tearful during the storm, maybe incorporating things that the whole family can do. A board game, read a book, watch a movie down in the basement or watch a movie down in your storm shelter. If you're in a place of shelter or in your own personal room, maybe making shadow puppets, playing board games, reading books, all these different kinds of fun activities that you can do with the family to make the period of the storm itself a little bit more fun and enjoyable for the child.

From the child's side of things, there are also a couple of other things that can be done as far as breathing exercises. Parents can do this with their child and model for them. What I have referred to commonly as bubble breathing, where we imitate, of course, first smelling a flower, which is a deep inhale through our nose, holding it for a period of time, maybe one to two seconds, and then blowing the air out through our mouth, exhaling almost as if we're blowing a bubble. You'll find that if children actually practice this technique, that it reduces a lot of stress, a lot of hormones within our system at the time of stress that are actually making our worry and anxiety worse. So this is one thing that we can do as parents for our children with storm anxiety, to model this behavior for them.

Another thing that we can do, of course, is grounding techniques. For those who aren't familiar with grounding techniques, what I mean by that is practicing this with your child, running across their five senses, naming a certain number of things that they can taste at the time, naming a certain number of things that they can see, touch, smell, hear. All of these different things can kind of bring them back down and refocus them, bring them back down to earth to where they're able to, I guess, for lack of a better phrase, get their feet back under them to where they're not caught up in this rumination, caught up in the worry and just blowing it up and catastrophizing without the parent's assistance.

For little, little children, what I've traditionally recommended is I rely a lot on children's books and there are several, several, several children's books that can be quite helpful in terms of facilitating education about what storms are, what is thunder? What is lightning? What is the heavy rain that's happening and why is this happening? So I think with children's books, you're introducing a lot of education to the children and removing a lot of this uncertainty, removing a lot of the mystery whenever it comes to storms, which I think is representing a lot of anxiety and a lot of worry when it comes to storms and for children fearing storms, those are the most immediate things that I would recommend from the parent's side, as well as the child's side of things, Melanie.

Melanie Cole (Host): What a comprehensive list. And everything you were talking about, I mean, I guess my parents did because of how much I love storms and the way that we all sort of celebrated as a family when it happened, and I'm the youngest of six kids, so it was a lot. Now, if we do have children that are afraid and we try some of these things, when is it that we talk to our pediatrician or seek professional help? And tell us about helping them to overcome these fears in the long-term so that they can enjoy them, I mean, while staying safe and yes, they can be very scary, but for the long-term.

Dr Jonathan Nauser: Absolutely. So that's a great question. As far as when to seek help from your pediatrician or someone like me, coming to see a psychologist for some of these concerns, I think some of your flags that would indicate it's time to talk to a clinical professional would be whenever your child's inconsolable, whenever you've ran through these brief interventions, these brief techniques, try to introduce these things, to relax your child, and whenever they become inconsolable tearful to the point of almost exhibiting tantrum behaviors, for example, I think that's when it's time to talk to a clinical professional of how we need to speak to a professional and develop further techniques to help cope with this storm anxiety.

I think another good flag to determine when a child has needed to be seen by a clinical professional is whenever you see that these worries have almost blown up larger than their original presentation. What I mean by that is, Melanie, for instance, if a child is starting to experience storm anxiety during a strong thunderstorm, I think whenever that child starts to generalize that experience to even just a shower or sprinkling outside. I think whenever a child starts to exhibit some of these extreme worried behaviors, tearfulness, clinging to a parent, hyperventilating almost even when it's just partly cloudy or is simply sprinkling outside, that's when we start to need to talk to a clinical professional, if you will.

Melanie Cole (Host): What an informative podcast. And Dr. Nauser, wrap it up for us. What would you like parents to know about when their kids are little, starting them young and they do see things on the news, horrific things, and people have lost their homes and it can be very, very scary, especially with things like tornadoes. And I got to just clarify for the listeners, I am afraid of those. And I do run into our basement, right? And we get into the closet or in a doorway or something. Tell parents what you want them to know about as they're raising their children, trying to educate their kids about what storms are, and hopefully reducing that anxiety.

Dr Jonathan Nauser: Absolutely. That's a great question, Melanie, and I'm going to go back to some of my original points. I think some of the things that I would want parents to know right off the bat would be the importance of validation. And what I mean by that is going to your child and actually having a conversation with them about this worry that is obviously observable to some children who are experiencing this during storms, being able to just have a discussion. What's scary to the child, what is their biggest worry and how can parents be of assistance at that time, while at the same time also ensuring to the child and providing the sense of safety. I think once we provide to them the sense of safety, as well as validating of their worries, I think then that opens the door for children to actually put into practice and be willing to participate in some of these things that I've already mentioned to help relax some of this storm anxiety, for them to help to adaptively cope with this storm anxiety.

But the first thing we need to do with any child, and I've experienced this quite a fair amount in my own practice, is getting our foot in the door. And I think to ensure safety and validate worry is our first toe, if you will, in the door, which opens up to a whole lot more possibilities in terms of helping a child cope with this anxiety.

Melanie Cole (Host): Thank you so much, Dr. Nauser. That was great information. Parents, please share these shows with your friends and your family on your social channels. We're learning from the experts at St. Louis Children's Hospital together. And for more advice and articles, check out the Mom Docs website at childrensmd.org.

That concludes this episode of Mom Docs with St. Louis Children's Hospital. I'm Melanie Cole.