The impact of climate-related disasters on children’s communication and wellbeing: Addressing Sustainable Development Goals

Abstract

Purpose

Natural disasters can significantly impact children’s health, development, and wellbeing, as well as their access to education and support services (including speech-language pathology). Children’s needs are often overlooked in the urgent aftermath of natural disasters. This is especially true for children with communication difficulties. This commentary explores the impacts of bushfire on Australian children, to propose a sustainable, community-based approach to supporting children’s health, wellbeing, and communication.

Result

The Royal Far West Bushfire Recovery Program, a multidisciplinary allied health program, supported children's recovery, resilience, and development in the aftermath of Australia’s Black Summer bushfires in 2019–2020. Children learnt coping strategies and were more able to communicate with adults and peers about their feelings and experiences, but residual impacts of bushfires remained for some children. Allied health telepractice services, including speech-language pathology, enhanced access for vulnerable children, highlighting the potential for technology to provide high-quality services to support recovery, particularly in remote areas.

Conclusion

Climate change increases the frequency and severity of bushfires and other natural disasters with significant consequences for vulnerable and at-risk communities. Children with communication needs are particularly vulnerable during and following these disasters. High quality, evidence-based interventions are needed to support the health, wellbeing, and communication needs of children, with opportunities for involvement of speech-language pathologists. This commentary paper focusses on SDG 1, SDG 3, SDG 4, SDG 9, SDG 10, SDG 11, SDG 13, and SDG 15.

Keywords:

• Sustainable Development Goals (SDGs)
• communication disability
• climate-related disasters
• wellbeing; bushfire
• forest fire
• wildfire
• fire
• no poverty (SDG 1)
• good health and well-being (SDG 3)
• quality education (SDG 4)
• industry, innovation and infrastructure (SDG 9)
• reduced inequalities (SDG 10)
• sustainable cities and communities (SDG 11)
• climate action (SDG 13)
• life on land (SDG 15).

Introduction

In an international call to action, 17 Sustainable Development Goals (SDGs; United Nations, 2015) were identified to promote equity, sustainability, peace, and prosperity for all people by the year 2030. Climate-related disasters and extreme weather events have widespread impacts in communities including injuries and mortalities; loss of homes and livelihoods; displacement; loss of native animals, livestock, and habitat; and experiencing trauma. The impacts are relevant to many of the SDGs, most obviously climate action (SDG 13), but also industry, innovation and infrastructure (SDG 9), sustainable cities and communities (SDG 11), and life on land (SDG 15). Individuals from vulnerable communities are most at risk, including children from rural and remote areas who already face inequities in access to health care, specialist services, and education, and children with pre-existing developmental vulnerabilities including communication disorders (Curtin et al., 2020; UNICEF Australia & Royal Far West, 2021). In the aftermath of natural disasters, children are at risk of poor long-term developmental outcomes. Climate-related disasters therefore also impact the achievement of good health and well-being (SDG 3), quality education (SDG 4), and reduced inequalities (SDG 10). This commentary explores the impact of bushfires on children and describes a community-based approach to supporting children’s health, wellbeing, and development, drawing on an evaluation of a Bushfire Recovery Program delivered in New South Wales (NSW), Australia following the Black Summer bushfires in 2019–2020. The role of speech-language pathologists (SLPs) in such interventions, ranging from public health and community level programs to individual intervention sessions, are discussed.

Background

Sherratt (2021) called upon speech-language pathologists to view climate change from a public health perspective and to consider the implications of the associated social and environmental determinants of health on the wellbeing of the population. Such a perspective has been applied to SLPs’ role in other public health issues such as poverty and COVID-19 (e.g. Tohidast et al., 2020). However, less attention has been paid to how climate change can affect children at a community level, in particular those with communication needs. Adverse childhood experiences, including trauma, abuse, and neglect, have been associated with detrimental short-, medium- and long-term outcomes for children, including developmental delays, heart disease, cancer, chronic obstructive pulmonary disorder, schizophrenia, and depression (Centers for Disease Control & Prevention, 2019, 2021; Felitti et al.,1998). More recently, a significant association between adverse childhood experiences and poorer outcomes in language development has been identified (Sylvestre et al., 2016; Westby, 2018). Exposure to trauma from climate-related disasters such as bushfires is one type of adverse childhood experience which can result in separation from family and community, mental health issues for parents and children, grief, and loss. There is a need to recognise the impact of experiencing climate-related disasters in childhood on children’s lives and the role of health professionals in supporting their development and facilitating a trajectory of recovery.

Bushfires can have significant impacts on children, including higher levels of mental health symptoms such as depression and anxiety, lower education levels, and less social mobility when compared to children not exposed to bushfire (Curtin et al., 2020). In particular, Gibbs et al. (2019) found that living in a bushfire affected community significantly reduced expected gains in reading and numeracy development over a 2-year period, highlighting the extended period of academic impact of bushfire exposure long after the event had passed. Children who already experience other aspects of vulnerability, including those with pre-existing developmental needs and diagnosed disabilities, are most at risk of long-term negative outcomes (Curtin et al., 2020). The far-reaching impacts of bushfires on families, communities, and local infrastructure mean children may not only experience trauma directly related to the bushfire exposure, but also lose the usual supports and protective factors present in their environments such as relationships with key adults, peers, and organisations through disruptions to participation in social structures, educational settings, extracurricular activities, and healthcare services. Significant adults in children’s lives who have key roles in facilitating children’s wellbeing and development, such as family members and educators, may be experiencing their own emotional reactions and trauma following bushfire, impacting their ability to support children effectively (Curtin et al., 2020). Support for children who are affected by bushfires to process their experiences and reactions is essential in optimising wellbeing, resilience, and developmental outcomes. Given bushfires are predicted to increase in frequency and severity as a result of climate change (Intergovernmental Panel on Climate Change, 2019), the development of evidence-based interventions for children at both the individual and public health level is a priority.

Few evidence-based interventions exist that are specifically designed to support children following bushfires (Curtin et al., 2020; Gibbs et al., 2014). To address this gap, a Bushfire Recovery Program was purpose-designed and implemented by Royal Far West, an Australian not for profit organisation, to support children’s wellbeing and development following bushfires. The Program was multifaceted and involved allied health professionals, including SLPs, supporting children and their significant adults by visiting 12 preschools and 25 schools in communities affected by the 2019–2020 Black Summer Bushfires in NSW, Australia. Prior to the Program, a needs assessment was conducted to identify key priorities for the intervention Program (UNICEF Australia & Royal Far West, 2021). The Program involved four components which varied for each school/preschool community based on their needs and preferences and were delivered in a phased approach:

1. Group intervention with children delivered daily for a week within schools/preschools. These groups were facilitated by allied health professionals (e.g. SLP, occupational therapist, psychologist, social worker), educators, and community service providers (e.g. youth workers). Groups incorporated resources primarily from the Good Grief Stormbirds “Growing Through Natural Disasters” program (MacKillop Family Services n.d.), and the range of Birdie’s Tree resources (Children’s Health Queensland, n.d.).

2. Professional development, training, and support for educators and other professionals;

3. Individual and group information sessions and support for parents/carers; and

4. Individual speech-language pathology, psychology, and occupational therapy services delivered via telepractice for children identified as needing further one-on-one assessment and intervention.

This commentary draws on an external evaluation of the Program (Curtin et al., 2021), focussing on the short- and medium-term impact of the group intervention (component 1) and allied health telepractice services (component 4) on children.

Evaluation of short- and medium-term impact of the Program on children

The short-term impact of the Program on children was evaluated using a suite of surveys and semi-structured interviews. Full details on the method used in this evaluation can be found in Curtin et al. (2021). Findings from surveys and interviews have been integrated and reported together, with quotes identified with unique codes relating to participant number and data source (Ch: child survey; PC: parent/carer survey; F: facilitator survey; PC_T: parent/carer telepractice survey; ST: school teacher interview; CR: community representative interview; S: medium-term survey respondent). Children who were interviewed identified their own pseudonym (“Jaydo” and “Venom”). Short-term and medium-term impacts are reported separately as follows.

Outcomes for children following the Bushfire Recovery Program

Short-term impacts for children

Short-term changes in children’s social communication and emotional development were identified following participation in the children’s groups (component 1). This component took a multidisciplinary approach to children’s wellbeing and how it can be supported by communication strategies. Parents/carers and facilitators felt the most important aspect of the children’s groups for promoting wellbeing was the opportunity for children to express their views regarding their experiences of the bushfire and its subsequent impact. While not all of the children attending the groups had diagnosed communication needs, it is likely all children can benefit from this tier 1 approach to facilitating communication and the expression of needs following disaster.

Following component 4, the allied health telepractice sessions which included individual speech-language pathology intervention, parents/carers reported short-term improvement in children’s participation and functioning at school, home, and socially and indicated children had learned strategies to understand, communicate, and manage emotions, change, and difficult life events.

Learning outcomes

Through participating in the children’s groups, key areas of learning for children included:

1. Shared experiences of bushfires: Connection and storytelling in a group setting was considered powerful. It was felt that “sharing what they [children] had talked about [in the Program] helped to open conversations about those things at home” (PC11). A key outcome was the “capacity to talk about traumatic events” (ST2). Storybooks and journal resources used in the groups facilitated children to talk about their experiences and feelings, for instance children took their journal home to “show it to their parents and use that to talk to their parents” (CR).

2. Understanding emotions and change: Children acknowledged “it is OK to be sad or angry” (Ch71) and “feel upset when these kind of things happen” (Ch9), and reportedly demonstrated “growth of understanding of feelings and emotions” (F7).

3. Strategies for communicating about and coping with their emotions: Children learned strategies such as “talk about the fires and let my feelings out” (Ch89) and “write down what we know and how we feel” (Ch135). Children also reportedly learned “how many people they were able to talk to at school” (F11) who “could be trusted with confidential and emotive material” (F6).

Enhanced access to allied health services

The increased access to allied health services was one of the most commonly reported benefits of the Program by parents/carers. Prior to the Program, parents/carers in the bushfire affected regions faced barriers to accessing allied health services, including prohibitive cost of services, long waiting times, and excessive travel distance. Barriers to accessing allied health services are not uncommon in rural and remote communities (Verdon et al., 2011), and these were the communities largely affected by the bushfires. Delivery of the Program in schools and preschools enabled the allied health professionals to identify children in need of further developmental assessment and intervention and enroll them directly in telepractice services, provide resources and information for educators and parents to support children’s development, and/or refer children and families to other appropriate services. Parents/carers of children who received individual telepractice speech-language pathology, occupational therapy, and/or psychology sessions commented on the “ease of being able to attend the appointments” (PC_T8), which they usually “don’t have access to” (PC_T11) or “would have to drive hours for” (PC_T19).

Persistent impacts of bushfire

Two children who participated in the Program were interviewed. Even though they commented on the Program being beneficial, they continued to experience fear and anxiety following the bushfires. Jaydo drew “goosebumps” when asked to illustrate how he felt following the bushfire (Figure 1). He was fearful of “big bush” but “only at night because it really feels like very scary […] it’s very hard to sleep.” He worried about more bushfires and stated that hearing a siren made him feel, “very, very, very scared.” Although Jaydo could not remember specific aspects of the Program, he talked about strategies that he learnt and how he implemented them in his life to manage stress associated with his bushfire exposure. He said “I was very happy at the end of the Program […]. There might not be any fires […] and I will be very safe” (Figure 2). To cope with worry, Jaydo said that when he goes to bed he tries “not thinking about [fires] and wake up and then going to play with your friends or watch TV or go on your iPad.”

Figure 1. Jaydo’s drawings depicting how he felt following the bushfire – “goosebumps”.

Figure 2. Jaydo's drawing depicting how he felt after attending the Program – “happy”.

Venom spoke of feeling sad. When asked to draw his feelings about the bushfire, he drew a koala that was sad because the fire “burnt his home […] burnt the leaves” (Figure 3). Venom remembered aspects of the program when prompted with photographs but could not identify specific strategies learnt during the Program that he used to manage his emotions. He learnt “sometimes to trust other people that you know.” To represent how he felt after the Program, Venom drew a koala with its thumbs up to indicate it was happy again (Figure 4).

Figure 3. Venom’s drawing depicting how he felt following the bushfire – “koala with thumbs down”.

Figure 4. Venom’s drawing depicting how he felt following the Program – “koala with thumbs up”.

Medium-term outcomes for children

The survey findings indicated that, in the medium-term following participation in the Program, the children knew who to talk to when they felt upset and were okay talking about change, but sometimes still found it difficult to say how they felt. It was reported that the strategies learnt in the Program increased children’s “resilience and understanding” (S20), enhanced their “capacity to identify their emotions and identify strategies to cope with change and uncertainty” (S10), and enabled children to “speak freely and be heard” (S20). A greater ability to manage emotions was thought to have impacted peer interactions, for instance one respondent stated:

• Outbursts of being overwhelmed by emotion have decreased. She [child] chose to attend a social event knowing she knew no one and had a great time and made friends. This was a first. It was wonderful to see (S35).

The capacity to talk about emotions and trust adults was also evident. Children knew “that it is OK to talk to someone whether it be mum or dad, the teachers or any adult in charge” (S24) and “became more confident about talking about their feelings” (S22).

For some children, other needs were identified that were not directly related to the bushfires, including “a learning difficulty” (S43), “suspected of being on the autism spectrum” (S14), and requiring “ongoing SLSO [school learning support officer] support in class” (S20). Many of these children were offered individual speech-language pathology, occupational therapy, and/or psychology telepractice sessions. For children who received further support via telepractice, positive outcomes were described:

• This student is now speaking with greater confidence, learning to master the use of correct pronouns and has greater involvement in class discussions as a result of speech intervention. Student’s early reading and writing skills development has been supported by the OT [occupational therapist] and speech sessions, she is demonstrating mastery of new skills that were challenging as a result of limited fine motor skills and delayed language development (S43, child 1).

The benefits of the telepractice sessions were evident in the requests for more sessions being available. This was summarised by respondents who stated,

• I hope the program will be ongoing, especially for schools such as ours, which is regional, quite isolated and services provided in the area are limited and the waiting list for professional support is 1–2 years (S20).

• The ongoing support for students via telehealth has been amazing. The students … would not have been able to access OT, speech, and psychology support without this program. The involvement of Royal Far West has significantly improved student wellbeing and educational outcomes for our small school (S43).

Discussion

Children’s wellbeing and the ability to communicate are inextricably linked (Gillett-Swan & Sargeant, 2018). Natural disasters such as bushfires can have devastating long-term impacts on children’s emotional wellbeing, development, and educational outcomes (Curtin et al., 2020). This can be exacerbated if children are not provided with adequate support to process what they have experienced in the short-, medium- and long-term following a disaster. The children who are at greatest risk are those from more vulnerable backgrounds who may experience other factors impacting their development and limiting their ability to overcome trauma from bushfires (Curtin et al., 2020). The evaluation demonstrated that a tiered, multidisciplinary program that supports children to learn about their emotional reactions and focuses on the communication of children’s needs can have positive impacts upon outcomes after experiencing a natural disaster.

The impact of bushfires was evident in the findings of the evaluation of the Bushfire Recovery Program (Curtin et al., 2021). Although the Program had a positive impact on children overall, it was found that some children continued to experience difficulties. This may be reflective of the children and families experiencing multiple disasters in their communities before, during, and after the Program (e.g. drought, COVID-19, floods), or potential pre-existing communication, social/emotional, and mental health needs prior to the fires. These persistent difficulties for children highlight the need for long-term allied health service provision following bushfires, beyond the time where support services are often withdrawn after disasters. In particular, it is essential that children who are already developmentally vulnerable be provided with a high level of multi-faceted support to facilitate not only their recovery from climate-related disasters, but also to mediate against the exacerbation of existing developmental needs (Curtin et al., 2021). Furthermore, strong connections between home, school and community are needed to ensure that strategies can be consistently implemented across all of the children’s environments to provide effective and predictable support.

One finding from the evaluation was that children often found it difficult to talk about their feelings after experiencing climate-related trauma, and that the Program helped them to share their feelings and experiences. Storybooks and journals were thought to help support children to talk about their experiences and feelings about bushfires in the group setting and later at home with their parents/families. Using visual methods to investigate children’s experiences of the Program also proved extremely helpful. A form of Photovoice (Wang & Burris, 1997), where children were shown photos from the Program, helped children to remember and discuss specific aspects that they enjoyed or found helpful. Using graphic elicitation enabled children to express their experiences in a way that was meaningful to them. It enabled the discussion to progress further than just conversation alone had done. Children’s drawings provided insight into their feelings and experiences and their concerns at the time of the fires and in the present moment. These tools may be helpful for parents and professionals who are trying to support children’s communication in the aftermath of climate-related trauma, particularly for children with communication difficulties (Verdon et al., 2021).

Implications for speech-language pathologists

Understanding the ongoing impacts of bushfire and natural disasters upon children has multiple implications for SLPs. First, it is evident that the need for support in affected communities is high. There may be many social, financial, geographical, and emotional barriers to accessing services that children need (McGill et al., 2020; Verdon et al., 2011). This is especially true if families have been displaced, lost their home, or if parents and/or children are experiencing ongoing mental health impacts as a result of the disaster. Previous research has shown that on a community level, children’s language, literacy and academic outcomes can be impacted for prolonged periods after bushfire exposure (Gibbs et al., 2019). This is further exacerbated for children with communication disorders who have not previously had access to speech-language pathology, such as those living in rural or remote communities (Verdon et al., 2011). With the increased frequency of climate-related disasters, services must also consider a preventative approach to prepare children, especially those living in high-risk areas. This may include teaching disaster-related vocabulary and having visual aids prepared for times of crisis (Boesch et al., 2022).

The data presented in this commentary aims to heighten SLPs’ awareness of potential areas in which children may need support in the aftermath of climate-related disasters and informs innovative solutions to assist children in the short, medium and longer term at public health and individual levels. Drawing upon community assets, as demonstrated in the Bushfire Recovery Program, can support children by upskilling the people in their environment such as teachers, parents, and other local professionals. Community infrastructure (such as schools) can also act as a bridge to supporting children when home-based services are not an option due to displacement or reduced parental capacity following bushfire (Hobfoll et al., 2007). Telepractice may be an avenue to enable continuity of services, thus reducing the negative impact upon already vulnerable children.

Conclusion

High quality, community-based, tailored interventions are needed to support children’s wellbeing in the aftermath of climate-related disasters. The findings of this evaluation (Curtin et al., 2021) highlighted that communication is a key skill in children’s recovery when exposed to climate-related disasters. While having the skills to communicate around these issues can be challenging for all involved, there are particular barriers for children with existing speech, language, and communication needs. Exposure to climate-related trauma in childhood could further compound these needs. Despite these needs, the Bushfire Recovery Program highlighted the sparsity of allied health services, including speech-language pathology, in rural and remote areas. It should not take a disaster to trigger the provision of essential health services to rural communities. It is vital that existing services are in place to draw upon in times of crisis. While parents and carers in this study highlighted the value of the Program to their children and communities, they felt these services needed to be ongoing in order for children to thrive. Telepractice provided a positive bridge between city-based services and rural communities affected by bushfires, with great potential for future use and benefit to communities affected by climate-related disasters.

Disclosure statement

No potential conflict of interest was reported by the authors.