Boehner Pulls Plan B Option













In a surprise development late Thursday night, House Speaker John Boehner pulled his so-called "Plan B option" -- an extension of current tax rates for Americans making up to $1 million a year -- from the House floor, admitting that it did not have the support necessary to pass and leaving a resolution to the fiscal cliff in question.


"The House did not take up the tax measure today because it did not have sufficient support from our members to pass. Now it is up to the president to work with [Democratic Senate Majority Leader Harry] Reid on legislation to avert the fiscal cliff," Boehner, R-Ohio, wrote in a statement. "The House has already passed legislation to stop all of the Jan. 1 tax rate increases and replace the sequester with responsible spending cuts that will begin to address our nation's crippling debt. The Senate must now act."


Immediately after the announcement that "plan B" had failed, Dow Jones Industrial futures traded down, with other stock indicators also signaling sharp losses and volatility for Friday morning's opening -- though stock futures generally are lightly traded in the evening. Indicators soon bounced off the initial lows but still signaled a rough start to the final trading session of the week.


In Washington, all legislative business has concluded for the week. House Majority Leader Eric Cantor's office said that members could still return "after the Christmas holiday when needed" if a breakthrough is eventually reached.






Jacquelyn Martin/AP Photo













Outgoing Sen. Joe Lieberman Criticizes Colleagues for Putting Party Above Country Watch Video









President Obama Promises Action to Reduce Gun Violence Watch Video





The outlook for a deal to avert the "fiscal cliff" by Christmas has reached a new low, with no clear path forward, though lawmakers and the White House maintained hope this week for a deficit-reduction compromise by the end of the year.


A senior aide to the speaker confirmed late Thursday evening that Boehner and Obama still have not spoken since Monday evening, when the speaker told the president that he would move ahead with his backup plan, although staff-level talks have continued behind the scenes.


"Speaker Boehner tried to play hardball by asking his members to vote for a tax increase. He learned the hard way that you must find a bipartisan solution," one senior House Democratic leadership aide said reacting to the developments. "Walking away has considerably weakened him and put the country literally on the precipice of the cliff."


Republicans had sought to act to avoid an income tax hike on 99 percent of Americans in 2013, and leverage new pressure on President Obama in the ongoing talks for a broader "cliff" deal.


Obama has threatened to veto the legislation, calling it counterproductive and the cuts burdensome for the middle class, and Reid, D-Nev., has promised not to bring it up for consideration in the Senate.


"'Plan B' ... is a multi-day exercise in futility at a time when we do not have the luxury of exercises in futility," said White House spokesman Jay Carney Thursday.


Democrats complained that the posturing on "plan B" distracted the focus from a broader bargain on taxes, spending, entitlement reforms and other measures that had begun coming into focus earlier this week.


Reid said the Senate would break for the Christmas holiday but return to Washington one week from Thursday. President Obama will not join his family in Hawaii on Friday as planned if the "cliff" is not resolved, an administration official said.


"If you look at Speaker Boehner's proposal and you look at my proposal, they're actually pretty close," Obama said Wednesday, appealing for a big "fair deal."


"It is a deal that can get done," he said. "But it cannot be done if every side wants 100 percent. And part of what voters were looking for is some compromise up here."






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State Department security chief leaves post over Benghazi


WASHINGTON (Reuters) - The U.S. State Department said on Wednesday its security chief had resigned from his post and three other officials had been relieved of their duties following a scathing official inquiry into the September 11 attack on the U.S. mission in Benghazi.


Eric Boswell has resigned effective immediately as assistant secretary of state for diplomatic security, State Department spokeswoman Victoria Nuland said in a terse statement. A second official, speaking on condition of anonymity, said Boswell had not left the department entirely and remained a career official.


Nuland said that Boswell, and the three other officials, had all been put on administrative leave "pending further action."


An official panel that investigated the incident concluded that the Benghazi mission was completely unprepared to deal with the attack, which killed U.S. Ambassador Christopher Stevens and three other Americans.


The unclassified version of the report, which was released on Tuesday, cited "leadership and management" deficiencies, poor coordination among officials and "real confusion" in Washington and in the field over who had the authority to make decisions on policy and security concerns.


"The ARB identified the performance of four officials, three in the Bureau of the Diplomatic Security and one in the Bureau of (Near Eastern) Affairs," Nuland said in her statement, referring to the panel known as an Accountability Review Board.


Secretary of State Hillary Clinton accepted Boswell's decision to resign effective immediately, the spokeswoman said.


Earlier, a U.S. official who spoke on condition of anonymity said Boswell, one of his deputies, Charlene Lamb, and a third unnamed official has been asked to resign. The Associated Press first reported that three officials had resigned.


PANEL STOPS SHORT OF BLAMING CLINTON


The Benghazi incident appeared likely to tarnish Clinton's four-year tenure as secretary of state but the report did not fault her specifically and the officials who led the review stopped short of blaming her.


"We did conclude that certain State Department bureau-level senior officials in critical positions of authority and responsibility in Washington demonstrated a lack of leadership and management ability appropriate for senior ranks," retired Admiral Michael Mullen, one of the leaders of the inquiry, told reporters on Wednesday.


The panel's chair, retired Ambassador Thomas Pickering, said it had determined that responsibility for security shortcomings in Benghazi belonged at levels lower than Clinton's office.


"We fixed (responsibility) at the assistant secretary level, which is, in our view, the appropriate place to look for where the decision-making in fact takes place, where - if you like - the rubber hits the road," Pickering said after closed-door meetings with congressional committees.


The panel's report and the comments by its two lead authors suggested that Clinton, who accepted responsibility for the incident in a television interview about a month after the Benghazi attack, would not be held personally culpable.


Pickering and Mullen spoke to the media after briefing members of the House of Representatives Foreign Affairs Committee and Senate Foreign Relations Committee behind closed doors on classified elements of their report.


Clinton had been expected to appear at an open hearing on Benghazi on Thursday, but is recuperating after suffering a concussion, dehydration and a stomach bug last week. She will instead be represented by her two top deputies.


Clinton, who intends to step down in January, said in a letter accompanying the review that she would adopt all of its recommendations, which include stepping up security staffing and requesting more money to fortify U.S. facilities.


The National Defense Authorization Act for 2013, which is expected to go to Congress for final approval this week, includes a measure directing the Pentagon to increase the Marine Corps presence at diplomatic facilities by up to 1,000 Marines.


Some Capitol Hill Republicans who had criticized the Obama administration's handling of the Benghazi attacks said they were impressed by the report.


"It was very thorough," said Senator Johnny Isakson. Senator John Barrasso said: "It was very, very critical of major failures at the State Department at very high levels." Both spoke after the closed-door briefing.


Others, however, took a harsher line and called for Clinton to testify as soon as she is able.


"The report makes clear the massive failure of the State Department at all levels, including senior leadership, to take action to protect our government employees abroad," Representative Mike Rogers, the Republican chairman of the House Intelligence Committee, said in a statement.


Senator Bob Corker, who will be the top Republican on the Senate Foreign Relations Committee when the new Congress is seated early next year, said Clinton should testify about Benghazi before her replacement is confirmed by the Senate.


Republicans have focused much of their firepower on U.S. Ambassador to the United Nations Susan Rice, who appeared on TV talk shows after the attack and suggested it was the result of a spontaneous protest rather than a premeditated attack.


The report concluded that there was no such protest.


Rice, widely seen as President Barack Obama's top pick to succeed Clinton, withdrew her name from consideration last week.


(Additional reporting by Tabassum Zakaria and Susan Cornwell; Editing by Christopher Wilson)



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Apple "pinch-to-zoom" patent deemed invalid






SAN FRANCISCO: A filing in a high-stakes legal battle between Samsung and Apple revealed that a "pinch-to-zoom" patent central to the case has been deemed invalid.

The patent was a centerpiece of a trial that ended in August with a jury ordering Samsung to pay Apple $1.05 billion in damages for illegally copying iPhone and iPad features for its flagship Galaxy S smartphones.

Samsung provided US District Judge Lucy Koh a copy of a US Patent and Trademark Office preliminary determination that, upon review, the Apple pinch-to-zoom technology wasn't original enough to merit a patent.

Samsung hoped the filing would bolster its argument for a new trial or to have the damages award slashed.

Since the verdict, US patent officials tentatively invalidated an Apple patent on technology that gives a "rubber-band" springing effect when a finger tugs at the edge of a touch-screen smartphone. That patent was also at issue at the trial.

Koh on Monday denied Apple's request to ban a set of Samsung smartphones from the US market based on the jury's finding that the South Korean firm was guilty of infringing on six of the Cupertino, California-company's patents.

Even though Apple was victorious in the patent case, the iPhone and iPad maker failed to prove that the technology at issue was the driving factor in people's buying decisions, Koh reasoned in the ruling.

Samsung -- the world's top mobile and smartphone maker -- has appealed the verdict.

- AFP/al



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BJP leading in Gujarat, Himachal

AHMEDABAD/SHIMLA: The ruling BJP was leading in both Gujarat and Himachal Pradesh over Congress in the assembly elections for which the counting of votes began today.

TV channels put BJP well ahead of the Congress in both the states. One channel placed the BJP ahead in 57 constituencies against Congress' 34 while another gave the figure of 56 and 28 respectively. Yet others projected BJP as being ahead in 46 and Congress 23 and 48 and 23 respectively.

The Gujarat Parivartan Party (GPP) headed by former chief minister Keshubhai Patel was not doing well leading in only three seats.

The Gujarat Assembly has 182 seats. The BJP has 117 in the outgoing assembly against Congress' 53.

In Himachal Pradesh, three TV channels showed BJP ahead in 12 constituencies and Congress in six. One of the channels showed BJP ahead in 14 and Congress six.

Himachal has a 68-member Assembly in which BJP had won 43 seats in the 2003 elections against Congress' 16.

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Experts: Kids are resilient in coping with trauma


WASHINGTON (AP) — They might not want to talk about the gunshots or the screams. But their toys might start getting into imaginary shootouts.


Last week's school shooting in Connecticut raises the question: What will be the psychological fallout for the children who survived?


For people of any age, regaining a sense of security after surviving violence can take a long time. They're at risk for lingering anxiety, depression, post-traumatic stress disorder.


But after the grief and fear fades, psychiatrists say most of Newtown's young survivors probably will cope without long-term emotional problems.


"Kids do tend to be highly resilient," said Dr. Matthew Biel, chief of child and adolescent psychiatry at MedStar Georgetown University Hospital.


And one way that younger children try to make sense of trauma is through play. Youngsters may pull out action figures or stuffed animals and re-enact what they witnessed, perhaps multiple times.


"That's the way they gain mastery over a situation that's overwhelming," Biel explained, saying it becomes a concern only if the child is clearly distressed while playing.


Nor is it unusual for children to chase each other playing cops-and-robbers, but now parents might see some also pretending they're dead, added Dr. Melissa Brymer of the UCLA-Duke National Center for Child Traumatic Stress.


Among the challenges will be spotting which children are struggling enough that they may need professional help.


Newtown's tragedy is particularly heart-wrenching because of what such young children grappled with — like the six first-graders who apparently had to run past their teacher's body to escape to safety.


There's little scientific research specifically on PTSD, post-traumatic stress disorder, in children exposed to a burst of violence, and even less to tell if a younger child will have a harder time healing than an older one.


Overall, scientists say studies of natural disasters and wars suggest most children eventually recover from traumatic experiences while a smaller proportion develop long-term disorders such as PTSD. Brymer says in her studies of school shootings, that fraction can range from 10 percent to a quarter of survivors, depending on what they actually experienced. A broader 2007 study found 13 percent of U.S. children exposed to different types of trauma reported some symptoms of PTSD, although less than 1 percent had enough for an official diagnosis.


Violence isn't all that rare in childhood. In many parts of the world — and in inner-city neighborhoods in the U.S., too — children witness it repeatedly. They don't become inured to it, Biel said, and more exposure means a greater chance of lasting psychological harm.


In Newtown, most at risk for longer-term problems are those who saw someone killed, said Dr. Carol North of the University of Texas Southwestern Medical Center, who has researched survivors of mass shootings.


Friday's shootings were mostly in two classrooms of Sandy Hook Elementary School, which has about 450 students through fourth-grade.


But those who weren't as close to the danger may be at extra risk, too, if this wasn't their first trauma or they already had problems such as anxiety disorders that increase their vulnerability, she said.


Right after a traumatic event, it's normal to have nightmares or trouble sleeping, to stick close to loved ones, and to be nervous or moody, Biel said.


To help, parents will have to follow their child's lead. Grilling a child about a traumatic experience isn't good, he stressed. Some children will ask a lot of questions, seeking reassurance, he said. Others will be quiet, thinking about the experience and maybe drawing or writing about it, or acting it out at playtime. Younger children may regress, becoming clingy or having tantrums.


Before second grade, their brains also are at a developmental stage some refer to as magical thinking, when it's difficult to distinguish reality and fantasy. Parents may have to help them understand that a friend who died isn't in pain or lonely but also isn't coming back, Brymer said.


When problem behaviors or signs of distress continue for several weeks, Brymer says it's time for an evaluation by a counselor or pediatrician.


Besides a supportive family, what helps? North advises getting children back into routines, together with their friends, and easing them back into a school setting. Studies of survivors of the Sept. 11 terrorist attacks found "the power of the support of the people who went through it with you is huge," she said.


Children as young as first-graders can benefit from cognitive-behavioral therapy, Georgetown's Biel said. They can calm themselves with breathing techniques. They also can learn to identify and label their feelings — anger, frustration, worry — and how to balance, say, a worried thought with a brave one.


Finally, avoid watching TV coverage of the shooting, as children may think it's happening all over again, Biel added. He found that children who watched the 9/11 clips of planes hitting the World Trade Center thought they were seeing dozens of separate attacks.


___


EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.


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Obama Invokes Newtown on 'Cliff' Deal













Invoking the somber aftermath of the school massacre in Newtown, Conn., President Obama today appealed to congressional Republicans to embrace a standing "fair deal" on taxes and spending that would avert the fiscal cliff in 13 days.


"If there's one thing we should have after this week, it should be a sense of perspective about what's important," Obama said at a midday news conference.


"I would like to think that members of that [Republican] caucus would say to themselves, 'You know what? We disagree with the president on a whole bunch of things,'" he said. "'But right now what the country needs is for us to compromise.'"


House Speaker John Boehner's response: "Get serious."


Boehner announced at a 52-second news conference that the House will vote Thursday to approve a "plan B" to a broad White House deal -- and authorize simply extending current tax rates for people earning less than $1 million a year and little more.


"Then, the president will have a decision to make," the Ohio Republican said. "He can call on Senate Democrats to pass that bill or he could be responsible for the largest tax increase in American history."








Fiscal Cliff Negotiations: Trying to Make a Deal Watch Video









House Speaker John Boehner Proposes 'Plan B' on Taxes Watch Video









'Fiscal Cliff' Negotiations: Deal Might Be Within Reach Watch Video





Unless Congress acts by Dec. 31, every American will face higher income tax rates and government programs will get hit with deep automatic cuts starting in 2013.


Obama and Boehner have been inching closer to a deal on tax hikes and spending cuts to help reduce the deficit. But they have not yet had a breakthrough on a deal.


Obama's latest plan would raise $1.2 trillion in new tax revenue over 10 years, largely through higher tax rates on incomes above $400,000. He also proposes roughly $930 billion in spending cuts, including new limits on entitlement spending, such as slower annual cost-of-living increases for Social Security beneficiaries.


Boehner has agreed to $1 trillion in new tax revenue, with a tax rate hike for households earning over $1 million. He is seeking more than $1 trillion in spending cuts, with significant changes to Medicare and Social Security.


The president said today that he remains "optimistic" about reaching a broad compromise by Christmas because both sides are "pretty close," a sentiment that has been publicly shared by Boehner.


But the speaker's backup plan has, at least temporarily, stymied talks, with no reported contact between the sides since Monday.


"The speaker should return to the negotiating table with the president because if he does I firmly believe we can have an agreement before Christmas," said Sen. Chuck Schumer, D-N.Y., a White House ally.


Schumer said Obama and Boehner are "not that far apart" in the negotiations.


"If they were to come to an agreement by Friday, they could write this stuff over the Christmas break and then we'd have to come back before the New Year and pass it," Schumer said.


Obama said he is "open to conversations" and planned to reach out to congressional leaders over the next few days to try to nudge Republicans to accept a "fair deal."


"At some point, there's got to be, I think, a recognition on the part of my Republican friends that -- you know, take the deal," he told reporters.


"They keep on finding ways to say no, as opposed to finding ways to say yes," Obama added. "At some point, you know, they've got take me out of it and think about their voters and think about what's best for the country."



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Inquiry harshly criticizes U.S. State Department over Benghazi attack


WASHINGTON (Reuters) - Security at the U.S. mission in Benghazi, Libya was grossly inadequate to deal with a September 11 attack that killed a U.S. ambassador and three others because of systemic failures within the State Department, an official inquiry found on Tuesday.


In a scathing assessment, the review cited "leadership and management" deficiencies at two bureaus of the department, poor coordination among officials in Washington and "real confusion" on the ground over who had the responsibility, and the power, to make decisions that involved policy and security concerns.


The attack killed Ambassador Christopher Stevens and three other Americans and set off a political furor as Republicans used the issue to attack President Barack Obama before the November 6 election.


The report's harsh assessment seemed likely to tarnish the four-year tenure of Secretary of State Hillary Clinton, who said in a letter accompanying the review that she would adopt all of its recommendations.


"Systemic failures and leadership and management deficiencies at senior levels within two bureaus of the State Department ... resulted in a special mission security posture that was inadequate for Benghazi and grossly inadequate to deal with the attack that took place," said the report by the official "Accountability Review Board."


The report specifically faulted the State Department's Bureau of Near Eastern Affairs and its Bureau of Diplomatic Security.


The incident has raised questions about the adequacy of security at U.S. embassies around the globe and where to draw the line between protecting American diplomats in dangerous places while giving them enough freedom to do their jobs.


Jon Alterman, head of the Middle East program at the Center for Strategic and International Studies, said the assessment reflected poorly on Clinton and its recommendations would probably make life harder for diplomats in the field


"This is a mark against Secretary Clinton. While she was not singled out, the report highlighted the lack of leadership and organization on security issues, and those fall into her bailiwick," Alterman said.


"The report, however, relies a little too much on bureaucratic fixes," he added. "Sprinkling people throughout the system who are not only empowered to say 'no,' but have an institutional interest in doing so, will make it harder for diplomats to get out of tightly guarded facilities."


The political uproar in the United States over the Benghazi attack has already claimed one victim.


U.S. Ambassador to the United Nations Susan Rice, widely tipped as a front-runner to replace Clinton when she steps down as secretary of state early next year, last week withdrew her name from consideration, saying she wished to avoid a potentially disruptive Senate confirmation process.


Republican lawmakers had blasted Rice for comments she made on several television talk shows in the aftermath of the attack in which she said preliminary information suggested the assault was the result of protests over an anti-Muslim video made in California rather than a premeditated strike.


The review. however, concluded that no protest took place before the attack.


Rice has said she was relying on talking points drawn up by U.S. intelligence officials.


(Editing by Christopher Wilson)



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Strong turnout for South Korea's presidential election






SEOUL: South Koreans cast their votes Wednesday in a tight and potentially historic presidential election that could result in Asia's fourth-largest economy selecting its first female leader.

The ballot is a straight fight between Park Geun-Hye, the conservative daughter of assassinated dictator Park Chung-Hee, and her liberal rival Moon Jae-In, the son of North Korean refugees.

Opinion polls indicate the result could go either way.

The eventual occupant of the presidential Blue House will have to deal with a belligerent North Korea, a slowing economy and soaring welfare costs in one of the world's most rapidly ageing societies.

Park, 60, was looking to make history by becoming the first female president of a still male-dominated nation, and the first to be related to a former leader.

Her father remains one of modern Korea's most polarising figures -- admired for dragging the country out of poverty and reviled for his ruthless suppression of dissent during 18 years of military rule.

He was shot dead by his spy chief in 1979. Park's mother had been killed five years earlier by a pro-North Korea gunman aiming for her father.

Moon, who was chief of staff to the late left-wing president Roh Moo-Hyun, is a former human rights lawyer who was once jailed for protesting against the Park Chung-Hee regime.

Polling booths opened at 6:00am (2100 GMT Tuesday) on a bright, chilly winter's morning, with the temperature hovering around -10 Celsius (14 Fahrenheit).

Initial turnout among the 40 million-plus registered voters was strong, with 35 percent having cast their votes by midday -- a sharp increase on the 2007 election.

"It's freezing cold, but I plead with the people to come out and vote to open a new era for this country," Park, wrapped up in a long coat and red scarf, said as she cast her ballot in Seoul.

After locking in the support of their respective conservative and liberal bases, the two candidates put a lot of campaign effort into wooing crucial centrist voters, resulting in significant policy overlap.

Both have talked of "economic democratisation" -- a campaign buzzword about reducing the social disparities caused by rapid economic growth -- and promised to create new jobs and increase welfare spending.

Moon has been more aggressive than Park in his proposals for reining in the power of the giant family-run conglomerates, or "chaebol" that dominate the economy.

"This is the only way for the people to change the world," Moon said as he voted in the southern city of Busan.

"This election is about our livelihoods, economic democracy, welfare and peace on the Korean peninsula," he added.

While both have signalled a desire for greater engagement with Pyongyang, Park's approach is far more cautious than Moon's promise to resume aid without preconditions and seek an early summit with North Korean leader Kim Jong-Un.

Although North Korea has not been a major campaign issue, its long-range rocket launch last week -- seen by critics as a disguised ballistic missile test -- was a reminder of the unpredictable threat from across the border.

The never-married Park has promised a strong, parental style of leadership that would steer the country through the challenges of global economic troubles.

"Like a mother who dedicates her life to her family, I will become the president who takes care of the lives of each one of you," Park said in her last televised news conference on Tuesday.

A female president would be a big change for a country that the World Economic Forum recently ranked 108th out of 135 countries in terms of gender equality -- one place below the United Arab Emirates and just above Kuwait.

Older Koreans, who generally favour Park, are seen as more dependable voters and Moon's camp has pushed hard to ensure the younger demographic that make up his support base cast their ballots.

One early voter, Kim Su-Eun, 29, said she had opted for the ruling party candidate.

"I think Moon's election promises are too radical while Park says she will carry out reform step by step. That's why I voted for her", she told AFP.

- AFP/al



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Funds crunch hits war on malaria

NEW DELHI: The amount of funds available for malaria prevention and control globally is less than half what is needed, the World Health Organization (WHO) has said in a report. While it is estimated that $5.1 billion is needed every year between 2011 and 2020 to achieve universal access to malaria interventions, only $2.3 billion was available in 2011. The WHO has blamed this on a slowing down in the efforts to reverse the epidemic.

This was stated in the World Malaria Report released on Monday, which summarised information from 104 malaria-endemic countries, including India. International funding for malaria control has been steadily rising, going up from less than $100 million in 2000 to $1.71 billion in 2010. National government funding for malaria programmes has also been increasing in recent years, touching an estimated $625 million in 2011. Yet the funds are far from adequate as malaria hits the poorest countries with higher proportions of their population living in poverty (less than $1.25 per person per day) have higher mortality rates from malaria.

Projections of both domestic and international resources available between 2013 and 2015 indicate that total funding for malaria control will remain at less than US$ 2.7 billion, substantially below the amount required.

The African continent accounts for the highest incidence of malaria with 219 million cases and 90% of all malarial deaths in the world. In the Southeast Asia region, India has the highest incidence of malaria (24 million cases) followed by Indonesia and Myanmar. According to the latest WHO estimates, worldwide there were about 219 million cases of malaria in 2010 and an estimated 660,000 deaths.

Together, the Democratic Republic of the Congo and Nigeria are estimated to account for over 40% of all malaria deaths globally. Similarly, the Democratic Republic of the Congo, India and Nigeria account for 40% of malaria cases.

The world report claims that 50 countries are on track to reduce their malaria case incidence rates by 75%, in line with World Health Assembly and Roll Back Malaria targets for 2015. However, these 50 countries account for just 3% (7 million) of the total estimated malaria cases. Moreover, malaria surveillance systems detect only around 10% of the estimated global number of cases, with case detection being lowest in the countries with the highest burden of malaria. In the African and Western Pacific Regions, the main constraint is the small proportion of patients attending public facilities who receive a diagnostic test for malaria.

In the Southeast Asia Region, the most important issue is the high proportion of patients who seek treatment in the private sector, as is happening in India where the private sector is not part of the health reporting system. With such constraints, most of the WHO figures are based on estimates and modelling.

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Experts: Kids are resilient in coping with trauma


WASHINGTON (AP) — They might not want to talk about the gunshots or the screams. But their toys might start getting into imaginary shootouts.


Last week's school shooting in Connecticut raises the question: What will be the psychological fallout for the children who survived?


For people of any age, regaining a sense of security after surviving violence can take a long time. They're at risk for lingering anxiety, depression, post-traumatic stress disorder.


But after the grief and fear fades, psychiatrists say most of Newtown's young survivors probably will cope without long-term emotional problems.


"Kids do tend to be highly resilient," said Dr. Matthew Biel, chief of child and adolescent psychiatry at MedStar Georgetown University Hospital.


And one way that younger children try to make sense of trauma is through play. Youngsters may pull out action figures or stuffed animals and re-enact what they witnessed, perhaps multiple times.


"That's the way they gain mastery over a situation that's overwhelming," Biel explained, saying it becomes a concern only if the child is clearly distressed while playing.


Nor is it unusual for children to chase each other playing cops-and-robbers, but now parents might see some also pretending they're dead, added Dr. Melissa Brymer of the UCLA-Duke National Center for Child Traumatic Stress.


Among the challenges will be spotting which children are struggling enough that they may need professional help.


Newtown's tragedy is particularly heart-wrenching because of what such young children grappled with — like the six first-graders who apparently had to run past their teacher's body to escape to safety.


There's little scientific research specifically on PTSD, post-traumatic stress disorder, in children exposed to a burst of violence, and even less to tell if a younger child will have a harder time healing than an older one.


Overall, scientists say studies of natural disasters and wars suggest most children eventually recover from traumatic experiences while a smaller proportion develop long-term disorders such as PTSD. Brymer says in her studies of school shootings, that fraction can range from 10 percent to a quarter of survivors, depending on what they actually experienced. A broader 2007 study found 13 percent of U.S. children exposed to different types of trauma reported some symptoms of PTSD, although less than 1 percent had enough for an official diagnosis.


Violence isn't all that rare in childhood. In many parts of the world — and in inner-city neighborhoods in the U.S., too — children witness it repeatedly. They don't become inured to it, Biel said, and more exposure means a greater chance of lasting psychological harm.


In Newtown, most at risk for longer-term problems are those who saw someone killed, said Dr. Carol North of the University of Texas Southwestern Medical Center, who has researched survivors of mass shootings.


Friday's shootings were mostly in two classrooms of Sandy Hook Elementary School, which has about 450 students through fourth-grade.


But those who weren't as close to the danger may be at extra risk, too, if this wasn't their first trauma or they already had problems such as anxiety disorders that increase their vulnerability, she said.


Right after a traumatic event, it's normal to have nightmares or trouble sleeping, to stick close to loved ones, and to be nervous or moody, Biel said.


To help, parents will have to follow their child's lead. Grilling a child about a traumatic experience isn't good, he stressed. Some children will ask a lot of questions, seeking reassurance, he said. Others will be quiet, thinking about the experience and maybe drawing or writing about it, or acting it out at playtime. Younger children may regress, becoming clingy or having tantrums.


Before second grade, their brains also are at a developmental stage some refer to as magical thinking, when it's difficult to distinguish reality and fantasy. Parents may have to help them understand that a friend who died isn't in pain or lonely but also isn't coming back, Brymer said.


When problem behaviors or signs of distress continue for several weeks, Brymer says it's time for an evaluation by a counselor or pediatrician.


Besides a supportive family, what helps? North advises getting children back into routines, together with their friends, and easing them back into a school setting. Studies of survivors of the Sept. 11 terrorist attacks found "the power of the support of the people who went through it with you is huge," she said.


Children as young as first-graders can benefit from cognitive-behavioral therapy, Georgetown's Biel said. They can calm themselves with breathing techniques. They also can learn to identify and label their feelings — anger, frustration, worry — and how to balance, say, a worried thought with a brave one.


Finally, avoid watching TV coverage of the shooting, as children may think it's happening all over again, Biel added. He found that children who watched the 9/11 clips of planes hitting the World Trade Center thought they were seeing dozens of separate attacks.


___


EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.


Read More..