Abstract
BACKGROUND: A comprehensive review of the design principles and methodological approaches that have been used to make inferences from the research on disasters in children is needed. OBJECTIVE: To identify the methodological approaches used to study children's reactions to three recent major disasters-the September 11, 2001, attacks; the 2004 Indian Ocean Tsunami; and Hurricane Katrina. METHODS: This review was guided by a systematic literature search. RESULTS: A total of 165 unduplicated empirical reports were generated by the search and examined for this review. This included 83 references on September 11, 29 on the 2004 Tsunami, and 53 on Hurricane Katrina. CONCLUSIONS: A diversity of methods has been brought to bear in understanding children's reactions to disasters. While cross-sectional studies predominate, pre-event data for some investigations emerged from archival data and data from studies examining non-disaster topics. The nature and extent of the influence of risk and protective variables beyond disaster exposure are not fully understood due, in part, to limitations in the study designs used in the extant research. Advancing an understanding of the roles of exposure and various individual, family, and social factors depends upon the extent to which measures and assessment techniques are valid and reliable, as well as on data sources and data collection designs. Comprehensive assessments that extend beyond questionnaires and checklists to include interviews and cognitive and biological measures to elucidate the negative and positive effects of disasters on children also may improve the knowledge base.