Ask the Expert: Niece is clingy after sibling’s accident

Q I am godmother to my 10-year-old niece. Her 12-year-old brother was in a serious accident and spent three months in hospital. She stayed with me and her grandmother for most of that time. We tried to keep things as normal as possible but I suppose she ended up being spoiled a bit by everyone. It wasn’t perfect, but we got through and she seemed happy enough.

Her brother is now home, on the mend, and will go back to school in September, but I’m worried about her now. She has recently become tearful, withdrawn, clingy and has started having tantrums. She used to love school, but it was a struggle to get her out the door for the last few weeks of the term. I know that all the attention was on her brother, and that she was affected too, but I’m wondering if her reaction is normal and whether there’s anything I can do to help. She won’t talk to her mum or dad about it.

A It is shocking for everyone in the family and community when a child is seriously injured. A long hospitalisation can pull the family in many directions as parents try to juggle family and work with spending as much time as possible with the sick child. It’s especially difficult for families who don’t live close to a big hospital and have to commute long distances. They must have been relieved to know that they could leave her safe and cared-for in your hands while they focused on their son.

Normal family life and structure often go out the window as everyone struggles to deal with a crisis situation like this and, even when the immediate danger is over and the dust has settled, there can be a long period of readjustment back into normal family life.

As a general observation, sudden regressive behaviour like this, which involves the child returning to behaviours associated more with a younger age, is usually a response to stress and is common following any type of trauma or upset in children. Most of what you’re describing could be seen in the context of being a “normal” 10-year-old reaction to a very stressful event, and her behaviour will probably settle with time. However, there might be a few points to consider.

There were obviously a lot of unavoidable changes for your niece and, as you say, her parents’ focus and attention was on her brother during those three months. However, it sounds as if she might have got a lot of special attention from you and her grandmother. Maybe her nose is a little out of joint and she’s now finding it hard to adjust back to sharing the adult attention with her brother. She might even be secretly resenting that her brother is home and even feeling guilty about having these thoughts after all he has been through. It’s important to let her know that initial feelings of resentment are normal and not “bad”. An open statement like “I think I’d be feeling a bit left out with all the attention he’s getting” might help her open up.

Along with everyone else, your niece has been shocked and upset by what happened, but unlike the adults, this might be the first serious illness or incident she has known in her life. It can be a huge revelation for children when they realise for the first time that “bad things” can happen and it can make them fearful and anxious that something else might happen to them or to someone they love. These feelings of worry and anxiety are possibly jumbled up with feelings of love, protection and resentment for her brother. You say she is close to him, so maybe at a conscious or subconscious level she wants to stay home from school to try and keep him safe.

While it can sometimes seem completely irrational to adults, children often blame themselves for illnesses or accidents even if adults can plainly see that it had nothing to do with them. Often, when they don’t fully understand what happened, they can insert their own beliefs and fantasies and come up with quite bizarre explanations.

Maybe she was present at the accident and thinks there was something she could have done to help or to avoid it. Her tantrums and tears might be partly as a result of a sense of worry or guilt about this. This is something that could be explored by explaining what happened and teasing out her understanding of the accident and her role in it.

Another important issue to consider is that something may have been going on for her in school – something unrelated to her brother’s illness. School refusal and the types of behaviours you’re describing could arise from bullying, and research would show that children who are a little vulnerable and low can fall prey to bullying or teasing more easily. There’s the possibility that she’s been having a hard time in school but doesn’t want to add to everyone’s worries.

Or maybe, as with many children who are bullied, she somehow blames herself or feels too afraid and embarrassed to discuss it. It would be important to link in with the school on this one, and you could have a chat with her about bullying and how to tackle it before the new term starts.

It’s important to recognise that while you’re all talking about the same accident, each of you will have a different perspective and experience of this traumatic time. If she doesn’t want to talk to her mum and dad, you might be the person to keep the communication open. Sometimes children feel, for whatever reason, that there are things they can’t say to their parents and a close relative can be an ideal sounding board.

Dr Sarah O’Doherty is a clinical psychologist