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[COLOMBO] School-based interventions helped young boys cope with the lingering psychological and social consequences of internal conflict in northern Sri Lanka, but had little effect on girls, according to a newly published study. 

Age and gender were critical factors in how well children responded to school-based interventions in the region that witnessed three decades of civil conflict between government forces and the separatist Liberation Tigers of Tamil Eelam, which ended in 2009 with the latter's defeat.

Previous studies reported prevalence rates of up to 30 per cent for post-traumatic stress disorder and 20 per cent for major depression among children in northeast Sri Lanka.

Previous international analyses of school-based interventions among trauma-affected children and adolescents, in Bosnia-Herzegovina, Indonesia, Nepal and the Palestinian territories; as well as children affected by the December 2004 Asian tsunami in Sri Lanka, had shown mixed results.

In the new study published in the June 2012 issue of World Psychiatry, researchers from the Netherlands, Sri Lanka and the US evaluated outcomes in the Tellippalai and Uduvil divisions of Jaffna district, between September 2007 and March 2008.

In the new study, the researchers divided about 400 children from 12 schools into groups of 15, and exposed them to a range of interventions including using drawing as a way to cope with past trauma, and creative expression through cooperative games, music, drama and dance.

Part of the challenge lay in seeing if the interventions would encourage ‘pro-social’ behaviours in children such as being kind to younger kids and sharing food and toys willingly.

The study found that the interventions worked with boys, but in the case of the majority of girls they appeared to slow natural recovery. Interventions were also more effective in younger children.

On average, the interventions helped children deal with behavioural problems such as using violence as a way to solve conflicts.

"Although we were impressed with the benefits seen from the intervention, despite children having gone through and being in really difficult circumstances, we should not assume that all children will benefit equally from an intervention," lead author Wietse Tol,  department of mental health, John Hopkins Bloomberg School of Public Health, explained to SciDev.Net.

"Some children will need more specialised care, even though it is challenging to organise," Tol added.

Menaca Calyaneratne, a director at the international non-government organisation Save the Children, said the government could adopt practical strategies such as providing support to families so that children can remain with them; and strengthening and expanding services for war-affected children, she said.

Link to abstract in World Psychiatry