Littleton, Colorado. Red Lake, Minnesota. Blacksburg, Virginia. Oakland, California. Newtown, Connecticut. Roseburg, Oregon. Parkland, Florida. Geography separates them, but what they have in common is they all contain the site of a mass murder on school grounds.

This week, the country reeled again as 17 students and staff members at Marjory Stoneman Douglas High School in Parkland, Florida, were gunned down by a former student. Fifteen more were injured. Mass shootings are not an uncommon occurrence; an entire generation of students has grown up preparing for the active shooter scenario in the same way that prior generations drilled in case of fire.

That mass shootings take place in the hallways of American schools is not in question, but what may be in question for many is how, or even if, parents should talk to children about them.

“We, as parents, understand how significant or serious this is, and kids don’t grasp it on the same level,” said Tamara Stevens, a child psychologist with Washington Pediatrics. “It really just seems generationally different. These kids — they have been raised that this is just another thing you practice for.”

Stevens has three school-age children of her own: one in middle school, one in high school and another in college. What determines how and if parents talk to children about school shootings depends on the child: his age, temperament and personality, she said.

“If you anticipate that they will hear about it, I think it’s reasonable to bring it up,” Stevens said. “Answer what questions they offer. I think it’s helpful to see what questions they have before you get into too much detail. Kids tend to ask questions about information they’re ready to know.”

Stevens said the best place to start a conversation is to find out what they already know and give basic details, taking the child’s age into consideration.

“It’s OK to verify it happened, whether it was close or far away, but they really don’t need to be exposed to ongoing news coverage or graphic images,” she said. “Of course, for older children, odds are they will be exposed, and you can’t control what they see. So, in that case, it’s better to preview, watch news coverage yourself, so you can answer questions as it goes along. … You want to be aware and share it with them, but you also don’t want to pass on your anxiety about it.”

Children’s emotional responses to mass killings in schools are individual, but it’s important to let them know it’s OK to be upset, and that they have parental support to talk about things, according to Stevens. Changes in emotional responses — does she seem sad, more irritated or fearful? —  as well as changes in sleep habits or vague physical complaints such as headaches or stomach aches could be a heightened response to anxiety or worrying.

“For younger children, if they have been exposed to it, they may be a little more clingy, may have fear of separating from loved ones, regressing to more immature behaviors or be more demanding,” Stevens said. “Some kids may just be able to roll with it, but those who are having trouble dealing with it, you may see these signs.”

In 2018, there have been 18 shootings on school campuses in the U.S., resulting in 22 deaths and 40 injuries. The increase in gun violence in schools led the American Academy of Pediatrics to issue a statement Thursday calling school shootings a “public health crisis” and calling on Congress to advance gun control legislation that would better protect children.

“Shootings have an indelible impact on entire communities, on the families who lost children and loved ones, and on the children who survived,” reads the statement from Colleen A. Kraft, MD and president of APA. “Parents across the United States send their children to school every day, and hope and trust they will be safe. As long as children continue to be injured and killed by guns in this country, pediatricians will not rest in our pursuit to keep them safe.”

In the wake of Wednesday’s shooting, officials have also stressed the need to recognize when children are in crisis that could lead to picking up a weapon to use against others.

“If you’ve got a child, who seems to be very isolated or disengaged, that your concerned about, bring it to the attention of school personnel, or kids can bring it to the attention of a parent or any other official that can reach out to that child and see if there is any service that they need,” Stevens said.