Noah Orona still had not cried.

The 10-year-old's father, Oscar, couldn't understand it. Just hours earlier, a stranger with a rifle had walked into the boy's fourth-grade classroom at Robb Elementary School and opened fire, slaughtering his teachers and classmates in front of him. One round struck Noah in the shoulder blade, carving a 10-inch gash through his back before popping out and spraying his right arm with shrapnel. He'd laid amid the blood and bodies of his dead friends for an hour, maybe more, waiting for help to come.

But there he was, resting in his hospital bed, his brown eyes vacant, his voice muted.

"I think my clothes are ruined," Noah lamented.

It was OK, his dad assured him. He would get new clothes.

"I don't think I'm going to get to go back to school," he said.

"Don't worry about it," his father insisted, squeezing his son's left hand.

"I lost my glasses," the boy continued. "I'm sorry."

The children and adults who die in school shootings dominate headlines and consume the public's attention. Body counts become synonymous with each event, dictating where they rank in the catalogue of these singularly American horrors: 10 at Santa Fe High, 13 at Columbine High, 17 at Marjory Stoneman Douglas High, 26 at Sandy Hook Elementary. And now, added to the list is 21 at Robb Elementary in Uvalde, Texas.

Those tallies, however, do not begin to capture the true scope of this epidemic in the United States, where hundreds of thousands of children's lives have been profoundly changed by school shootings. There are the more than 360 kids and adults, including Noah, who have been injured on K-12 campuses since 1999, according to a Washington Post database. And then there are the children who suffer no physical wounds at all, but are still haunted for years by what they saw or heard or lost.

No one understands that better than Samantha Haviland, who for years directed counseling services for Denver Public Schools. One day in 2008, she sat on the floor of a school library's back room, the lights off, the door locked. Crouched all around her were teenagers pretending that someone with a gun was trying to murder them.

No one there knew that Haviland, then a counselor in her mid-20s, had survived Columbine nine years earlier.

On that day, April 20, 1999, Haviland ran from gunfire and heard some of it, too, but she didn't get shot or see a bullet strike anyone else. The shock and grief solidified her plan to become a counselor, though Haviland didn't get counseling herself for years.

The nightmares — always of being chased — lingered for years, but she didn't think she deserved help, not when classmates had died, been maimed or had witnessed the carnage firsthand. She would be OK.

But now there she was, a decade later, sitting in the darkness, practicing once again to escape what so many of her friends had not. Then she heard footsteps and saw the shadow of an administrator checking the locks. Her chest began to throb, and suddenly, Haviland knew she wasn't OK.

On Tuesday, Haviland did all she could to avoid the details of what had happened in Texas. She didn't want to know. Years of therapy had helped, but the passage of time was no cure. On Wednesday, she turned 40.

Noah was only 10, but his father and mother were already worried about what this would all mean for him decades from now. It tortured Oscar and his wife, Jessica, to know how close he'd come to escaping it.

They'd been at the school on Tuesday morning to watch Noah win an award for art and music, sitting in the front row for the assembly. They felt so proud.

Noah was a quiet kid. He spent much of his time playing Mario and Pokémon games on his Nintendo Switch. For his birthday earlier this month, the family drove him to San Antonio to go bowling and pick out Pokémon cards. His parents had seen glimpses of him growing up, though. He'd started ordering steak for dinner, medium-rare, just like his dad. And he wanted to become a dental hygienist, just like his mom, when he grew up.

Now here he was, receiving an award.

His parents told him to smile for a photo, but Noah didn't like to smile for photos, so he held the certificate up to his nose. His dad laughed and told him to put it down. Finally they coaxed a grin. They also took a photo of Noah with his friends, and later, his dad would fear that his son was the only child in the image who survived.

"Can I go with y'all?" Noah asked after the pictures were taken.

Oscar hesitated. Noah's class was planning to go outside that afternoon to blow bubbles in the grass. His parents had given him extra so he could share. They didn't want him to miss that, his dad told him.

"OK," Noah replied, and off he dashed down the hallway, back toward the classroom where the shooting began an hour later.

- - -

The three seniors at Newtown High School had nearly made it. They were less than a month from graduation, two days from the senior dinner dance and spirit week had just begun.

Tuesday's theme was "country vs. country club," and each of the girls took it seriously. Camille Paradis already owned cowboy boots and a hat, so that made her decision easy. Rayna Toth also picked country, sporting a flannel shirt and a bandanna around her neck. Maggie LaBanca couldn't resist the visor she spotted during a shopping trip, so she added a tennis skirt and a sweater to complete her country club-themed ensemble.

It was a fun, silly day, the sort that it had taken them a long time to enjoy again after Dec. 14, 2012, when they'd huddled in darkened classrooms while 20 of their schoolmates were shot dead in another at Sandy Hook Elementary.

And then came the news of a school massacre in Texas, and all of them felt as if they were in third grade again. It was the year that had defined their young lives. They'd never escaped it, at least not for long.

Camille, now 18, flashed back to the moment she stumbled out of the building, her hands on the shoulders of the girl in front of her. Her mother soon found her, and began shouting when a TV reporter tried to shove a microphone into Camille's face.

For years, Camille's trauma surfaced through debilitating panic attacks. They would hit her during swim practice, because the moment she felt short of breath, her body would unravel. She'd sit on the edge of the pool deck, crying and shaking.

Their freshman year, on the day of the Sandy Hook anniversary, a threat to the elementary school forced students there to evacuate. When Camille found out, she collapsed to the floor in her French class and couldn't move. She couldn't see or hear, either. She felt like she was suffocating.

Lately, migraines and nausea have replaced the panic attacks, and Camille suspects she knows why. She's leaving Newtown, and with it, all the people who understand the day that shaped her. She's sensed the discomfort that strangers feel when they hear about what she's been through, and she worries that the people she meets in college will react the same way.

Rayna, now 17, understood. She was the girl whose shoulders Camille held when they were fleeing. Tuesday took her back to the brick firehouse just up the road from Sandy Hook. The people in charge were trying to figure out who was accounted for and who wasn't. One whole class, Rayna noticed, was missing.

At first, Rayna couldn't stand to be by herself. She couldn't shower with the door closed or walk down the stairs in her own house alone. She could never be left there without someone, even if her mom was only leaving for a five-minute errand.

Rayna still can't go inside anywhere without thinking through how she would get out — at restaurants, she notes the exits before she decides what to order; at school, she plots how she would escape if another gunman showed up.

For Maggie, Tuesday had been a difficult day even before she heard about Uvalde. She works at an ice cream shop in Newtown, and another girl who is a fellow survivor was passing her a pint when someone else dropped a box. The slam against the floor sounded like a distant gunshot, a noise she knew well.

The pint slipped from her friend's hand, and Maggie, 18, felt the air rush from her lungs. The girls held hands, waiting for the fear to subside.

It wasn't until that evening, past 9, that she checked her phone. A batch of voice mails and texts about Texas awaited her. She rushed home to be with her parents and all of them cried together. They'd done that before.

Maggie's best friend in 2012 was a boy named Daniel Barden. She was in third grade and he was in first, but they liked to dance to Taio Cruz's "Dynamite" and play pirates together on the Bardens' swing set.

On some evenings, when he was learning to read, they sat together on a big rock near their homes and she pointed at the words in a Little Critter book.

By nightfall on Dec. 12, Daniel still hadn't been found, so she, her family and the Bardens all gathered at another neighbor's house. They wouldn't go home, they'd decided, until Daniel did, too.

Then the call came, and Maggie learned that she would have to go home, even though Daniel never would.

The most enduring consequence of the shooting for Maggie was what his killing did to her. Afterward, she hesitated to connect with people. She had lost the best friend she ever had. Making new ones meant she would only have somebody else to lose.

- - -

What makes America's youngest school shooting survivors the most vulnerable to lasting trauma is their view of the world around them, said Bruce Perry, a psychiatrist who has worked for years with grieving families. Most teenagers have grown to accept that adults can't always protect them, a reality that many elementary-schoolers don't understand.

"In general, the more a traumatic experience shatters your world view," Perry said, "the harder it is to recover."

Zoey Hall was only 4 years old on the afternoon that a shooter came to her school on Sept. 28, 2016, and she remembers almost everything about it, even though the people who love her wish she didn't.

The memories might have faded by now if Zoey hadn't refused to let them go. It was the worst day of her life but it was also the last one she spent with her 6-year-old brother, Jacob. The last day she called him "Bubba" and he called her "Sissy." The last day he held her hand and walked her into Townville Elementary.

Mostly, though, there are the bad memories, the ones that come back — as they did again this week — when she hears that what happened to Jacob in rural South Carolina has happened again to other kids in some other place.

"I felt sad and scared, at the same time," Zoey, now 9, said of her reaction to the news she'd heard about Uvalde. She understood what some of those children had endured, because Zoey had endured it, too. Once, when she was just 6, she sat on the bedroom floor at her grandparents' house and explained, in striking detail, her memories of losing her brother.

She took out her tablet and pointed at a photo she'd found online of the 14-year-old shooter, who by then had received a life sentence for murdering Jacob . Zoey knew all that, and much more.

"First, he shot his father. Then he came to the school ... and Miss Fredericks, our, umm, what's" — she paused, looking at her grandmother, Sandra McAdams, for help, until the word came to her — "principal. She came on the announcement saying to get in the bathroom, and we got in the bathroom. It was when I was in 4K."

McAdams, who she called "Nanny," watched in silence, eyes welling as she sat atop a "PAW Patrol" comforter on the bottom mattress of the bunk bed Zoey shared with her younger brother.

"And our teachers told us to be quiet," Zoey continued, putting an index finger over her mouth. "And they was both holding the door shut, but they had it locked so nobody could break in. And when it was over, we unlocked the bathroom and we went out the back door ... I saw Nanny, and she picked me up and said, 'Where's Jacob? Where's Jacob?' And then they said he had been flew into Greenville Memorial Hospital, and they did all they could to keep him alive. He lost so much blood. And they shot him right there," Zoey said, pointing to her right leg.

Zoey had thought about what caused it all, too, and she announced what she thought the country should do about it.

"I think all the guns should be in the trash can where nobody could buy them guns, where they won't shoot people," she said. "Because guns are not good for people."

Ava Olsen thought the same thing. She adored Jacob, the smallest child in their first-grade class. He would hold her hand by the swings when no one was looking. She called him "Jakey" and imagined they would get married one day. He was the only boy she'd ever kissed.

Ava had been out on the playground with him that day, but she'd escaped. Distraught, she wrote letters in 2018 to elected leaders — including then-President Donald Trump and her state's Republican senator Lindsey Graham — explaining what she'd witnessed and pleading with them to do something about it.

They didn't, and eventually she stopped sending her letters.

Ava, who'd run away when the shooting started, suffered from crippling post-traumatic stress in its aftermath. She was prescribed antipsychotics and antidepressants and began hitting herself and yanking out her eyelashes. Her parents withdrew her from school.

Ava is 12 now and doing better. She has started playing basketball and soccer, activities in crowded, noisy places that would have overwhelmed her with anxiety five years ago.

What she still cannot bear, and what her parents try hard to hide from her, is the news of other school shootings.

On Tuesday evening, she was sitting on her living room couch, watching funny cat videos on TikTok. Then a different kind of video popped up. It showed that more than a dozen children had been shot dead at an elementary school in Texas.

She started screaming, and her mother rushed into the room.

"Why?" Ava cried. "Why?"

The Washington Post's Joanna Slater, Razzan Nakhlawi,Meryl Kornfield and Ian Shapira contributed to this report.