Many children experience traumatic events throughout their lifetimes. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), by sixteen, more than 67% of children will have experienced at least one traumatic event in their life.1 When a child experiences trauma, it is imperative for parents/caregivers to seek out support for the child to assess the impact and develop a support plan.
What Is Childhood Trauma?
Childhood trauma can look very differently depending on the situation and the individual, but generally, childhood trauma is when a child experiences, witnesses, or hears about any threatening or dangerous situation. All trauma is not equal, though, as something that was traumatic for one person could be seen as typical or easily resolved for someone else.
Childhood Trauma & PTSD
Traumatic events for children cause various reactions, and for some can lead to Post-Traumatic Stress Disorder (PTSD), but it is important to note that not all exposure to trauma leads to a diagnosis of PTSD. The duration and perceived severity of trauma in conjunction with protective factors, such as whether or not the individual has safe and supportive surroundings, plays a large part in whether or not an individual develops PTSD.
However, PTSD can occur in anyone who has experienced trauma. These traumatic experiences can be an isolated event or series of events, both of which can have traumatic effects into adulthood.2
What Experiences Might Be Traumatic?
Some situations that could be potentially traumatic for a child include:
- Institutional racism in schools or communities
- Living with a parent/caregiver with significant mental illness
- Loss of a loved one due to various circumstances (e.g. death, divorce, separation)
- National disasters or terrorism
- Parental incarceration
- Violence in the home, school, or community
- Witnessing or experiencing domestic violence
*This is not an exhaustive list, and many events or experiences can be traumatic
How Common Is It?
Millions of children deal with traumatic events throughout their lifetime. However, it is important for children to know that they are not alone when going through difficult times. Many children experience traumatic events in schools, communities, and homes that could be traumatic in nature.
According to SAMHSA:1
- Many children are abused and neglected in the United States, with over 680,000 children being abused in 2015
- 25% of high school students were in at least 1 physical fight
- Bullying is common for high school students, where 1 in 5 students had been bullied at school and 1 in 6 experienced cyberbullying
- 17% of Children 12-17 years old reported being physically abused
- Over 50% of families have been impacted by some type of disaster
Signs & Symptoms of Traumatic Stress in Children
The signs of trauma and PTSD in children can vary greatly. However, it is important for parents/caregivers to keep a close eye on children to see if they notice any changes in behavior, academic performance, eating patterns, or sleep patterns specifically after a life changing event that could possibly be traumatic to a child.
Potential signs of trauma that parents/caregivers, or others who interact with the child, may notice include, but are not limited to:
- Avoidance of certain people, places, and things
- Changes in academic performance
- Changes in behavior
- Constant worrying or anxiousness
- Difficulty focusing
- Hyperactivity
- Increased feelings of sadness or intense fear
- Isolating self from family and peers & hyper-independence
- Overreacting to situations that were once not a big deal
- Avoiding activities that they once use to enjoy
- Trouble focusing in situations that were once easy to focus on
- Changes in appetite
- Difficulty sleeping
- Problems with authority figures
- Volatile emotions (ex. sadness, anger, irritable)
The response to traumatizing events can vary depending on the characteristics of the child, such as their age, developmental level, support system, and experiences.3 In many cases, the response may go beyond emotional symptoms.
Signs of Lingering Childhood Trauma in Adults
With time, maturity, or professional treatment, some people will be able to process and recover from their childhood trauma. Other people will continue being influenced by the unwanted events from childhood and carry these feelings into adulthood.
Some signs of childhood trauma that can linger into adulthood include:
- Poor, unfulfilling, or chaotic relationships
- Lack of trust in others
- Mood changes and emotional instability
- Problems with focus, attention, and concentration
- Problematic substance use
- Anger and aggression
Impacts of Childhood Trauma
If not addressed, childhood trauma can have a lasting impact on children in many different aspects of their lives, including emotionally, physically, and in relationships.
Mental Health Impacts
Trauma, especially childhood trauma, increases the risk of many mental health disorders. Not only is there a greater chance of post-traumatic stress disorder, but the events may result in other psychological conditions like:
- Depressive disorders
- Anxiety disorders
- Obsessive-compulsive disorder (OCD)
- Bipolar disorders
- Substance use disorders
Relationship Issues
Many childhood traumas involve a trusted loved one, a caregiver, or even a family member. These events can deteriorate feelings of trust, safety, and security. People could find maintaining old or establishing new, healthy relationships very challenging.
Difficulty in School
Exposure to traumatic experiences has a lifelong effect on learning and may have a negative impact on a child’s short- and long-term academic achievement. The negative impact may manifest itself in various ways. Children may avoid school and schoolwork, exhibit inattentiveness, show a lack of respect for authority figures in the academic setting, and/or experience a general decline in overall academic performance.
Physical Symptoms
As children get older and grow into adulthood, the ACE Study has shown that trauma symptoms can manifest physically as well. According to the Center for Disease Control (CDC), traumatic experiences can have lasting negative effects on health, well-being, and opportunity.4 Adverse childhood experiences can increase the risks of physical health concerns such as cancer, heart disease, diabetes, and suicide.
Other Impacts
The possible direct and indirect impacts of childhood trauma are nearly endless. For example, someone with trauma could struggle in school and then end up dropping out early, which leads to low income, poor housing, and exposure to additional trauma. Trauma not only impacts the individual who has been traumatized. In many cases, their families, friends, coworkers, and classmates struggle with the events and the influence of the events.
How to Help Children Who Have Experienced Trauma
If your child has experienced a traumatic event, it is imperative as a parent/caregiver to provide support and to also seek out professional help for your child to assess their needs. The first step should be to visit your child’s pediatrician to assess the symptoms and ensure that what he/she is experiencing is not a physical or medical illness.
Once physical causes of the symptoms are addressed, you should seek out mental health services to support your child. Many pediatricians can provide contact information for mental health providers that specialize in child and adolescent counseling.
When looking for a mental health provider for treatment of childhood trauma, take your time and seek out someone who has the expertise in trauma-informed care specializing in children and adolescents. You may research mental health providers who specialize in children and adolescents by using an online directory, getting a list of providers from your insurance company, getting a referral from your child’s pediatrician, and/or getting a recommendation from a colleague, friend, or family member.
The following are essential considerations when finding a mental health professional to support your child if she/he has experienced a traumatic event:
- Check to see if the therapist is accepting new patients.
- Ensure that the provider focuses on children’s mental health.
- Ensure that they practice trauma-informed practices, especially as they relate to children and adolescents.
- Encourage collaboration with your child’s therapist and school to support the child in the academic setting.
- Ask if the therapist accepts your insurance plan or offers affordable cash payment options.
Treatment Options for Childhood Trauma
When a child is exposed to a traumatic event, it is important for a parent/caregiver to seek out mental health support to assess the needs of the child. Treatment for children who have been exposed to trauma may vary based on the mental health diagnosis. Depending on the diagnosis, healing from childhood trauma often includes therapy such as cognitive behavioral techniques, particularly trauma-focused cognitive behavior therapy, in addition to techniques developmentally appropriate for children and adolescents, such as art therapy for children.
In addition to PTSD, there are other diagnoses that children may experience when exposed to traumatic events. Trauma may influence ADHD, anxiety, or depression in children. Parents and caregivers should consult with their child’s pediatrician or a child psychiatrist if they believe their child is experiencing any of these conditions.
It is also key when parents/caregivers are seeking out treatment for children to identify a mental health professional who has expertise in working with children exposed to trauma.
Therapy Options
There are several evidence-based types of therapy that can work to treat childhood trauma:
- The Child and Family Traumatic Stress Intervention (CFTSI): The goals of CFTSI are to reduce post-traumatic stress symptoms and at the same time support parents/caregivers by increasing communication amongst them, and providing healthy coping strategies for children to cope in spite of the reactions that they may face related to the traumatic event.5
- Cognitive Processing Therapy (CPT): The main goal of CPT is to help the client decrease thoughts that are limiting and barriers to the client thriving in spite of the traumatic event(s).6
- Narrative Exposure Therapy (NET): NET seeks to reframe trauma in a manner that allows someone to contextualize the traumatic experience(s) in order to decrease the overarching power the trauma has in the child’s life. This therapeutic model asks children to recount life events, but in a way that brings into focus positive thoughts of self.6
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): Specifically designed for children, TF-CBT combines psychoeducation and cognitive techniques to teach children and parents/caregivers how to express themselves, learn cognitive coping skills to deal with stressors, develop relaxation skills, create and process trauma narratives, and manage behaviors that could be detrimental to outcomes.7
- Sensorimotor Psychotherapy: The goal of sensorimotor psychotherapy is to address and heal ongoing psychological and physical difficulties related to trauma by integrating body movement into traditional talk therapy.
Medication
Medications often first used to treat PTSD are in the category of selective serotonin reuptake inhibitors (SSRIs). SSRIs are recognized as effective medications to aid in relief from mood and anxiety disorders as well.6 Depending on the child’s symptoms, other categories of medicine may also be considered.
SSRIs are not safe for everyone, especially when there are co-occurring disorders that require medications which might interact adversely with other medications. Any time medications are given to children, they should be discussed with the child in an age-appropriate manner.
Lifestyle Changes
When considering lifestyle changes to support children who have experienced traumatic events, it is important to ensure that children get the professional help that they need on top of these changes. One main goal in determining lifestyle changes is to avoid re-traumatizing children
The following lifestyle changes for children may be great additions to a treatment plan designed by a mental health professional:
- Ensure that the child gets enough sleep for his/her age
- Teach the child relaxation techniques appropriate for his/her developmental level (e.g. deep breathing techniques, positive visualization, positive affirmations)
- Encourage children to get exercise and engage in activities that bring them joy
- Practice eating healthy foods that refuel them
- Help them reframe negative thoughts
- Encourage them to identify people who are a part of their support system and encourage them to spend quality time with them
Helping Your Child Cope With a Traumatic Experience
Seeing your child deal with a traumatic event can be painful as a parent/caregiver. However, it is imperative for parents/caregivers to support children who have experienced a traumatic event by ensuring they get the support that they need to thrive in spite of the trauma.
Here are several ways to help your child recover from trauma:
- Educate yourself as a parent/caregiver on the topic of trauma
- Become aware of your child’s triggers
- Take your child to see a licensed mental health therapist to assess the needs of the child
- If your child is prescribed medication, make sure he/she takes the medication regularly and as prescribed
- Give children an emotionally safe space to express themselves when dealing with situations that could be traumatic
- Practice taking care of yourself as a parent/caregiver and seek out mental health support if you need it
- Collaborate with your child’s school to make sure he/she receives appropriate academic support when facing social and emotional stressors
- For emergency situations, always call 911, as well as the National Suicide Prevention Lifeline at 1-800-273-8255
For Further Reading
- Best Books on Trauma & PTSD
- Centers for Disease Control and Prevention of Adverse Childhood Experiences
- ChildTrauma Academy
- Harvard University Center on the Developing Child
- SAMHSA’s National Child Traumatic Stress Initiative
- The National Child Traumatic Stress Network
- 10 Tips On How to Heal From Trauma
