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.
Types of Traumatic Events
Some situations that could be potentially traumatic for a child include the following, although this list is not exhaustive:
- 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
Signs of Childhood Trauma: What It Looks Like
The signs of trauma can vary from child to child. 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.
The response to traumatizing events can vary depending on the characteristics of the child, such as their age, developmental level, support system, and experiences.2 In many cases, the response may go beyond emotional symptoms.
Research has shown that trauma can compromise brain development, negatively impact behavioral and physical development, lead to mental health challenges, decrease cognitive abilities, and cause difficulties in the academic setting.3
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
- Increased feelings of sadness or intense fear
- Isolating self from family and peers
- Overreacting to situations that were once not a big deal
Signs of Trauma in Young Children
Young children may have a challenging time articulating their emotions and stressors related to traumatic experiences. Due to their difficulty expressing emotions and even preemptively following a traumatic event, it is crucial that parents/caregivers pay close attention to children’s behaviors and changes in behaviors. It should be noted that all children process trauma differently, and even children living in the same home might exhibit different reactions to the same traumatic event.
According to SAMHSA, symptoms that young children may experience include, but are not limited to:1
- Appetite changes
- Changes in sleep pattern
- Clinging more to parents/caregivers
- Crying more often than usual
Signs of Trauma in Pre-Adolescents
Pre-adolescence can be challenging for all children. Even at this stage, children may have a difficult time recognizing and articulating the traumatic experience, triggers, and ways to communicate when having a challenging time. Therefore, it is important for parents/caregivers at this age to open up and have genuine conversations about what children are experiencing to give them a safe space to express themselves.
Signs that parents/caregivers may notice amongst pre-adolescents include, but are not limited to:
- Easily triggered
- Hyper aroused
Signs of Trauma in Adolescents
Adolescents go through various transitions, from middle school to high school, high school to college, job, military, or other activities after high school. Adolescence brings about positive change that can also be stressful for some children, and in the midst of these changes, children also experience feelings of trauma, or be faced with a traumatic event.
Signs that parents/caregivers may notice include, but are not limited to:
- Changes in eating patterns
- Changes in peer groups or social activities.
- Changes in sleep patterns
- Using of drugs or alcohol to self-medicate
- Various emotions that were not there in the past such as anger, depression, hopelessness
Symptoms of Childhood Trauma
While symptoms may vary from child to child, it is important as parents/caregivers to listen to when children are expressing their concerns and thoughts related to what they are experiencing. At times, this can be challenging for children due to having limited vocabulary to articulate what they are experiencing. The symptoms that children experience may be physical, behavioral, and/or emotional.
Some common symptoms that children may experience are:
- 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
- Various emotions (ex. sadness, anger, irritable)
Reactions to Trauma
Traumatic events for children cause various reactions. The SAMHSA states that when one is assessing trauma, they should consider the “3 Es” of trauma: the event, the experience and the effects.4 It is important to note that not all exposure to trauma leads to a diagnosis of Post-Traumatic Stress Disorder (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.4
The Lasting Effects of Childhood Trauma
If not addressed, childhood trauma can have a lasting impact on children. 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 school work, exhibit inattentiveness, show a lack of respect for authority figures in the academic setting, and/or experience a general decline in overall academic performance.
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 of Disease Control (CDC), traumatic experiences can have lasting negative effects on health, well-being, and opportunity.5
According to the CDC, these adverse childhood experiences can increase the risks of physical health concerns such as cancer, heart disease, diabetes, and suicide. There are other risk factors associated with adverse childhood experiences that parents/caregivers must be mindful of, and ensure that protective factors are put in place to support children as preventative measures, and also additional supports, when a child is facing life changing events.
Treatment of 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, treatment for trauma often includes cognitive behavioral techniques, particularly trauma-focused cognitive behavior therapy, in addition to techniques developmentally appropriate for children and adolescents.
Other techniques used include, but are not limited to, Child and Family Traumatic Stress Intervention,Cognitive Processing Therapy and Narrative Exposure Therapy. Any form of treatment should focus on trauma-informed practices that aim at not re-traumatizing children while processing their concerns.
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.
The Child and Family Traumatic Stress Intervention (CFTSI)
According to the National Child Traumatic Stress Network, CFTSI is a preventative model for children between the ages of 7-18 and is normally done in 5-8 sessions for children.6 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.
Cognitive Processing Therapy (CPT)
CPT normally takes place during 12 sessions with the goal of challenging beliefs that are not helpful in processing the trauma of the client.7 One 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). In CPT, a child learns new techniques to reframe the trauma and helpful skills to manage thoughts that may be triggering.
Narrative Exposure Therapy (NET)
According to the American Psychological Association (APA), Narrative Exposure Therapy (NET) is often used in group or community settings to assist children with complex trauma.7 Some of these events can vary based on the exposure of the child.
This modality seeks to reframe trauma in a manner that allows the child 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. NET can normally be completed in about 4 to 10 sessions.7
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
Trauma-focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based practice for children and adolescents who have symptoms related to trauma. Sessions for this treatment normally range from 8-25 sessions. However, it is important for parents/caregivers to realize that the number of sessions may vary depending on several factors.
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.8
Medication: Who Prescribes & What Is Most Common
In addition to PTSD, there are other diagnoses that children may experience when exposed to traumatic events, such as Attention Deficit Hyperactivity Disorder, Anxiety, or Depression.
Parents/caregivers should consult with their child’s pediatrician or a child psychiatrist if they believe their child is experiencing any of these conditions. 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.7 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.
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.
How to Get Help for Childhood 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.
Childhood Trauma Statistics
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
Helping Your Child Cope with Trauma
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 is a list of tips to help your child cope:
- 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.