PTSD can affect people at any age who have experienced a traumatic event. Children with PTSD may appear anxious, depressed, and have difficulty sleeping. They may isolate themselves from family and peers and struggle to concentrate in school. Trauma-informed care is available for children with PTSD and can help them recover.
What Is PTSD?
Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after a person experiences a traumatic event.1,2 A traumatic event is an experience that involves violence, death, or danger. It can be an isolated event, like a natural disaster or car accident, or a recurring experience, like abuse.
The person may experience the event themselves, witness it happen to someone else, or hear of it happening to a loved one. This condition can affect people of all ages. In fact studies have found that between 14% and 43% of children and teens have experienced at least one instance of childhood trauma.3 Between 3 percent and 15 percent of girls and 1 percent and 6 percent of boys go on to develop PTSD after trauma.
PTSD Symptoms in Children
PTSD is a reaction to trauma. People with PTSD re-experience the traumatic event in some way, engage in avoidance, and experience anxiety and mood changes.1,2 While people of all ages can develop PTSD, it can present differently in children vs. adults.4
Some PTSD symptoms in children include:4,5
- Difficulty remembering details of the traumatic event
- Confusion around the sequence of events
- “Omen formation,” which is a belief that the child could have predicted or foreseen the trauma and possibly prevented it
- Post-traumatic play, where children act out the trauma
- Fear and helplessness
- Depression
- Anger
- Aggressive behavior
- Nightmares
- Difficulty sleeping
- Avoidance of people, places, or things that remind them of the traumatic event
- Conflict with family and peers
- Physical symptoms, like stomachaches and headaches
Signs of PTSD in Children
Children with PTSD may show different signs depending on their age.6 For example, young children may cry and cling to their parents, while teens may be more likely to act out by using drugs or alcohol, self-harming, or having sex. You may notice changes in different areas of your child’s life, like school, friendships, and how they eat and sleep.
Common signs of PTSD in children are:6
- Feelings of anxiety, depression, guilt, and/or shame
- Distress when separated from a parent or caregiver
- Excessive crying or screaming
- Changes in weight or appetite
- Sleeping problems
- Poor concentration
- Drug or alcohol use
- Self-harming
- Disordered eating, like binging or restricting their food
- Engaging in risky sexual behaviors
Causes of PTSD in Children
Any event where a child feels that their life or the life of someone they care about is threatened can lead to PTSD. Certain risk factors can increase the likelihood that a child who experiences a trauma goes on to develop PTSD, including family problems, a lack of social support, having a parent with mental health issues, and a history of emotional problems.4,5
Some common causes of PTSD in children include:4
- Sexual, physical, or emotional abuse
- Natural disasters like hurricanes, fires, or tornadoes
- School shootings
- Kidnapping
- Car accidents
- Suicide of a friend or family member
- Domestic violence at home
- Community violence
- War
Experiencing one of these traumatic events does not guarantee that your child will develop PTSD. Some people can experience trauma and not show signs of PTSD. Having a good support system and getting treatment early on may help children cope more effectively with and reduce the likelihood of them developing PTSD.4,5 Conversely, if there is ongoing trauma, like recurring domestic abuse, a child may develop C-PTSD instead of PTSD.
9 Tips for How to Care for a Child With PTSD
As a parent or caregiver, you play a vital role in supporting a child with PTSD. Giving your child an opportunity to talk about their trauma, supporting them, and encouraging positive habits can help them cope with their symptoms. Also taking good care of yourself is important so you can be the best possible support.
Here are nine ways parents and caregivers can help children with PTSD:
1. Create a Safe Environment for Them to Talk About Their Trauma
Children may vary in how comfortable they are talking about their trauma. Explain that you are here to talk if they would like, but don’t pressure them to open up before they are ready.
2. Acknowledge Their Feelings
Hearing your child talk about their trauma can be difficult and you may feel like there is nothing you can do to “fix” it. Instead, focus on listening and expressing empathy. Use feeling words to help children label their emotions (e.g., “scared,” “worried,” or “sad”).
3. Avoid Harsh Discipline
Children who have experienced trauma, particularly those that have been abused, can be further traumatized by harsh forms of discipline, like spanking. When discipline is necessary, stick to gentler approaches, like taking away electronics. Always try to ensure that the punishment is fair and remember to offer praise when they exhibit good behavior.
4. Support Their Self-Confidence
Children with PTSD often have low self-esteem, especially if their trauma involved abuse. You can help encourage their confidence by highlighting their strengths. Also be sure to refrain from name-calling or putting down the child, even when they misbehave.
5. Create a Schedule
Children who are dealing with emotional concerns like PTSD can benefit from structure and a schedule. Come up with a consistent wakeup and bedtime and encourage them to eat regular meals and get good sleep. This gives them stability, which is important for trauma survivors.
6. Encourage Good Sleep Hygiene
Children with PTSD often have difficulty sleeping and may struggle with nightmares. You can help your child sleep well by encouraging a consistent bedtime, limiting sugar, caffeine, and liquids before bed, and doing a relaxing activity each night. If your child continues to struggle with sleep, speak with their pediatrician about other options.
7. Encourage Their Participation in Positive Activities
Isolation is a common response to trauma. Try to help your child engage in positive and healthy activities, like joining a sports team or club. If they are too anxious, you can agree to go with them in the beginning and then gradually encourage them to do it on their own for longer periods of time.
8. Teach Them Healthy Coping Techniques
Children who are dealing with PTSD can benefit from learning healthy coping skills, like mindfulness or grounding techniques. These skills can help reduce anxiety and promote calm. Consider learning about them and practicing together as a family.
9. Engage in Your Own Self-Care
As a parent, it’s important that you also take care of your own physical and emotional needs. This allows you to be a better support to your child and models healthy behavior. Be sure to do positive, healthy activities for yourself and don’t hesitate to seek your own therapy if needed.
Treatment for PTSD in Children
If your child has experienced a traumatic event, consider seeking professional help for them, even if they’re not showing signs of PTSD. Getting help shortly after a trauma may help prevent PTSD.5 If your child is already showing signs of PTSD, talk to their pediatrician or find a therapist using a therapist directory where you can search for those with expertise in childhood trauma and trauma-informed care.7
Therapy
Cognitive behavioral therapy (CBT) is commonly used for children with PTSD.5 While it was originally intended to treat depression and anxiety, it’s been adapted to help with PTSD. Trauma-focused cognitive behavioral therapy (TF-CBT) is also designed for this purpose.4 It focuses on changing negative thoughts and beliefs related to the trauma and teaching children coping skills to manage anxiety.
Cognitive processing therapy (CPT) is another type of CBT that has been used with children who have experienced trauma.8 It also helps them change negative thought patterns and develop more adaptive ones, but it is typically limited to 12 sessions.
Young children may benefit from play therapy, which uses toys, games, and art to help children talk about and process their trauma.4 Eye movement desensitization and reprocessing (EMDR) is another type of treatment where a therapist asks a client to recall the trauma while engaging them in side-to-side rapid eye movements.5
Final Thoughts on PTSD in Children
Supporting a child with PTSD can be difficult. Knowing the signs of childhood trauma and PTSD can give you a sense of what to look for in your own child. If you suspect that your child is dealing with PTSD, don’t hesitate to reach out for help today.
For Further Reading
If you’d like more resources pertaining to PTSD in children, consider self-help books on PTSD or refer to trusted organizations for more information and guidance.
Here are additional resources on PTSD symptoms in children:
