How Children React to Trauma

When a child feels intensely threatened by an event he or she is involved in or witnesses, we call that event a trauma.

Child traumatic stress (CTS) is a psychological reaction that some children have to a traumatic experience. There are numerous kinds of traumas, such as:
  • Automobile accidents
  • Serious injuries
  • Acts of violence
  • Terrorism
  • Physical or sexual abuse
  • Medical procedures
  • The unexpected death of a loved one
  • Life-threatening natural disasters
Children who suffer from CTS have developed reactions to trauma that linger and affect their daily lives long after the traumatic event has ended. These children may experience:
  • Intense and ongoing emotional upset
  • Depression
  • Anxiety
  • Behavioral changes
  • Difficulties at school
  • Problems maintaining relationships
  • Difficulty eating and sleeping
  • Aches and pains
  • Withdrawal
  • Substance abuse, dangerous behaviors, or unhealthy sexual activity among older children

Traumatic Stress and Young Children

Think of what it is like for young children to be in traumatic situations.
  • Young children can feel totally helpless and passive.
  • Young children can cry for help or desperately wish for someone to intervene.
  • Young children can feel deeply threatened by separation from parents or caretakers.
  • Young children become particularly upset when they hear cries of distress from a parent or caretaker.
  • Young children rely on a protective shield provided by adults and older siblings who can judge the seriousness of danger and ensure their safety and welfare.
  • Young children often don’t recognize a traumatic danger until it happens —for example, in a near drowning, an attack by a dog, or an accidental scalding.
  • Young children can be the target of physical and sexual abuse by the very people they rely on for their protection and safety.
  • Young children can witness violence within the family or be left helpless after a parent or caretaker is injured, as might occur in a serious automobile accident.
It is extremely difficult for very young children to experience the failure of being protected by adults when something traumatic happens.
  • Young children may become passive and quiet, easily alarmed, and less secure about being provided with protection.
  • Their minds may stay on a central action, like being hit or seeing someone fall to the floor.
  • Young children may have simple thoughts about protection, for example, “Daddy hit mommy, mommy call police.”
  • Young children can become more generally fearful, especially in regard to separations and new situations.
  • In circumstances of abuse by a parent or caretaker, the young child may act confused as to where to find protection and where there is threat.
  • A child may respond to very general reminders of a trauma, like the color red or the sounds of another child crying
The effects of fear can quickly get in the way of recent learning. For example, a child may start wetting the bed again or go back to baby-talk. Because a child’s brain does not yet have the ability to quiet down fears, the preschool child may have very strong startle reactions, night terrors, and aggressive outbursts.

Traumatic Stress and School-Aged Children

School-age children start to face additional dangers, with more ability to judge the seriousness of a threat and to think about protective actions.
  • School-age children usually do not see themselves as able to counter a serious danger directly, but they imagine actions they wish they could take, like those of their comic strip heroes.
  • In traumatic situations when there is violence against family members, they can feel like failures for not having done something helpful.
  • School-age children may also feel very ashamed or guilty.
They may be without their parents when something traumatic happens, either on their own or with friends at school or in the neighborhood. Sexual molestation occurs at the highest rate among this age group.

The reactions of school-age children after a trauma include a wide range of intrusive images and thoughts.

School-age children think about lots of frightening moments during their traumatic experiences. They also go over what could have stopped them from happening and what could have made them turn out differently.

School-age children respond to very concrete reminders about the trauma, such as:
  • Someone with the same hairstyle as an abuser
  • The monkey bars on a playground where a child got shot
  • A feeling of being alone inside like they had when one parent attacked the other
They are likely to develop intense specific new fears that link back to the original danger. They can easily have fears of recurrence that result in their avoiding even enjoyable things they would like to do.
  • More than any other group, school-age children may go back and forth between shy or withdrawn behavior and unusually aggressive behavior.
  • School-age children can have thoughts of revenge that they cannot resolve.
  • Normal sleep patterns can be easily disturbed. They can move around restlessly in their sleep, vocalize, and wake up tired.
  • Their lack of restful sleep can interfere with their daytime concentration and attention.
  • It can then be more difficult for them to study because they remain on alert for things happening around them.

Traumatic Stress and Adolescents

With the help of their friends, adolescents begin a shift toward more actively judging and addressing dangers on their own. This is a developing skill, and lots of things can go wrong along the way. With independence, adolescents can be in more situations that can turn from danger to trauma. They could:
  • Be drivers or passengers in car accidents
  • Be victims of rape, dating violence, and criminal assault
  • Be present during school or community violence
  • Experience the loss of friends under traumatic circumstances
During traumatic situations, adolescents make decisions about whether and how to intervene, and about using violence to counter violence.

They can feel guilty, sometimes thinking their actions made matters worse.

Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger. They are also learning more about human motivation and intent and struggle over issues of irresponsibility, malevolence, and human accountability.

Adolescents are particularly challenged by reactions that persist after traumatic experiences.
  • Adolescents can easily interpret many of these reactions as being regressive or childlike.
  • Adolescents may interpret their reactions as signs of “going crazy,” of being weak, or of being different from everyone else.
  • Adolescents may be embarrassed by bouts of fear and exaggerated physiological responses.
  • Adolescents may harbor the belief that they are unique in their pain and suffering.
These reactions may result in a sense of personal isolation. In their posttrauma thoughts, adolescents think about behavior and choices that go back to well before a traumatic situation. They are also very sensitive to the failure of family, school, or community to protect them or carry out justice. Afterward they may turn even more to peers to judge risks and to take protective action. They may be especially “grossed out” or fascinated by grotesque injury or death and remain very focused on their own scars that serve as daily trauma reminders.

While younger children may use play, adolescents may respond to their experience through dangerous reenactment behavior, that is, by reacting with too much “protective” aggression for a situation at hand. Their behavior in response to reminders can go to either of two extremes: reckless behavior that endangers themselves and others, or extreme avoidant behavior that can derail their adolescent years.

The avoidant life of an adolescent may go unnoticed.
  • Adolescents try to get rid of posttrauma emotions and physical responses through the use of alcohol and drugs.
  • Their sleep disturbance can remain hidden in late night studying, television watching, and partying.
  • It is a dangerous mix when adolescent thoughts of revenge are added to their usual feelings of invulnerability.
The National Child Traumatic Stress Network
Understanding Child Traumatic Stress

Positive Coping Strategies for Families:

  • Maintain your normal schedule
  • Healthy eating and sleeping routines
  • Spend time doing enjoyable activities together-go on a walk together, play games, watch a favorite movie or read books
  • Talk with children when they initiate conversations about what happened and listen to their concerns
  • Seek counseling, if needed