When Children Are Battled Scarred: Signs And Symptoms Of PTSD In Children

Medically reviewed by Andrea Brant, LMHC
Updated April 29, 2024by BetterHelp Editorial Team
Content Warning: Please be advised, the below article might mention trauma-related topics that include abuse which could be triggering to the reader. If you or someone you love is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

Upon hearing the phrase post-traumatic stress disorder, many of us likely think of combat-related PTSD, sometimes called shell-shock or battle fatigue. However, PTSD can occur in anyone, of any age—including children. While PTSD in children still occurs as a response to a traumatic event, the signs and symptoms of this disorder may present differently in children than they do in adults. However, just as with adults, it is possible to treat the symptoms of PTSD in children.

Caring for a child experiencing PTSD can be difficult

The symptoms of PTSD in children

According to the most recent Diagnostic and Statistical Manual of Mental Disorders, the diagnostic criteria for PTSD are separated based on age. Children ages six and older and adults must exhibit one set of symptoms while children younger than six must display different symptoms.

No matter the child’s age, they must first be exposed to a traumatic event such as a threat of death, sexual abuse, serious injury, or natural disaster. The child can experience the event firsthand, witness the event occurring to others, or learn that the event has impacted a family member or caregiver. Children ages six years and older may also have experienced trauma through repeated exposure to details of a traumatic event.

All children must then experience one or more of the following symptoms:

  • Distressing memories of the event; in children this may occur as seemingly innocently reenacting the experience through play.
  • Recurrent distressing dreams related to the event; for young children the dreams may not contain content related to the event.
  • Flashbacks of the event; this may occur as a reenactment during play for children.
  • Intense or long-lasting psychological distress that occurs as a response to internal or external items that symbolize the event.
  • Physiological reactions to reminders of the event.

Along with displaying one of the above symptoms, children must also avoid stimuli that remind them of the event in order to be diagnosed with PTSD. This may be evidenced by one or both of the following:

  • Avoiding memories or feelings related to the event.
  • Avoiding people, places, items, and situations that serve as reminders of the traumatic event.

The noticeable changes in “arousal and reactivity” vary depending on the age of the child, but all children must experience at least two of these changes. Children of all ages may experience the following, and children over six may also experience trouble concentrating.

  • Trouble falling or staying asleep
  • Irritable behavior; angry outbursts like temper tantrums
  • Difficulty concentrating
  • Hyper-vigilance
  • Heightened startle response

Finally, children must also experience changes in mood and/or cognition. 

Children under six may experience the following:

  • Increased feelings of negative emotions including fear, guilt, and sadness
  • Decreased interest/participation in activities such as play
  • Social withdrawal
  • Expressing fewer positive emotions

Children over six must exhibit two or more of the following:

  • Lack of memory regarding major aspects of the traumatic event.
  • Negative beliefs or expectations about the world, oneself, or others.
  • Blaming oneself for the occurrence of the traumatic event.
  • Persistent feelings of negative emotions such as fear, horror, anger, guilt, or shame.
  • Decreased interest or participation in major activities like school, sports, or play.
  • Feeling removed from others.
  • Persistent inability to feel positive emotions.

The above symptoms must occur for at least a month. Additionally, they must harm relationships or the ability to function in school.


Diagnosing PTSD in children

As mentioned above, the symptoms of PTSD in children can be diverse and may present differently in children of different ages. For example, older children may experience flashbacks that cause them to dissociate from the world around them. However, when younger children experience flashbacks, they may reenact the experience through playing with toys or other kids.

While children must experience a traumatic event to develop PTSD, other factors may increase the likelihood of the onset of PTSD. These include a poor support network, experiencing more than one traumatic event, and other psychiatric challenges. A mental health professional can take these factors into consideration when they are evaluating a child.

While parents and caregivers may notice signs of PTSD in their children, other adults should also be on the lookout for signs of trauma in children. Teachers, camp counselors, and doctors are all classified as mandated reporters. This means that if they suspect the child is experiencing abuse, they must report it to the authorities. While not all children who experience trauma will develop PTSD, connecting these children with professionals will help them get the assistance they need to move forward from their trauma.

Treating PTSD in children

Although PTSD is a serious disorder, its symptoms can be treated. Treatment often involves helping the child feel safe. This may allow them to explore the truth of what happened during the event as well as express their feelings about it. Depending on the situation, the child may meet with a mental health professional on their own or with caregivers.

Various psychotherapeutic approaches can be used to help treat the symptoms of PTSD in children. However, one of the most used treatment approaches is trauma-focused cognitive behavioral therapy (TF-CBT). A recent review of studies involving treating PTSD in children found that psychological interventions can be an effective way to reduce symptoms of PTSD in children. It also found that there was little evidence to support the use of medication to improve PTSD symptoms in adolescents.

A 2007 study looked at the effect of CBT on 24 individuals with PTSD. The participants' ages ranged from 8 to 18. Some of these individuals received individual CBT for ten weeks and others were put on a waitlist. At the end of the ten weeks, 92% of those who received CBT no longer met the criteria for PTSD, while 42% of those on the waitlist no longer met the criteria. This suggests that CBT can help lessen the symptoms of PTSD in children and adolescents. 

Supporting a child experiencing PTSD

When a child is living with PTSD, it often affects more than the individual child. Parents, caregivers, family members, and teachers can also be impacted. Oftentimes, adults wish they could remove the traumatic event from the child’s past or help remove their current symptoms.

The truth is that PTSD often warrants the help of a mental health professional. Therefore, one of the best ways to support the child is by connecting them with the help they need. 

Another way adults can support children with PTSD is to receive help themselves. It can be taxing and stressful to care for a child who is experiencing social withdrawal, distressing dreams, emotional outbursts, or other symptoms of PTSD. Connecting with a licensed therapist may help you learn ways to cope with the child’s symptoms as well as understand how you can offer support.

Find support with online therapy

When you’re attempting to support a child with PTSD, it can be hard to find the time to head to an in-person therapy session. Additionally, you may not want to leave your child home alone. Online therapy is an alternative way to get the professional support you need.

Not only may online therapy easily fit into your schedule, but a study has shown that online therapy can feel more personal than traditional therapy. Ninety-six percent of people using online therapy reported feeling a personal connection with their online therapists as opposed to 91% who saw face-to-face therapists.

Caring for a child experiencing PTSD can be difficult


Post-traumatic stress disorder can occur in children of all ages, although the presentation of symptoms can vary depending on the child’s age. Connecting with a mental health professional may allow the child to receive the help they need. Additionally, it’s important for parents and other caregivers to receive support if needed so they can properly care for the child.
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