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.
The Symptoms Of PTSD In Children
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
- 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.
How can you tell if a child has PTSD?
Identifying post-traumatic stress disorder (PTSD) in children can be challenging because their symptoms may manifest differently from those in adults. Children may have difficulty articulating their emotions and experiences which may cause them emotional and phsyical distress. However, there are several signs and behaviors that parents, caregivers, and professionals can look for if they suspect a child may have PTSD. It's important to note that these signs should be evaluated by a mental health professional for a proper diagnosis and to have PTSD treated. Here are some common indicators:
- Nightmares or night terrors related to the traumatic event.
- Flashbacks or intrusive memories of the trauma.
- Extreme distress when reminded of the traumatic event.
Avoidance and Numbing Symptoms:
- Avoidance of places, people, or activities associated with the trauma.
- Loss of interest in previously enjoyed activities.
- Emotional numbing, including difficulty feeling positive emotions.
- Withdrawal from family and friends.
Increased Arousal and Reactivity:
- Irritability or anger outbursts.
- Difficulty sleeping, including trouble falling asleep or staying asleep.
- Hypervigilance or exaggerated startle response.
- Concentration problems.
- Excessive worry or fear about safety.
Changes in Mood and Behavior:
- Depressive symptoms, such as sadness, hopelessness, or feelings of guilt.
- Regressive behaviors, such as bedwetting or thumb-sucking in younger children.
- Changes in eating habits (either increased or decreased appetite).
- School difficulties, including declining academic performance or refusal to attend school.
- Complaints of physical ailments like headaches or stomachaches that have no apparent medical cause.
- Changes in eating or sleeping patterns, which can lead to weight gain or loss.
- Being easily startled or frightened.
- Exhibiting extreme restlessness or being constantly on edge.
- Being excessively jumpy or anxious.
What does PTSD from childhood look like?
Childhood PTSD can manifest in various ways, often with symptoms impacting emotional, behavioral, and social aspects of a person's life. These individuals may experience recurrent distressing memories or nightmares related to the traumatic events they endured during childhood. Avoidance behaviors may be prominent, leading to avoidance of situations, people, or places that trigger reminders of the trauma. They may also struggle with heightened emotional arousal, exhibiting symptoms like irritability, hypervigilance, and difficulty concentrating. These symptoms can disrupt daily functioning, academic performance, and interpersonal relationships, making it essential for individuals with childhood PTSD to receive proper therapy and support to help them heal and develop healthier coping skills or mechanisms.
How do PTSD children behave?
Children with PTSD may exhibit a range of behaviors that can be distressing and disruptive due to their experiences with trauma. These behaviors can vary depending on the child's age, the nature of the trauma, and individual differences. Some common behaviors in children with PTSD include:
- Re-Experiencing the Trauma: Children may have nightmares or flashbacks related to the traumatic event. They might reenact violent personal attacks or other aspects of the trauma during play or repeatedly talk about it.
- Avoidance: Children may avoid situations, places, or people that remind them of the trauma. This could include refusing to attend school, avoiding specific places, or isolating themselves from friends and family.
- Emotional Dysregulation: Children with PTSD may struggle to manage their emotions. They might have frequent outbursts of anger, irritability, mood swings, or other mental health disorders. Alternatively, they may exhibit emotional numbness or a persistent negative mood.
- Hyperarousal: These children may be easily startled, have difficulty sleeping, or experience hypervigilance, where they are constantly on high alert for potential threats.
- Regression: Trauma can lead to regression making children of a young age act younger than they should. This means they may revert to behaviors more typical of a younger age, such as bedwetting, thumb-sucking, or baby talk.
- Academic and Social Problems: PTSD can interfere with a child's ability to concentrate, leading to academic difficulties. They may also have problems forming and maintaining relationships with peers.
- Physical Symptoms: Some children with PTSD may complain of physical symptoms like headaches or stomachaches, even when there's no underlying medical cause.
- Self-Destructive Behavior: In severe cases, adolescents with PTSD may engage in self-destructive behaviors like self-harm or substance abuse as a way to cope with their emotional pain.
Does childhood PTSD go away?
Childhood PTSD, like PTSD in adults, can improve and even remit with the right treatment and support. However, it doesn't always go away on its own, and its trajectory can vary widely depending on factors such as the nature and severity of the trauma, the child's age, the presence of a supportive environment, and the type and quality of treatment received.
What triggers PTSD in children?
PTSD in children can be triggered by a wide range of traumatic events, and the response to trauma can vary from one child to another. Ten common traumatic experiences that can trigger PTSD in children include:
- Physical or Sexual Abuse: Physical abuse, sexual abuse, or even witnessing domestic violence can be profoundly traumatic for a child and can lead to PTSD symptoms.
- Neglect: Prolonged neglect, where a child's basic physical and emotional needs are not met, can also be traumatic and lead to PTSD.
- Accidents: Involvement in or witnessing serious accidents, such as car crashes, fires, or natural disasters, can be traumatic for children.
- Medical Trauma: Experiencing a serious illness, medical procedure, or hospitalization can be traumatic, especially if it's associated with pain or fear.
- Community Violence: Exposure to community violence, such as shootings or gang-related incidents, can trigger PTSD symptoms.
- Bullying: Prolonged and severe bullying at school or online can be traumatic for children and adolescents.
- Loss or Separation: The death of a loved one, parental divorce, or prolonged separation from a primary caregiver can also be traumatic for children.
- War and Conflict: Children living in war-torn or conflict-ridden areas may experience trauma due to exposure to violence, displacement, or the loss of family members.
- Abduction or Human Trafficking: Experiencing abduction, kidnapping, or human trafficking can be highly traumatic for children.
- Natural Disasters: Living through earthquakes, hurricanes, floods, or other natural disasters can be traumatic, especially if a child's safety is compromised.
What happens if PTSD is left untreated in children?
If PTSD is left untreated in children, it can have significant and lasting negative effects on their emotional, psychological, and social well-being. Untreated childhood PTSD can lead to a range of problems, including:
- Long-Term Emotional Distress: Children with untreated PTSD may continue to experience distressing symptoms, such as nightmares, flashbacks, and extreme anxiety, which can interfere with their ability to lead a healthy, happy life. These symptoms can persist into adolescence and adulthood.
- Impaired Relationships: PTSD can affect a child's ability to form and maintain healthy relationships with peers, family members, and romantic partners. They may have difficulty trusting others, struggle with emotional regulation, and experience social isolation.
- Academic and Occupational Problems: Untreated PTSD can lead to academic difficulties, lower educational attainment, and challenges in the workplace later in life. Concentration problems and emotional dysregulation can hinder a child's ability to succeed in school and career endeavors.
- Increased Risk of Co-Occurring Disorders: Children with untreated PTSD are at a higher risk of developing co-occurring mental health disorders, such as depression, substance abuse, anxiety disorders, and self-harm behaviors, further complicating their psychological well-being.
- Physical Health Concerns: The chronic stress associated with untreated PTSD can contribute to physical health problems, including cardiovascular issues, immune system dysfunction, and chronic pain.
Untreated childhood PTSD can have far-reaching and adverse consequences that affect multiple aspects of a child's life well into adulthood. Early intervention and appropriate treatment are crucial to mitigate these effects and help children recover and develop healthier coping mechanisms.
What are the 4 main things childhood trauma deeply affects?
Childhood trauma can deeply affect a child's physical, emotional, cognitive, and social development, with wide-ranging and interconnected consequences. While the impact of trauma varies from person to person, there are four main areas in which childhood trauma can have profound and lasting effects:
- Emotional and Psychological Well-Being: Childhood trauma can lead to a range of emotional and psychological issues, including depression, anxiety disorders, posttraumatic stress disorder (PTSD), and other mental health conditions. Trauma can disrupt a child's ability to regulate emotions, leading to mood swings, irritability, and difficulty forming healthy attachments with others.
- Physical Health: The chronic stress associated with childhood trauma can negatively affect physical health. Trauma survivors may be at an increased risk of developing physical health problems such as cardiovascular issues, gastrointestinal disorders, immune system dysfunction, and chronic pain.
- Cognitive Functioning: Trauma can impair cognitive functioning, including memory, attention, and problem-solving skills. Children who have experienced trauma may have difficulty concentrating in school, leading to academic challenges and lower educational attainment.
- Social Development: Childhood trauma can interfere with a child's social development and their ability to form and maintain healthy relationships. Trauma survivors may struggle with trust, intimacy, and communication, which can lead to difficulties in forming attachments with caregivers, peers, and romantic partners.
What age can a child be diagnosed with PTSD?
A child can be diagnosed with post-traumatic stress disorder (PTSD) at any age, including infancy. However, diagnosing PTSD in very young children can be more challenging because they may not have the language skills to express their emotions and experiences effectively. The diagnostic criteria for PTSD, as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), apply to individuals of all ages, but they may manifest differently in children based on their developmental stage.
Can PTSD in children look like ADHD?
Yes, PTSD in children can sometimes resemble attention-deficit/hyperactivity disorder (ADHD) because both conditions can involve symptoms related to attention, concentration, and hyperactivity. This overlap in symptoms can sometimes lead to misdiagnosis or confusion between the two disorders.
How do you discipline a child with PTSD?
Disciplining a child with PTSD requires a sensitive and trauma-informed approach that takes into account the child's emotional and psychological needs. Discipline should prioritize safety, emotional regulation, and building trust, rather than punitive measures. Here are some strategies for disciplining a child with PTSD:
- Seek Professional Help: Before implementing any discipline strategies, it's crucial to have the child evaluated by a mental health professional or child psychiatrist who specializes in trauma and child psychology. They can provide guidance on the child's specific needs and triggers. A professional may also encourage prevention programs to manage PTSD symptoms before they advance.
- Trauma-Informed Care: Educate yourself and others involved in the child's care (teachers, caregivers, family members) about trauma-informed care principles. This approach recognizes the impact of trauma on behavior and focuses on creating a safe and supportive environment.
- Predictability and Routine: Children with PTSD often benefit from a structured and predictable routine. Consistency in daily activities and expectations can help reduce anxiety and provide a sense of safety.
- Clear and Age-Appropriate Communication: Use clear, simple language to communicate expectations and consequences. Be patient and understanding, and avoid yelling or punitive language that may trigger the child's trauma response.
- Positive Reinforcement: Encourage and reward positive behaviors. Reinforce good behavior with praise, affection, or small rewards to motivate the child to repeat those behaviors.
- Safety Plans: Develop safety plans with the child to help them recognize and cope with triggers. Teach them strategies for self-regulation, such as deep breathing or grounding exercises.
- Previous Article
- Next Article