Understanding Trauma and Its Effects on Children

Trauma is a person’s emotional, physical, or psychological response to an event or experience that feels frightening, overwhelming, or threatening. Some traumatic experiences happen unexpectedly, while others may be anticipated. Examples of traumatic experiences include natural disasters, witnessing violence, hospitalizations, and serious injury, among many others.

• Every child responds to trauma differently. How children react to trauma often depends on their age, developmental level, personality, and previous experiences.
• Some children have reactions to trauma immediately after an event. Others have reactions weeks or months later.
• Some traumatic events are over quickly, but memories of them can last much longer. Certain sights, sounds, and smells might trigger thoughts. For example, a child injured in a car accident may become anxious in vehicles, or a child who experienced a painful medical procedure may become distressed when visiting a clinic.
• Some individuals have a single trauma experience while others have many.
• Children often think that a traumatic event will happen again; they can find it difficult to believe that it won’t be repeated.

Trauma can cause physical and psychological reactions. These reactions are common, are often part of the healing process, and can differ for each child. 

Physical reactions

• Trouble sleeping or experiencing nightmares
• Headaches, stomachaches or other physical symptoms
• Increased breathing rate
• Increased blood pressure
• Jumpiness or a quick startle response

Emotional reactions

• Fear
• Anger
• Guilt or shame
• Anxiety or nervousness
• Feelings of emptiness, numbness, or detachment (disconnected from emotions, memories, or surroundings)
• Feelings of insecurity
• Depression

Behavioral reactions

• Less interest in usual activities
• Regression (returning to old behaviors, or behaviors of a younger child)
• Difficulty concentrating
• Outbursts of anger, irritability
• Non-compliance or rule-breaking behaviors
• Changes in eating (loss of appetite, eating much more than normal, etc.)

Trauma-specific reactions

• Flashbacks (thinking about the event over and over; re-experiencing the event)
• Hypervigilance (constantly on guard for possible danger)
• Strong reactions to reminders or triggers
• Avoidance of the places or people associated with the trauma

Children’s reactions can vary greatly by age. Common age differences include:

Young Children

• Clinginess
• Separation anxiety
• Toileting accidents
• Increased tantrums or outbursts
• Repetitive play about the event

School-age children

• Trouble concentrating
• Academic difficulties
• Irritability
• Physical complaints

Adolescents / Teens

• Withdrawal from friends
• Risk-taking behaviors, such as use of substances
• Anger
• Feelings of hopelessness
• Changes in school performance

You play an important role in your child's recovery. Children often look to trusted adults for comfort, reassurance, and guidance after a traumatic event. Your calm support can help your child feel safer and more secure. 

Here are some things you can do and some things you shouldn’t do.

Do:

• Listen carefully and without judgment.
• Let them know they’re safe.
• Sit quietly together.
• Allow them to show all kinds of emotions.
• Answer their questions honestly and appropriately for their age.
• Spend extra time with them.
• Hug, with permission.
• Support them, even when they’re in a bad mood.
• Encourage them to play.
• Maintain a consistent routine.
• Let them have some private time.
• Offer choices, whenever possible.
• Remain calm when around them.
• Expect some regression (going back) in behavior and skills. (For example, they might have toileting accidents.)
• Let them re-tell the traumatic event, if they wish to do so.
• Give them time to heal their physical and emotional wounds.
• Remember that “firsts” and anniversaries (for example, the first holiday after a trauma) may be difficult.
• Take care of yourself.

Don’t:

• Force children to talk or re-tell the story.
• Minimize or make light of their feelings.
• Make big changes while they’re adjusting.
• Lie to them.
• Expose children to violent images or movies, or reminders of trauma.
• Let children hurt themselves or others.
• Blame children for causing a traumatic event.
• Ignore their concerns or feelings.

Talk with a healthcare provider if you or your child:

• Feel constantly anxious, fearful, or overwhelmed
• Continue to relive or re-experience the event
• Avoid important daily activities
• Have significant changes in mood or behavior
• Have ongoing sleep problems
• Struggle at school, work, or home
• Withdraw from preferred activities or healthy friendships
• Use alcohol, nicotine, or other substances to cope
• Have symptoms that continue to interfere with daily life
• Struggle to attend medical appointments or follow through with recommendations from healthcare providers (e.g., refuse medications)

Getting support early can help with recovery and prevent symptoms from becoming more severe.

Remember: Recovery looks different for everyone. Most people gradually feel better over time. You are not alone, and support is available if you need it.