Recognizing the Effects of Trauma on Children

Sometimes bad or painful things happen to us – our children, our families, our communities. A lot of these things can be called trauma. If you suspect or know your child has gone through a traumatic event, there are ways they can heal and there’s help to move forward. Trauma needs its own healing process. On this page, we can help you look for the signs that your child is struggling so you can help them have the tools to be as happy and healthy as possible.

What Is Trauma?

Trauma can be something that happens once or many times. It is something scary, dangerous, or violent that happens directly to a child (or any person). Or something that they witness happening to someone else, especially a loved one. Not all scary, dangerous, or violent events are trauma. Trauma includes situations where children fear for their lives, believe they or someone else will be badly hurt, feel a serious threat, or are personally violated. Everyone experiences traumatic events differently.

Traumatic events include things like:

• Physical abuse, sexual abuse, neglect, and domestic violence (once or many times).
• Assaults (like being attacked, beaten, shot, or raped).
• Sudden or violent death of a loved one.
• Serious or invasive medical procedures and long-term hospitalizations (including extended stays in a neonatal or regular intensive care unit).
• Serious illness or accidents (including car accidents).
• Abandonment or extended separation from a parent or caregiver (like in divorce or adoption).
• Severe emotional abuse or bullying.
• Homelessness or the stress of extreme poverty.
• School or neighborhood shootings and violence.
• Terrorist attacks and wars.
• Natural disasters (like floods, earthquakes, and fires).

You might want to see our Emergency Preparedness for Families of Children With Disabilities page to help plan ahead and reduce trauma in case a natural disaster happens.

If your child has a disability or special health care need, medical trauma is an issue to consider. Medical trauma might happen after a major illness, surgery, doctor’s treatment, or hospitalization. Many children struggle to cope with the stress of those experiences, especially if they were in an intensive care (ICU) or neonatal intensive care (NICU) setting or have been in and out of the hospital often. In helping your child’s body heal, don’t forget to help their mind and spirit heal too.

It’s hard to know how children will react to trauma, but it is important to recognize the effects and remember that every child reacts in a different way – right in the moment, afterwards, and down the line. If your child has had trauma, they might feel many things, including: terrified, overwhelmed, untrusting of others, unsafe, guilty, or ashamed. While some children bounce right back after a trauma, others can have mental, physical, social, emotional, or spiritual challenges for years to come.

Recognizing Traumatic Stress in Children

If your child has been through a traumatic event, and you notice they’re just not acting like they used to, it might be the first sign of something called “traumatic stress.” Traumatic stress is a certain kind of stress that can happen after a trauma. Your child might have it when a situation is just too much for them to cope with and their minds and bodies get overwhelmed.

Depending on your child’s age or developmental stage, here are more signs of traumatic stress you can look for:

• Toddlers and young children: restless, crying a lot, start bedwetting again or doing other baby-like things, are afraid to be away from you, have nightmares, aren’t growing right or are losing weight, don’t want to eat much, refer to the trauma in their play, or keep asking about death.
• Elementary school children: afraid or worried a lot, become clingy to you or a teacher, seem to feel guilty, keep talking and thinking about the traumatic event, become very upset about a small injury, seem to not feel anything at all, can’t sleep or focus, or are easy to startle.
• Pre-teens and teenagers: talk and think a lot about the trauma, say they feel nothing about what happened, don’t want to do things or go places that remind them of it, feel depressed and alone, start having trouble in school, start having sex or taking drugs, other risky behavior, can’t sleep well, or just feel out of control and different.
• At any age: trauma can impact your child’s brain and nervous system development if a child does not get help or treatment.

A lot of times, parents see their children having trouble when something reminds them of the trauma in some way (called “trauma triggers”). Without help, a survivor of trauma can have problems for their entire lives. Fortunately, there are good ways that children (and adults) can get treatment and heal. And there are many professionals and programs that can help you treat your child’s symptoms and figure out what is going on – whether it’s traumatic stress or something else.

Remember that, sometimes, a child’s responses to trauma don’t happen right away or might look a lot like other challenging behaviors. Children that have lived through multiple or complex traumas might actually develop a mental health condition like post-traumatic stress disorder (PTSD), depression, or anxiety, but many children will not develop these.

Listen to what your child has to say and support how they feel. If they seem to be having trouble recovering from a traumatic event or are saying and doing things that concern you, get help.

How to Help a Child Before or After a Trauma

We want you to know that there are people and programs to help, and ways to give your child the tools to cope with and prevent problems. Many mental health professionals are trained in dealing with trauma and traumatic stress. When you take your child to get help, be sure to mention the traumatic event or events that happened and what behaviors and emotions you’re seeing in your child.

There are things you can look for in the programs and services your child gets – from schools to therapies to medical care – that reassure you they know about trauma. As a parent, you can help your child too by knowing more about trauma and trauma treatment. We’ve collected some tips from parents and other experts here.

The National Child Traumatic Stress Network has these tips for parents and caregivers and these tips for finding help from a professional. You can also visit our Finding the Right Mental Health Resources for Children page to learn more about mental health professionals and programs. You can also help your child by building up their resilience.

Resilience

Resilience means that a person can experience stress or trauma, cope with it, and move on in their lives. You can build up your child’s resilience to lower the chances of problems later and make them more mentally healthy.

Here some ways to build resilience:

• Talk to your child about their special strengths and give them chances to make decisions and try new things.
• Praise them honestly and specifically so they can build self-confidence.
• Help them take on what they can handle, not more.
• Show your child how to act by your actions – being respectful, knowing right from wrong, and caring for others.
• Tell them what you want them to do rather than what you don’t want them to do. And remember that risky behaviors might be a cry for help when your child is under stress.
• Try not to compare siblings’ strengths to each other. Every child is different.
• Make time to connect as a family.
• Build a home that feels safe and loving no matter what, where your child can express any type of feeling or worry.

All children (and people) can build up their resilience at any point, even if they do not have a mental health condition and have never experienced trauma. Healthy Children.org has even more tips for building your child’s resilience.

How Should Professionals Treat Your Child?

There is an approach to treatment called “trauma-informed care.” It is used in medical, educational, mental health, and social service programs to make sure that anyone receiving care is not traumatized (or further traumatized) in the process. It means that the professionals in your child’s programs, services, and treatment know about trauma, know how to spot the effects of trauma, and know how to respond in the right ways. And everyone, from the person at the front desk to the doctor to the maintenance staff, is on the same team about preventing and healing trauma. Not every program is completely trauma-informed, but it’s definitely something you can ask about or look for.

For example, some places might restrain (tie down or hold down) a child with a disability or special health care need when their behavior gets hard to manage. Since restraint is often traumatic to children, other places use it as a last resort, and they try a lot of other things first to help your child stay still, calm, or safe during an outburst or a treatment. Restraint is a complicated topic and sometimes necessary for medical reasons. In trauma-informed care settings, staff avoid restraint for behavioral or mental health crises.

Here are some things that parents and other experts believe are important in a trauma-informed care program – things you can look for:

• Staff are focused on safety.
• You and your child trust the staff and know what is going on with treatments and policies.
• There are other families (like yours) there that you can turn to for support, like Certified Family Partners. They work or volunteer in the program.
• Professionals want to work with you and share the decision making about your child’s care.
• Your child (and family) feel like they can speak up if something isn’t going right.
• People from all different types of backgrounds and cultures feel comfortable there.
• You and your child have choices about treatment.

You can go a long way in helping your child and your family just by knowing about trauma, listening to your child, and facing trauma and its effects head on.