For the longest time children were not thought to be able to develop post-traumatic stress disorder (PTSD).   The traumatic events traditionally thought to cause PTSD were not believed to happen to children.  There are many myths about how resilient they were or what made an event “traumatic.”  All of these things impacted how adults thought of children. Myths continue about how if a child were tougher or stronger they would not be bothered by something that has happened in the past, or that that they would have “gotten over it.”

Myth#1 – Children don’t get PTSD

The people who first researched and wrote about post-traumatic stress disorder studied the effects of war on soldiers. It was known that they were exposed to a potentially traumatic event. Children were thought to be are low risk for post-traumatic stress disorder because the most common traumatic events that children are exposed to take place in secrecy and sometimes in the context of a child’s family. Domestic violence, physical abuse, parental substance abuse, and sexual abuse happen most often in secrecy.
For example, sexual abuse, an experience that is unfortunately true for 1 in 10 children before their 18 birthday is incredibly difficult to ‘prove’ but has a tremendous impact on children. The secret nature of child sexual abuse means that many times adults in a child’s life are seeing the impact of a trauma on a child without knowing what may be fueling some behaviors. Of course, children are in car accidents, suffer traumatic losses, and are victims of other violent crimes and these children are at risk to develop PTSD or a traumatic stress response as well.

Myth #2 – It happened so long ago they don’t remember it.

A child’s reluctance to put words to what has happened is often misinterpreted by adults as their inability to remember. Avoidance is one of the hallmark features of PTSD. It is a common reaction for children to try not to think about or express feelings about what happened. Just because kids and teens don’t talk about what happened, or they say they don’t remember doesn’t mean they aren’t experiencing traumatic stress reactions.

Myth #3 – Children are resilient

So this myth isn’t completely wrong. Children have amazing abilities to grow and adapt. What we know about how children’s brain grow, and develop is that brains develop over time, and at certain stages of childhood grow rapidly. This rapid brain growth is wonderful for children who are safe from violence and well nutured.  Trauma has the unfortunate ability to disrupt normal child development. This traumatic stress is now known to effect brain development. Children who have experienced trauma are at higher risk for many mental health problems, like depression, anxiety and PTSD.

Myth #4 -After a while children just get over it.

The idea that children should just “get over” traumatic events shames children who can’t. Not everyone who experiences a traumatic event goes on to develop PTSD.  A traumatic event is a subjective experience, and a series of risk and protective factors impact whether or children do develop PTSD. Some times there are long delays between experiencing a traumatic event, and developing PTSD. Many factors go into determining whether a not a child goes on to develop PTSD. These include: how old they are when the traumatic happened, how long or severe was it, was the child believed and protected, what sort of traumatic event happened, and whether or not the trauma happened in the context of a caregiving relationship..

Myth #5 -You shouldn’t bring it up, or dig too much into the past.

It is normal for parents to want their child to forget about the terrible thing that happened. In fact for some parents that is their litmus test of whether or not a child has healed from a traumatic event. What we know is that children who experience a traumatic even, often remember it. It can be more alarming when children deny remembering anything at all. Although depending how old a child was when something happened, and how long ago it happened it would be very normal to not remember all or parts of it. Some children as part of their avoidance in talking about what happened will say they don’t remember it.
In counseling for childhood PTSD talking about what happened is part of the process of making meaning of what happened, to desensitizing a child to trauma reminders, and to challenge unhelp beliefs a child might have about what happen. The stress that children with unresolved trauma have is tremendous. It is often at the forefront of their mind, often fuels troublesome behaviors.

Jeff LaPonsie LMSW

Jeff LaPonsie is a clinical social worker at Kalamazoo Child and Family Counseling, PLLC. He provides counseling to children and families in the Kalamazoo, Portage, Mattawan, and South West Michigan area. He is passionate about helping challenging children and frustrated parents. Jeff has over seven years of experience working with at risk youth. His clinical expertise includes working with children with behavioral, anxiety, attachment and trauma related disorders.

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Post-Traumatic Stress Disorder (PTSD) can develop after something scary, shocking, dangerous, and or life-threatening happens. Children who are exposed to violence, are victims of physical or sexual abuse, experience a medical trauma, a car crash, or experience a sudden and tragic loss are all vulnerable to develop symptoms of Post-Traumatic Stress Disorder.

Important things to remember about traumatic events

1. A traumatic event can be anything where there is exposure to actual or threatened death, serious injury or sexual violence.
2. It’s a child’s perception of an event that is important. The factual nature of their recollection of an event is not important.  Trauma is very subjective; one child may be in a bad car accident and never wish to be a passenger again.  While another child may be in the exact same car accident but get a car immediately afterwards and have no difficulty.
3. Chronic or ongoing abuse or neglect is often referred to as complex trauma. Complex trauma impacts children differently than single or event-based traumas.  Complex trauma occurs in the context of a parent-child relationship and is often ongoing and unpredictable.  Children who have experienced complex trauma often have impacted development and cognition, and emotional and behavioral dysregulation. This article will discuss event-based or more single-incident post-traumatic stress disorder.

Symptoms of Post-Traumatic Stress Disorder in Children:

Re-experiencing in Post-Traumatic Stress Disorder

When a traumatic event happens a child’s ability to make sense of the event is overwhelmed. A child’s struggle to process a traumatic event can come out spontaneously in a child’s play.  For some children have repetitive or stuck play (think broken record) .  This often a repeating loop that reenacts parts of the traumatic event.  Other Children may think of or remember the event when they do not want to. They may describe the event as playing in their head like a movie, or that a certain picture or image is stuck in their head.

Some children have intrusive memories of the events that appear in their dreams, or nightmares. For some children with post-traumatic stress disorder the distressing dream or nightmare may not be related the traumatic event but the general theme is distressing, anxious or scary.

Previously non-threatening events, places, things, people can trigger anxiety in children who have experienced a trauma. For some children who have been in a car accident the next time they need to ride in a vehicle they may be distressed or worried.  Sometimes these are easy to spot, and other times not-so much.

Avoidance in children with Post-Traumatic Stress Disorder

Children who have experienced a traumatic event may avoid activities, places, or other reminders of the traumatic event. While this may not seem troublesome at first, avoidance often gets in the way of children and their families living their lives the way they would like.  For example a child who was in a bad car accident may find it difficult to ride the bus that takes them to school, causing them to be late, miss the bus or be anxious their entire trip to school.

Avoidance is difficult to help in children because it often alleviates stress and anxiety in the moment for a child.  When a child is successful in avoiding getting in the car, the stress that they had in anticipation of getting in the car is relieved.  This doesn’t make them more capable of tolerating stress or desensitize them to the car—it just teaches them that avoiding works.

Symptoms of hyperarousal, and reactivity in children with Post-Traumatic Stress Disorder

When something terrible or tragic happens in a child’s life their perception of the world as a safe place changes. For some children the awareness that the world can be dangerous leads to being constantly on the lookout, or hypervigilant.   Sleep problems and exaggerated startled responses (think jumping to loud noises) are also common. Trouble concentrating or  mood problems like having  irritable behavioral or angry outburst are also common in children with post-traumatic stress disorder but are often mistake for ADHD or other mental health disorders.

While this is not an exhaustive lists of what or how children with PTSD may act or behave—it’s a good start to thinking about how a child who has experienced or witnessed something traumatic may be responding.   For many children with PTSD, Trauma-Focused Cognitive behavioral Therapy is an effective, evidenced-based treatment that is proven to be effective.

Jeff LaPonsie LMSW

Jeff LaPonsie is a clinical social worker at Kalamazoo Child and Family Counseling, PLLC. He provides counseling to children and families in the Kalamazoo, Portage, South West Michigan area. He is passionate about helping challenging children and frustrated parents. Jeff has over seven years of experience working with at risk youth. His clinical expertise includes working with children with behavioral, anxiety, attachment and trauma related disorders.

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