Post-Traumatic Stress Disorder and Children
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
- A traumatic event can be anything where there is exposure to actual or threatened death, serious injury or sexual violence.
- 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.
- 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.