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Post-Traumatic Stress Disorder (PTSD) is often thought of as a mental health condition that only affects adults, particularly those who have experienced extremely traumatic situations such as combat or major accidents. However, PTSD can also affect children of all ages, and recognizing the signs early is imperative for effective intervention and support. In this blog article, we’ll highlight some of the signs and symptoms of PTSD in children to help caregivers support the well-being and healthy development of children who have faced potentially traumatic events.

Understanding PTSD in Children

PTSD, or Post-Traumatic Stress Disorder, is a mental health condition that occurs after experiencing, witnessing, and/or learning about a potentially traumatic event. While adults may show classic signs of PTSD, such as flashbacks or severe anxiety, the disorder can manifest differently in children. It’s important to understand these developmental differences to identify and address PTSD in children effectively.

In children, PTSD can cause regression in developmental milestones. For instance, a child who has been potty trained might start wetting the bed again. They may become excessively clingy, fearing separation from their caregivers, or experience intense anxiety about leaving home. There might also be an increase in tantrums or sudden changes in behavior. 

Another notable sign of PTSD in children is how they incorporate traumatic events into their play. For example, a child who was involved in a car accident might repeatedly act out crash scenes with their toys, trying to process the event through their play activities.

Causes and Triggers

Children can develop PTSD from various potentially traumatic events, such as abuse, negelct, accidents, natural disasters, or exposure to violence. Specific triggers can include being bitten by a dog or another animal, experiencing prolonged separation from a caregiver, particularly under stressful conditions, or undergoing a stressful medical procedure, such as surgeries. The death of a loved one, whether a family member or a pet, can also be a significant trigger for PTSD in children.

It’s also important to understand that traumatic situations affect children differently, and not all children exposed to trauma will develop PTSD. Additionally, an individual’s perception determines whether an event is traumatic to them, so a family may experience a potentially traumatic event and respond to it in different ways. Some family members may go on to experience symptoms of traumatic stress and others not.

Signs and Symptoms

Recognizing the signs and symptoms of PTSD in children is the first step towards helping them. These symptoms can be categorized into emotional, behavioral, and physical manifestations.

Emotional symptoms may include:

• Nightmares and flashbacks

• Persistent fear or anxiety

• Unprovoked anger or irritability

Behavioral symptoms may include:

• Avoidance of places, people, or activities that remind them of the traumatic event

• Increased aggression or tantrums

• Withdrawal from friends and family

• Talking about the traumatic event impulsively and in blunt terms

• Reenacting the traumatic event through play and/or depicting the traumatic event in drawings

Physical symptoms may include:

• Headaches and stomachaches

• Changes in appetite and gastrointestinal issues

• Disturbed sleep patterns

For example, a child who witnessed a traumatic car accident might have frequent nightmares about the event, become overly anxious when approaching a car, and complain of stomachaches regularly.

Recognizing PTSD Across Different Age Groups

The symptoms of PTSD can vary significantly across different age groups, reflecting developmental differences in how children process trauma.

Preschoolers:

• May show signs through play, re-enacting the traumatic event repeatedly

• Might struggle with separation anxiety and cling to caregivers more than usual

• Can exhibit developmental regressions, such as bed-wetting or thumb-sucking

School-age Children:

• May have trouble concentrating in school and show a decline in academic performance

• Might become more irritable and have outbursts of anger

• Often express their distress through physical complaints, like headaches or stomachaches

Adolescents:

• Are more likely to talk about their experiences but may do so in a blunt or inappropriate manner

• Can engage in risky behaviors including substance abuse as a way to cope with their emotions

• Might experience intense feelings of guilt or shame related to the traumatic event

Importance of Early Detection

Early detection of PTSD in children is crucial. Recognizing the signs early on can lead to timely intervention, preventing long-term psychological consequences and improving the overall outcome for the child. Early intervention helps children process their trauma, develop healthy coping mechanisms, and reduces the risk of chronic mental health issues.

When to Seek Help

Caregivers should seek professional help if they notice significant changes in their child’s behavior or emotional state following a potentially traumatic event. It’s important to remember that not all children who experience trauma will develop PTSD. However, if a child continues to struggle despite the caregiver’s best efforts, it’s time to seek support from mental health professionals.

Caregivers may avoid discussing the traumatic event with their child, not knowing how to approach the subject. In such cases, a therapist or Parent Specialist can provide valuable guidance. They can help caregivers find the right words to explain the situation in a way that the child can understand, making the process less stressful and intimidating for both the child and the caregiver. Learn more about how Little Otter can support your family here.

Examples of Treatment Models

Effective treatment for PTSD in children often involves therapy. Two common models include:

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT):

• Typically used for children aged six and up

• Helps children and caregivers understand and manage the thoughts, feelings, and behaviors associated with the trauma

Child-Parent Psychotherapy (CPP):

• Designed for young children from birth to about age six

• Focuses on strengthening the relationship between the child and their caregiver, helping both to process the trauma through play-based interventions

Supporting Children with PTSD

Supporting a child with PTSD involves creating a safe and nurturing environment for them. Here are some tips and strategies for caregivers:

1. Listen actively and validate their feelings: Encourage the child to express their feelings and listen to them without judgment. Validate their emotions, letting them know that it’s okay to feel upset or scared.

2. Encourage healthy coping mechanisms: Help the child develop healthy ways to cope with their emotions, such as engaging in hobbies, physical activities, or relaxation techniques.

3. Maintain predictable routines: Children who have experienced trauma often feel a loss of control. Predictable routines can provide a sense of stability and security for them.

4. Be patient with the process: Recovery from PTSD takes time. Be patient and understanding as the child works through their feelings and experiences.

5. Seek support for yourself: Supporting a child with PTSD can be challenging. Caregivers should seek their own support, whether through therapy or support groups, to ensure they’re in the best position to help the child.

Recognizing and addressing PTSD in children is a crucial step in supporting their mental health and overall well-being. With early detection, appropriate intervention, and a supportive environment, children can overcome the challenges posed by PTSD.

For more information or support, consider reaching out to Little Otter. Our team consists of mental health experts and Parent Specialists who focus on providing tools, interventions, and strategies to address concerns like PTSD. Get started with us at the link below.

This article was written with support from Little Otter therapist, Hilary Leja, and Little Otter’s Director of Clinical Research and Programs, Alison Stoner, PhD.