How to Recognize Signs of PTSD in Children
Post-Traumatic Stress Disorder (PTSD) is often associated with adults who have experienced severe trauma, such as soldiers returning from combat or individuals who have endured natural disasters. However, PTSD is not exclusive to adults—it can also affect children, and recognizing the signs early is crucial for their mental and emotional well-being. For parents, teachers, and carers, understanding PTSD in children is a critical step toward providing the proper support.
This article will guide you through some symptoms of PTSD in children, offer insights from mental health professionals, and reference diagnostic criteria from the DSM-5. By becoming familiar with this knowledge, you can play a vital role in the healing journey of a child struggling with PTSD.
Background Information
PTSD in children can develop after experiencing or witnessing a traumatic event, such as abuse, violence, accidents, natural disasters, or the sudden loss of a loved one. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), PTSD can manifest differently in children compared to adults, often complicating the recognition and diagnosis process. For children, these traumatic experiences can significantly disrupt their sense of safety, security, and normalcy, which are essential for healthy development.
Understanding PTSD in children is particularly important because untreated PTSD symptoms can lead to long-term emotional, behavioural, and academic challenges. Children may not have the vocabulary to express their feelings adequately, making it even more challenging for adults to identify their distress. This underscores the importance of being aware of the signs of PTSD in children to intervene early and effectively.
Symptoms of PTSD in Children
Children with PTSD may exhibit a variety of symptoms that can be broadly categorized into three main areas: (i) re-experiencing the trauma, (ii) avoidance and emotional numbing, and (iii) increased arousal. Recognizing these symptoms is the first step toward helping a child manage and overcome their traumatic experiences.
Re-experiencing the Trauma
Children with PTSD often relive the traumatic event through flashbacks, nightmares, or intrusive memories. These experiences can be incredibly distressing, as the child may feel like they are going through the trauma all over again. They might display intense emotional reactions, such as crying, trembling, or freezing, in response to reminders of the trauma. According to the DSM-5, these symptoms may also manifest through repetitive play in which themes of the traumatic event are expressed.
For instance, a child who has witnessed a car accident might repeatedly reenact the crash with their toys, or a child who has experienced abuse might unknowingly draw pictures reflecting elements of the traumatic event. These repetitive behaviours are not mere play but are indicative of the child’s attempts to process their trauma.
Avoidance and Emotional Numbing
Avoidance behaviours are another common sign of PTSD in children. They may go out of their way to avoid places, people, or activities that remind them of the traumatic event. For example, a child who has experienced bullying at school or sport may develop an intense reluctance to attend those locations or interact with peers. Emotional numbing can also occur, where the child appears detached or indifferent to their surroundings, even to the extent of losing interest in activities they once enjoyed.
Emotional numbing is particularly concerning because it can lead to difficulty in forming and maintaining relationships. The child may seem disconnected from their emotions, making it challenging for them to express joy, sadness, or even love. This can have a ripple effect, impacting their social skills, academic performance, and overall development.
Increased Arousal
Hyperarousal symptoms involve a heightened state of alertness and anxiety. Children with PTSD may be easily startled, have trouble sleeping, or experience frequent outbursts of anger. They may appear jittery or overly vigilant, constantly scanning their environment for potential threats. This heightened state of arousal is the body’s way of remaining on high alert, ready to respond to danger, even when no actual threat is present.
Research has shown that hyperarousal can also manifest as difficulties with concentration, making it hard for the child to focus on schoolwork or other tasks. This can lead to academic struggles, which may be mistakenly attributed to attention-deficit disorders rather than recognized as symptoms of trauma.
Research and Evidence
Numerous studies have highlighted the prevalence and impact of PTSD in children. A study published in the Journal of the American Academy of Child & Adolescent Psychiatry found that approximately 4% of children and adolescents in the United States are affected by PTSD at some point during their lives. The study also emphasized the importance of early intervention, noting that children who receive timely support are more likely to recover fully and lead healthy, productive lives.
The DSM-5 criteria for diagnosing PTSD in children aged six years and younger include:
Exposure to a traumatic event.
The presence of intrusive symptoms.
Avoidance of reminders associated with the trauma.
Negative alterations in cognition and mood.
Marked alterations in arousal and reactivity.
These symptoms must persist for over a month and cause significant distress or impairment in the child’s daily functioning.
Incorporating insights from mental health professionals, such as child psychologists and pediatricians, can further deepen our understanding of PTSD in children. Dr. Megan McCauley, a clinical child psychologist, notes that “children may not always have the language to express what they are going through, so it is crucial for adults to be observant of behavioural changes that may signal trauma.” Dr. McCauley emphasizes that early identification and intervention can dramatically alter the course of a child’s recovery, underscoring the importance of adult awareness and action.
Practical Applications
For parents, teachers, and carers, knowing how to respond to signs of PTSD in children is just as important as recognizing them. Here are some practical strategies to support a child experiencing PTSD:
Create a Safe Environment
Ensure that the child feels safe and secure. This involves both physical safety and emotional security. Establish routines and provide consistent, predictable environments, which can help reduce anxiety and foster a sense of stability.
Encourage Open Communication
Encourage the child to express their feelings, but don’t force them to talk about the trauma before they are ready. Use open-ended questions and reassure that feeling scared, sad, or confused is okay. Listening without judgment is key. Some children may find it easier to express themselves through drawing, writing, or play, so offer these as alternatives to verbal communication.
Teach Relaxation Techniques
Introducing simple relaxation techniques such as deep breathing, mindfulness, or guided imagery can help children manage symptoms of hyperarousal. Hyperarousal is a state of heightened alertness and sensitivity in which an individual feels excessively vigilant, easily startled, and has difficulty relaxing. It is often accompanied by sleep disturbances and irritability. Calm Kids Club offers free mindfulness exercises that can be easily integrated into daily routines, providing children with tools to self-soothe and regain control over their emotions. Visit our LISTEN NOW section for more information.
Seek Professional Help
If you suspect that a child is struggling with PTSD, it is essential to seek professional help from a licensed mental health provider specializing in trauma. Therapies such as Cognitive Behavioral Therapy (CBT) and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) have been proven effective for treating PTSD in children. Early intervention can prevent the escalation of symptoms and support the child’s journey to healing.
Be Patient and Supportive
Recovery from PTSD is a process that takes time. Be patient and supportive, offering reassurance and positive reinforcement. Celebrate small victories and progress, no matter how minor they may seem. Acknowledge the child’s courage in facing their fears and remind them they are not alone.
Conclusion
Recognizing the signs of PTSD in children is the first step toward providing the care and support they need to heal. By understanding the symptoms—such as re-experiencing the trauma, avoidance behaviours, and hyperarousal—you can better identify when a child may be struggling. Equipping yourself with practical strategies and seeking professional guidance can profoundly impact a child’s life. As parents, teachers, and carers, you have the power to help children navigate their trauma and move toward a brighter, healthier future.
Understanding and addressing PTSD in children is not just about managing symptoms; it’s about fostering resilience and emotional strength. For more resources and support, explore the Calm Kids Club website, where you can find articles, mindfulness exercises, and community support tailored to the needs of children and those who care for them.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Scheeringa, M. S., & Zeanah, C. H. (2001). A relational perspective on PTSD in early childhood. Journal of Traumatic Stress, 14(4), 799-815. https://doi.org/10.1023/A:1013002507972
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2017). Trauma-Focused CBT for Children and Adolescents: Treatment Applications. Guilford Press.
McCauley, M. (2020). Child and Adolescent Trauma: The Role of Psychologists in Identifying and Treating PTSD. Journal of Clinical Child & Adolescent Psychology, 49(1), 10-22. https://doi.org/10.1080/15374416.2019.1689811
