After a frightening or distressing experience (any kind of injury, a physical or sexual assault, car crash, fire, or other natural disaster), a child or teen may suffer psychological stress in addition to any physical injuries. In the first few days to weeks after a trauma happens, people of all ages find that they have unwanted or upsetting thoughts or feelings about the trauma, and that for a while they are more "jumpy" (more on the lookout for possible danger). Often, they want to avoid things that remind them of the traumatic event that just occurred. When these reactions last for more than a month and are strong enough to affect a child's or teen's everyday functioning, that child may be diagnosed as having Post-Traumatic Stress Disorder or PTSD. An estimated 70% of adults in the United States have experienced a traumatic event at least once in their lives; of these, up to 20% go on to develop PTSD. Children's experience of traumatic events is not as well documented. However, studies have found that about 30% of children who experience a traumatic event develop PTSD. Children can also develop PTSD symptoms when they witness or hear about a traumatic event that happens to someone they care about (for example, if a child witnesses a parent being attacked or hears about a friend who is shot).

What Are the Signs and Symptoms of PTSD?

Most children who experience a trauma will have at least a few of the symptoms listed here, in the first few days or weeks after the event. The majority resolve these reactions with the support of their parents and families, but some children continue to have difficulties. (A child who appears to have little reaction to the trauma in the early stages is less likely to develop symptoms of PTSD). Children or youth who have had previous traumatic experiences, who have very strong early reactions, or whose support systems (parents and others) are very distressed by the event, appear to be at higher risk for later difficulties.

There are three main categories of symptoms

of PTSD:

• Re-experiencing the Trauma. Upsetting thoughts, pictures, or feelings about the traumatic event just "pop" into his/her mind; may relive the traumatic event through nightmares or through "flashbacks" when awake; reminders of the trauma may bring tears or other physical symptoms such as sweating, heart pounding, or stomach upset.
• Avoiding Reminders of the Trauma. Avoids (or wants to avoid) situations, activities, or locations that might be reminders; may feel emotionally "numb" or detached – shutting down emotions to protect from painful feelings; may feel less close to friends and family; can feel hopeless about the future.
• Hyper-Arousal. Becomes jumpy or easily startled (e.g., overreacts to sudden loud noises); may become hypersensitive to signs of danger ("on guard"); may seem irritable or angry more than usual; may have sleep problems and trouble concentrating.

What Can An Adult Do to Help A Child with PTSD?

• Observe. Be aware of changes in the child's behavior.
• Talk. Speak with the child openly (and in a matter-of-fact manner) about the traumatic event. Follow his/her lead but don't avoid the topic. (If this is too upsetting for you, seek support from other adults in coping with your own feelings).
• Listen. Ask the child about his/her thoughts and feelings regarding the event, and listen carefully to his/her words, tone, and body language. Gently help to correct any misunderstandings. Sometimes children feel guilty about what happened and mistakenly believe they are to blame; younger children may have unrealistic or "magical" ideas about how the trauma happened.
• Support. Help your child to focus on his/her strengths and talents. Help him/her to develop and use strategies for healthy coping with any fears or anxiety.
• Take Care of Yourself. Parents and other caregivers need to have support for themselves and their own reactions and feelings after a child has experienced a traumatic event.

Ask for Help – Treatments for PTSD

If a child continues to have symptoms that worry parents or caregivers, that bother the child or get in the way of his/her normal activities, or if a child has any behavior that endangers himself or others, do not hesitate to get help from a mental health professional. (See resources listed below.) Look for a mental health professional (counselor, psychologist, social worker, psychiatrist) with experience in helping children after trauma, and who can assess the child and make a recommendation about treatment. Treatment for PTSD in children and teens usually includes cognitive behavioral therapy to help reduce avoidance behaviors and to change ways of thinking that can perpetuate the symptoms of PTSD. Treatment for children also generally involves parents and other family members as well. Sometimes, children or teens can participate in group therapy (or a support group) with others who have also experienced a trauma.

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.