Imagine a four-year-old child found covered in blood, lying over her mother’s naked, dead body, whimpering incoherently. She’s witnessed her mother being raped and murdered, and her own throat had been cut, twice in an attempt to leave behind no witnesses. She’s alone with her mother for approximately eleven hours before she is discovered.
After being hospitalized she is released as a ward of the state and put into foster care with no follow up treatment for the trauma she experienced.
How will she go on through life with those images etched in her mind? How will she survive psychologically? How will her mind protect her from such traumatic experiences?
This story is unfortunately a very true story, one of several stories of childhood trauma that can be found in the book, The Boy Who Was Raised As A Dog by Bruce Perry and Maia Szalavaitz.
Tragedies like this occur across our nation and the world everyday, leaving behind sometimes physical, but always emotional and psychological scars.
Post Traumatic Stress Disorder is a condition that 30 or so years ago was reserved only for soldiers who had experienced traumatic events at war. It was later recognized that rape survivors, people who had been through terrible accidents or natural disaster, also exhibited symptoms of PTSD including flashback, hyper-vigilance and avoidance behaviors.
When it came to children however, the mental health and medical fields were slow to realize the impact of trauma on their lives.
Children were thought to be naturally resilient and would “bounce back” without the aid of any type of support or treatment. Those same children who had experienced trauma would often later develop psychiatric problems, depression and attention issues that would sometimes led to medication.
We know now that children who have live through tragedies, are just as affected as adults, perhaps even more so. This is evident in the great way the mental health community around the nation responded to the Sandy Hook Elementary School tragedy.
What Causes PTSD?
PTSD can occur in anyone who has lived through an event in which they could have been killed or severely hurt or where they witnessed someone else getting killed or severely hurt. These can include violent crimes, physical or sexual abuse, someone close to them committing suicide, car crashes, shootings, war and natural disasters just to name a few.
Approximately 40% of children by the age of 18 will experience a traumatic event, which includes the loss of a parent or sibling and domestic violence. In the United States, child protective services receives an estimated 3 million reports of abuse and neglect yearly, involving approximately 5.5 million kids. About 30% of all those cases show proof of abuse:
- 65% neglect
- 18% physical abuse
- 10% sexual abuse
- 7% psychological (mental) abuse
This of course doesn’t include the estimate 66% of child abuse cases that are never reported.
The Likely Hood Of PTSD Developing
Girls are more likely than boys to develop PTSD symptoms. Approximately 3-15% of girls and 1-6% of boys who experience a trauma will develop PTSD. The chances of developing PTSD are higher depending on the type of trauma experienced. Some of the risk factors for PTSD include:
- How severe the trauma was
- How the parents react to the trauma
- How close or far away that child is from the trauma
Of course children who go through the most severe traumas have the highest level and severity of PTSD symptoms. Incidents where people are hurting other people such as assault and rape, tend to result in PTSD more frequently. Children who have healthy support systems tend to have less severe symptoms.
The age of the child during the traumatic experience doesn’t seem to effect rather PTSD symptoms will develop, however PTSD looks different in children of different ages.
What Does PTSD Look Like In Children Ages 5-12?
- children may not have flashbacks or problems remembering parts of the trauma like adults with PTSD often do.
- Children might, however put the events of the trauma in the wrong order.
- They might also think there were signs that the trauma was going to happen and thus they think that they will see these signs again before another trauma happens.
- They think that if they pay attention, they can avoid future traumas which can lead to hyper-vigilance.
Children around this age may also show signs of PTSD during their play. They may keep reenacting part of the trauma. For instance, a child who has seen a shooting may want to play video games involving shootings or carry a gun to school.
Teens (ages 12-18)
In teens, some of the PTSD symptoms may be similar to those of adults including flashbacks, reoccurring nightmares about the event, hyper-vigilance and exaggerated startle responses. Teens are more likely than children or adults to show aggressive and impulsive behavior.
What are the other effects of trauma on children?
Other effects of trauma on children from PTSD comes from research done with children who have been through sexual abuse. They include:
- fear
- worry
- sadness
- anger
- feeling alone and apart from others
- feeling as if people are looking down on them
- low self-worth
- not being able to trust others
- undesired behaviors such as aggression, out-of-place sexual behavior, self-harm, and abuse of drugs or alcohol
For many children, PTSD symptoms go away on their own after a few months. Yet some children show symptoms for years and possibly a lifetime if they do not get treatment.
How Is PTSD Treated In Children?
For some children, the symptoms of PTSD will go away on their own with healthy supports and when they aren’t being re-traumatized by anxious parents or the media. For others, they may need professional help including:
- Cognitive-Behavioral Therapy such as Trauma-Focused Cognitive Behavioral Therapy
- Psychological first aid/crisis management
- Eye movement desensitization and reprocessing (EMDR)
- Play therapy
- Special treatments may be necessary for children who show out-of-place sexual behaviors, extreme behavior problems, or problems with drugs or alcohol.
What Can You Do To Help?
Educated yourself on PTSD and pay attention to your child for signs such as anger, avoidance of certain places and people, problems with friends, academic changes and sleep problems. If you need professional help, find a therapist in your area that treats PTSD and that your child feels comfortable with. Where to Get Help .
Sources: The National Center for PTSD
Today I counseled an inmate who was upset because he had been diagnosed with what he called Post Dramatic Stress Disorder (PDSD). What he meant and I quickly corrected him, was Post Traumatic Stress Disorder.
Licensed Mental Health Counselor 