Child Trauma

Introduction

Negative experiences can disrupt a child’s sense of safety and security. These negative experiences in childhood are sometimes referred to as child trauma. Research suggests more than two-thirds of children report experiencing at least one traumatic event by age 16.¹ Examples of these experiences can include events that happen once, like the death of a loved one, parental separation or divorce, or a serious car accident.¹ They can also include traumatic experiences that occur repeatedly, like physical or emotional abuse, neglect, being bullied, witnessing violence at home or school, or living with someone who has a mental health or substance use disorder.¹ Traumatic experiences can overwhelm a child’s ability to cope with what they have experienced, which can lead to child traumatic stress² and long-lasting effects that negatively impact health, well-being, and opportunities in life.³

Fortunately, children who have experienced traumatic events can recover and flourish. Creating safe, stable, nurturing relationships and environments for children can buffer against the effects of negative experiences and help children thrive.⁴ As a parent or someone in a parenting role, your support and guidance matters greatly. Learning about child trauma and how it can affect your child will help you support them. It will help your child feel safe and manage their strong and sometimes overwhelming feelings and behaviors while building a healthy parent-child relationship.

This document provides an overview of how a child’s brain responds to stress, the impact of child trauma on health and well-being, and reactions to trauma at various stages of child development. This document also provides guidance for what actions you can take to support your child after they have experienced a traumatic event and what you can do to help your child manage challenging behaviors. Finally, as a parent or someone in a parenting role, your child’s trauma affects you as well. While caring for and supporting your child through their difficult moments, it is vital to take care of yourself. Guidance on specific actions to care for yourself with compassion is provided.

The Brain’s Response to Stress

Learning how to respond to and manage stress is a normal part of a healthy child development. When a child is exposed to an everyday stressor, their body’s stress response system is activated. For example, meeting a new friend, giving a speech in science class, or learning a new skill like how to ride a bike causes the body’s natural stress response to activate. A stress response generally includes an increased heart rate and a slight elevation in the hormone cortisol.⁵ In these situations, the stress response is brief, and the body quickly returns to normal.⁵ While the experience might be stressful, a child doesn’t experience any adverse lasting effects.⁵ These everyday experiences are a typical part of healthy development and necessary for a child to develop a positive stress response system,⁵ which they will need throughout their life.

In contrast to everyday experiences that cause a positive or tolerable stress response, some experiences can be traumatic, “meaning they threaten the life or physical integrity of the child or someone significant to the child (such as a parent or those in a parenting role or sibling.).”⁶ Traumatic experiences include singular events like a vehicle accident or the death of a loved one.¹ They can also include recurring events like physical or emotional abuse, neglect, or witnessing violence at home or school.¹ Traumatic experiences like these can result in the child experiencing a toxic stress response where the body is on high alert, and the child experiences strong feelings and intense physical reactions.⁵ They can experience a fight, flight, or freeze response, which is the brain’s way of helping the child survive but can significantly reduce effective problem-solving and inhibit their coping skills.¹,2 Toxic stress can leave children of any age feeling overwhelmed, vulnerable, and ill-equipped to cope with what they have experienced.^1,5 A toxic stress response can “disrupt the development of brain architecture and other organ systems, and increase the risk for stress-related disease and cognitive impairment, well into the adult years.”⁵

Responses to Traumatic Events at Different Ages

Not all children who experience something traumatic will develop traumatic stress or experience the traumatic event in the same way.⁵ Many factors contribute to how a child will respond to a traumatic event. Factors that influence a child’s traumatic response include the age and developmental stage of the child, whether they have had other traumatic experiences, whether the traumatic experiences are reoccurring, whether the child is the victim or witness of the trauma, and if the child has caring and supportive relationships with adults that can help buffer the stress of the experience.⁶

While responses to a traumatic experience can vary, understanding some of the general responses of children at different developmental stages can help you as a parent or someone in a parenting role understand why your child behaves the way they do and learn ways to provide support and guidance when it’s needed most.

Ages 0-4

Children ages 0-4 are experiencing many rapid changes. Infants and children are learning about themselves, their strengths and limitations, why they feel the way they do, and how they relate to others.⁴ They are experiencing rapid brain development. Research suggests that 90% of a child’s brain develops by age five.⁷ Both positive and negative early life experiences greatly influence their brain development.⁸

Experiencing a traumatic event at a young age can cause both behavioral and physiological symptoms.⁸ Young children who have experienced an exceptionally stressful event “may be clingy, fearful of new situations, easily frightened, difficult to console, and aggressive and impulsive. They may also have difficulty sleeping, lose recently acquired developmental skills, and show regression in functioning and behavior.”⁸ Young children may “cry or scream a lot, eat poorly or lose weight, and have nightmares.”⁹ Young children cry to communicate their strong feelings like fear, confusion, helplessness, or frustration. Play is a primary form of learning for young children. A child who has experienced trauma may “repeat all or part of the traumatic event” when playing or repeat a specific moment of the trauma repeatedly in their play.¹¹

Ages 5-10

Children ages 5-10 are learning to understand rules, cooperate with others, and are excited to try new activities. A child’s learning is based on interactions with others in their environment. They are increasingly engaged in social play. Children ages 5-10 who have experienced a traumatic or exceptionally stressful event may struggle to concentrate or have recurring thoughts of the event, which could include intrusive dreams.¹⁰ They may fear a similar event will happen ¹⁰and avoid people, places, and things that make them think of the trauma that has occurred.¹¹ They may also avoid talking about “anything remotely related to the traumatic events” or talk about “certain events all the time.” ¹¹ Children may react to situations or events like a much younger child would react.¹¹ They may have a hard time getting restful sleep.⁹ Children ages 5-10 may act out in social situations, deliberately break rules, or misbehave.¹⁰ Children may respond with intense feelings like anxiety, anger, irritability, and grief, or they may have physical reactions like headaches or stomach aches.¹⁰

Ages 11-14

Children/Teens ages 11-14 are experiencing many physical body changes related to puberty and are growing in their cognitive and social awareness.¹⁰ Like younger children, children/teens ages 11-14 who experience an exceptionally stressful event may have difficulty concentrating, and their school performance may suffer.¹⁰ For example, their grades might start to decline.¹⁰ They may experience intense feelings like worry, guilt, shame, and fear. They may feel isolated and alone.⁹ They may also withdraw from their friends, normal routines, or activities they once enjoyed.¹¹

Ages 15-19

Teens ages 15-19 strive to figure out who they are and want to be as they gain greater independence. Teens can anticipate the consequences of their behaviors and modify them to meet their long-term goals and aspirations.¹¹ Teens ages 15-19 who have experienced a traumatic or exceptionally stressful event may develop symptoms of depression.⁹ They may lose interest in once enjoyable activities or need more energy to get through the day.⁹ They may have difficulty learning new information and paying attention in school.¹¹ They may also struggle to develop trusting relationships with others.¹¹ Teens may start using alcohol or engage in other risky behaviors as a response to trauma.⁹

Reactions to Trauma Reminders (Triggers) at Any Age

Regardless of a child’s age, after a child has experienced a traumatic event, they may encounter things that remind them of the experience. These reminders are often called trauma reminders or triggers.¹¹ Triggers vary and are specific to the child but can include specific places, smells, emotions, or sounds. Triggers can relate to specific times or events like birthdays or holidays.¹¹ Triggers can also include people that a child connects to a traumatic event.¹¹ For example, if a child has experienced physical or emotional violence, being around anything that reminds them of the experience, like hearing someone yelling (trigger), can make them feel like they are experiencing the traumatic event again. Trauma reminders or triggers can elicit the fight, flight, or freeze response.¹² Triggers can elicit intense physical reactions and intense feelings and can cause children to display challenging and often difficult behaviors.¹¹ These responses “are best thought of as reflexes – they are not deliberate or planned.”¹²

Parents Play an Important Role

As a parent or someone in a parenting role, your support can minimize the effects of traumatic experiences and help your child feel safe, understand and manage intense feelings and physical reactions, understand and manage difficult behaviors, and develop resilience to overcome challenges.¹¹ Actions you can take to support your child’s healing process and address their challenging behaviors are provided. Further, because caring for a child who has experienced trauma can be difficult, there is also a list of actions that you can take to care for yourself as well.

Actions to Support Your Child’s Healing Process

Supporting your child after a traumatic experience can help them recover and thrive. Here are some actions you can take to support your child’s healing and grow a healthy parent-child relationship.

• Make sure your child’s environment is conducive to healing. It is not likely that your child can recover from trauma if they continue to live in an environment that is not safe, stable, or nurturing.¹³
• Pay close attention to your child’s cues about how they feel.
  • For young children, their facial expressions, body movements, and sounds can help you understand what they are trying to communicate.
  • For older children, reassure them they are safe and all feelings are accepted. It is okay to feel angry, sad, scared, or lonely. Don’t discount how your child feels or try to talk them out of a feeling by saying something like, “You shouldn’t feel that way.” Instead, when your child shares a feeling, acknowledge it and offer a reflection. You could say, “Thanks for sharing how you feel about that. I can see why you would feel sad.”
• Consistently respond to and meet your child’s needs.¹¹ Being responsive to your child’s cries and needs and showing them love and care is critical for building your child’s resilience and helping them reestablish a sense of safety.
• Establish consistent and predictable routines. Establishing routines can reestablish safety and security. Eating meals, doing homework, doing chores, and waking up and going to bed at predictable times are ways to establish consistency and predictability throughout the day.
• Meet your child where they are.¹⁴ For example, if your child is used to sleeping without a nightlight and now requires one to go to sleep, that’s okay. Turn the nightlight on and let your child know you are here for them when they need it.
• Learn about the grief process. Grief is a normal reaction to a traumatic event. Understanding the grieving process for children can help you know what your child is working through and offer you empathy and patience.
• Invite your child to talk about the traumatic experience and their feelings, but don’t push them to share. You could say, “I am here if you want to talk, but it is okay if you don’t want to talk about it right now. You can come to me at any time.” Sometimes, simply being present as your child engages in play or another activity is reassuring and comforting.
• As your child ages, ask them how you can support them. You could say, “I know you are struggling with what happened. How can I support you?” Allow time for them to think about it.
• Model good listening skills. Good listening will increase the likelihood that your child will talk to you about topics that concern them.
• Share your feelings about the traumatic experience in an age-appropriate way. Sharing how you feel can let your child know it is also okay for them to share big feelings with you. “I feel sad and angry about what happened.” 
• Brainstorm ways your child can manage intense physical reactions and feelings safely and appropriately. For example, teach your child to breathe deeply. Deep breathing is more than just a nice thing to do. It decreases the stress chemicals that have flowed over your brain and allows you to regain access to your creativity, language, and logic rather than staying stuck in your primal brain. Practicing deep breathing with your child can offer them a powerful tool to use anytime, anywhere they feel overwhelmed with intense feelings or physical reactions.
• Help your child notice and name their trauma triggers so they can develop self-awareness and learn to manage their reactions. You could say, “I notice that when you hear an angry voice, you freeze. What do you notice in your body when that happens? What feelings do you have when you hear an angry voice?” 
• If your child experiences a trauma reminder or trigger, and you are with them, respond by assuring them they are safe. Using a calm voice, encourage them to breathe or use another one of their coping strategies. You could breathe with them slowly. Don’t try to talk about the situation until they are calm (they won’t hear you until then).
• Point out your child’s resilience when working through intense physical reactions and feelings. This will help them notice their resilience and know it is there when the next challenge arises. You could say, “I noticed that when you heard someone yelling, you started practicing deep breathing. That’s great. How did it feel to use that strategy to help calm yourself?”

Actions to Address Challenging Behaviors

Children who have experienced a traumatic or exceptionally stressful event that caused a toxic stress response may display challenging behavior. Those challenging behaviors can be difficult and disrupt daily life. As a parent or someone in a parenting role, your response when dealing with challenging behaviors is essential. Your goal is to address the challenging behavior while also maintaining and building your relationship with your child.

After experiencing trauma, it may feel like your child has regressed. You may see behaviors you haven’t seen in a while. Teaching your child to experience their intense physical reactions and feelings in safe and appropriate ways is critical to your child’s healing. Rest assured, you can help your child grow skills to manage their thoughts, feelings, and actions. Here are some actions you can take to address challenging behaviors.

• While reacting quickly to your child’s challenging behaviors can be easy, give yourself time to reflect before responding. This short reflection time can help you respond with empathy and connection and help you avoid being reactive to their behavior. Ask yourself:
  • “What are some reasons my child might behave this way?” Remember, you want to look past the behavior to uncover the feelings that may be influencing the behavior. As a parent or someone in a parenting role, the challenge is to avoid interpreting the behavior before trying to understand what is motivating the behavior. For example, feeling unsafe may be encouraging inappropriate behavior.
  • “What is my reaction to this behavior? How do I feel?” Remember, your emotions and current state of mind will influence your listening and talking.
  • “What positive behavior do I need to teach and help my child to practice?”
• Focus on the relationship before the content.
  • For parents or those in a parenting role with infants, connect by responding to their cries. Notice gestures and narrate what you are doing. You could say, “I hear you crying. I think you might need a diaper change. Let’s see if that helps.”
  • For parents or those in a parenting role with young children, connect by getting down on your child’s level, making eye contact, and then engaging them by noticing their gestures or facial expressions and listening for thoughts and feelings. You could say, “You look angry because your face is red. Are you feeling angry?”
  • For parents or those in a parenting role of children and teens, connect by being fully present. Put phones or screens away to avoid distraction. Share what you notice and invite a conversation. You could say, “You seem worried. Is that right? I would like to talk about how things went. Would now be a good time for us to talk?” 
• Use intentional communication to engage in a conversation with your child.
• After engaging in intentional communication, spend time reflecting on your experience. You could ask yourself:
  • ”Did I react in a constructive way that could foster learning for my child?”
  • “How could I handle the situation better next time?” Brainstorm ideas.
  • “Do I need help from a professional to manage this behavior?”
• Ask for help when you need it. A traumatic event can be highly disruptive and require help and support outside of the family. Supporting your child in healing from trauma requires an immense amount of patience, regulation, and emotional energy from you as a caregiver. Getting professional help from someone who specializes in treating children with trauma can help.

Actions to Care for Yourself

A child’s trauma also affects you. Compassion fatigue, also called secondary trauma or vicarious trauma, is common when caring for another person.¹⁴ Compassion fatigue is a broad term to describe the emotional, physical, and spiritual distress that can occur when caring for someone else.¹⁵

Some symptoms of compassion fatigue / secondary trauma may include

• physical symptoms like headaches, trouble sleeping, and stomach problems;
• behavioral symptoms like avoiding other people, feeling critical of others, and substance misuse;
• emotional symptoms like anxiety, irritability, depression, and
• cognitive symptoms like difficulty concentrating, difficulty making decisions, and forgetfulness.¹²

Taking care of yourself is the key to reducing compassion fatigue / secondary trauma. To be available and supportive for your child as they heal from trauma, you must take care of yourself. Here are some actions you can take to care for yourself.

• Reach out to your support network and ask for help when you need it. Everyone needs support. Ask yourself, “Who will I call when I feel exhausted or overwhelmed?” Create a list of supportive people and add their phone numbers beside their names. Talking with a supportive person can help you gain a new perspective.
• Be patient with yourself. You might feel discouraged that things aren’t back to how they were before the trauma. Remember, healing takes time.
• Notice, name, and accept your feelings. It is okay if everything isn’t “fine.” Notice what you are honestly feeling and name it. “I’m tired and cranky this afternoon.” Accepting those feelings rather than fighting them can be a relief.
• Consider if you have endured an adverse experience or trauma as a child (many parents or those in a parenting role have) because your child’s trauma may be triggering your own.¹² Develop a list of your coping strategies.
• Develop a growth mindset. A growth mindset means believing that skills and abilities can be learned and that information and feedback are learning pathways, not a reflection of a person’s value or worth. Remember, you don’t always have to do things right. You are learning.
• Take time for yourself. It is essential to take care of yourself so you can care for others. Find time every day to do something you enjoy. You could use the time to take a walk outside, read, take a bath, meditate, go to the gym, or whatever helps you feel re-energized and connected. Caring for yourself can help you maintain a healthy perspective.

Closing

Traumatic experiences can overwhelm a child’s ability to cope with what they have experienced. Fortunately, children who have experienced traumatic events can recover, thrive, and reach their full potential. As a parent or someone in a parenting role, you can support your child by helping them feel safe, manage strong and sometimes overwhelming feelings, and manage difficult behaviors.