How children experience traumatic events and how they express their lingering distress depends, in large part, on the children’s age and level of development.
Preschool and young school-age children exposed to a traumatic event may experience a feeling of helplessness, uncertainty about whether there is continued danger, a general fear that extends beyond the traumatic event and into other aspects of their lives, and difficulty describing in words what is bothering them or what they are experiencing emotionally. This feeling of helplessness and anxiety is often expressed as a loss of previously acquired developmental skills. Often, children lose some speech and toileting skills, or their sleep is disturbed by nightmares, night terrors, or fear of going to sleep. In many cases, children may engage in traumatic play (a repetitive and less imaginative form of play) that may represent a child’s continued focus on the traumatic event or an attempt to change the negative outcome of a traumatic event.
School-age children’s traumatic experience may elicit feelings of persistent concern over their own safety and the safety of others. These children may be preoccupied with their own actions during the event. Often, they experience guilt or shame over what they did or did not do during a traumatic event. School-age children might engage in constant retelling of the traumatic event, or they may describe being overwhelmed by their feelings of fear or sadness. A traumatic experience may compromise the developmental tasks of school-age children as well. Children of this age may display sleep disturbances, which might include difficulty falling asleep, fear of sleeping alone, or frequent nightmares. Teachers often comment that these children are having greater difficulties concentrating and learning at school. Following a traumatic event, children may complain of headaches and stomach aches without obvious cause, and some children engage in unusually reckless or aggressive behavior.
Adolescents exposed to a traumatic event feel self-conscious about their emotional responses to the event. Feelings of fear, vulnerability, and concern over being labeled “abnormal” or different from their peers may cause adolescents to withdraw. Adolescents often experience feelings of shame and guilt about the traumatic event and may express fantasies about revenge and retribution. A traumatic event for adolescents may foster a radical shift in the way these children think about the world. Some adolescents engage in self-destructive or accident-prone behaviors.
How to Help
For young children, offer support by providing comfort, rest, and an opportunity to play or draw. Provide reassurance that the traumatic event is over and that the children are safe. Help children verbalize their feelings so that they don’t feel alone with their emotions. Providing consistent caretaking can provide a sense of security for children who have recently experienced a traumatic event. Caregivers may need to tolerate regression in developmental skills for a period of time following a traumatic event.
Older children will also need encouragement to express fears, sadness, and anger in a supportive environment. These school-age children may need to be encouraged to discuss their worries. It is important to acknowledge the normality of their feelings and to correct any distortions of the traumatic events that they express.
For Adolescents who have experienced a traumatic event, encourage discussion of the event and feelings about it and expectations of what could have been done to prevent the event. It may be important to help adolescents understand “acting out” behavior as an effort to voice anger about traumatic events. It may also be important to discuss thoughts of revenge following an act of violence, address realistic consequences of actions, and help formulate constructive alternatives that lessen the sense of helplessness the adolescents may be experiencing.
