Factsheet 20: Traumatic stress in children: for parents
and teachers
About this factsheet
This is one in a series of factsheets for parents, teachers
and young people entitled Mental Health and Growing Up.
The aims of these factsheets are to provide practical, up-to-date
information about mental health problems (emotional, behavioural
and psychiatric disorders) that can affect children and young
people. This factsheet describes the causes and symptoms of
traumatic stress, and provides practical advice on how to get
help.
Introduction
What is traumatic stress?
Children, like adults, sometimes experience or witness
something extremely frightening and dangerous, such as a road
accident, a serious injury or a crime. This can cause a traumatic
stress reaction, which affects the way the child thinks, feels and
behaves. Children can be as severely affected as adults. If you
recognise it, you will be better able to help your child to
recover, and also to know when to seek professional help.
What are the signs of traumatic stress?
Individual children react in different ways to traumatic
events. Immediately after the traumatic event, children may find it
hard to sleep and have bad dreams and nightmares. Sometimes, the
effects may not appear for days or weeks. They may, however:
- become fearful, clingy and anxious about being separated from
their parents
- start bedwetting and thumb-sucking again
- become preoccupied with thoughts and memories of the event
- be unable to concentrate
- be irritable and disobedient
- complain of physical symptoms such as headaches and
stomach-aches.
All these are normal reactions to an extremely frightening
event. With help and support from the people close to them,
children begin to get over the shock in a few days, and usually
recover after a few weeks.
Longer-lasting effects
Sometimes a child has feelings of depression and anxiety that
go on for several weeks and may get worse. If they go on for a long
period of time, it is likely that the child may need some help to
feel better.
If the traumatic experience was so bad that the child was in
danger of being killed or seriously injured, they may have felt
terrified, horrified and helpless. Post-traumatic stress
disorder (PTSD) might follow a dreadful experience of this
sort. Typical signs are:
- `flashbacks' of the event. For a few moments, it seems as
though you are re-living the experience in your mind, like watching
an action-replay, which can be distressing and frightening -
particularly for children;
- deliberately avoiding thoughts or feelings about it. If you've
been in a car crash, you may avoid roads, or even TV programmes
about cars, because they remind you of the accident;
- sleeping badly;
- being easily startled and jumping out of your skin at the
slightest noise.
These reactions can go on for months and can interfere
considerably with a child's daily living. They may be unable to
enjoy playing or find it difficult to concentrate on their school
work. Occasionally, these problems can continue as the child grows
into adulthood.
What can help?
The best approach, immediately after a traumatic event, is to
accept that a child will be distressed _ this is normal. At this
stage, parents can help greatly by letting their child talk about
the event if they want to, or helping them to relive it in games
and drawings. Leaving children alone `to forget things' does not
help. Talking can help children to adjust. It helps them to make
sense of what has happened, to feel less alone with their worries
and to regain a sense of control. However, forcing someone to talk
about it when they don't want to does not seem to be helpful.
If you have been involved in the traumatic event, you may also
be distressed. It is usually better to admit to your children that
you are feeling sad and upset. At the same time, you need to make
it clear that you don't expect them to look after your
feelings.
Sometimes, children find it easier to talk to other adults
rather than their parents. Professional help may be needed to help
get them get back to normal more quickly, and to prevent or reduce
the harmful effects of prolonged stress reactions.
Ask for help if:
- the child's upset feelings and behaviour seem to be getting
worse.
- the signs of extreme stress last for longer than about one
month.
- worries prevent you, your child or your family getting on with
normal, everyday life.
- the child has symptoms of PTSD that go on for longer than a
month.
Where can I get help?
If you are concerned about your child at any time following a
traumatic event, consult your general practitioner, who will be
able to offer you help and support. If problems continue, the
doctor may suggest extra help from the local child and adolescent
mental health service.
If you have been involved directly in a community disaster,
special support services will be arranged. Do not hesitate to make
contact with them if you want to talk over your worries.
References
- Carr, A. (ed.) (2000) 'What Works with Children and
Adolescents?' - A Critical Review of Psychological Interventions
with Children, Adolescents and their Families. London:
Brunner-Routledge.
- Rutter, M. & Taylor, E. (eds) (2002) 'Child and
Adolescent Psychiatry' (4th edn). London: Blackwell.
- Scott, A., Shaw, M. & Joughin, C. (eds) (2001) 'Finding
the Evidence' - A Gateway to the Literature in Child and Adolescent
Mental Health (2nd edn). London: Gaskell.
Sources of further information
- The Mental Health and Growing Up series contains 36
factsheets on a range of common mental health problems. To order
the pack, contact Book Sales at the Royal College of Psychiatrists,
17 Belgrave Square, London SW1X 8PG. Tel. 020 7235 2351, ext. 146;
fax 020 7245 1231; e-mail: booksales@rcpsych.ac.uk, or
you can download them from this website.
© [2004]
Royal College of Psychiatrists. This factsheet may be downloaded,
printed out, photocopied and distributed free of charge as long as
the Royal College of Psychiatrists is properly credited and no
profit is gained from its use. Permission to reproduce it in any
other way must be obtained from the Head of Publications. The College
does not allow reposting of its factsheets on other sites, but
allows them to be linked to directly.
Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.
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