Traumatic events and children

Your child could experience a one-time traumatic event or a repeated trauma that happens over and over again.

Examples of one-time traumatic events are:

• Natural disasters, such as a tornado, hurricane, fire, or flood
• Sexual assault
• Physical assault
• Witnessing shooting or stabbing of a person
• Sudden death of a parent or trusted caregiver
• Hospitalization

Examples of traumatic events that your child experiences over and over are:

• Physical or emotional abuse
• Sexual abuse
• Gang violence
• War
• Terrorist events

Your child may be having emotional reactions and feels:

• Nervous
• Worried about safety
• Agitated
• Withdrawn
• Sad
• Scared of sleeping alone at night
• Temper tantrums
• Dissociated, which is an extreme and common reaction to a traumatic event. Your child copes with the trauma by withdrawing from the world. They feel detached and see things happening around them as if it is unreal

Your child may also be having physical problems like:

• Stomachaches
• Headaches
• Nausea and vomiting
• Trouble sleeping and nightmares

Your child may also be reliving the event:

• Seeing images
• Remembering every detail of what happened and what they did
• Have the need to tell the story over and over again

One half of the children who survive traumatic events will show signs of PTSD. Every child's symptoms are different. In general, your child may have:

• Intense fear
• Feelings of helplessness
• Feelings of being agitated and disorganized
• Trouble sleeping
• Trouble focusing
• Loss of appetite
• Changes in their interactions with others, including more aggressive or more withdrawn

Your child may also go back to behaviors they had outgrown:

• Bedwetting
• Clinging
• Sucking their thumb
• Emotionally-numb, anxious, or depressed
• Separation anxiety

Let your child know that they are safe and that you are in control.

• Know that your child is taking cues from you on how to react to the traumatic event. It is OK for you to be sad or hurt.
• But your child needs to know that you are in control and are protecting them.

Let your child know that you are there for them.

• Return to a daily routine as soon as you can. Create a schedule for eating, sleeping, school, and playing. Daily routines help kids know what to expect and make them feel safe.
• Talk to your child. Let them know what you are doing to keep them safe. Answer their questions in a way they can understand.
• Stay close to your child. Let them sit near you or hold your hand.
• Accept and work with your child on regressed behavior.

Monitor information that your child is getting about an event. Turn off the TV news and limit your conversations about events in front of young children.

There is no one way that children recover after traumatic events. Expect that your child should go back to their usual activities over time.

If your child is still having trouble recovering after one month, get professional help. Your child will learn how to:

• Talk about what happened. They will tell their stories with words, pictures, or play. This helps them see that the reaction to the trauma is normal.
• Develop coping strategies to help with fear and anxiety.

Let teachers know about traumatic events in your child's life. Keep open communication about changes in your child's behavior.

Stress - traumatic events in children

Augustyn MC, Zukerman BS. Impact of violence on children. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 14.

Kallay T, Berkowitz C. Child abuse. In: Zimmerman JJ, Clark RSB, Fuhrman BP, et al, eds. Fuhrman and Zimmerman's Pediatric Critical Care. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 121.

Updated by: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.