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https://www.samhsa.gov/child-trauma/recognizing-and-treating-child-traumatic-stress#signs

Recognizing and Treating Child Traumatic Stress

Learn about the signs of traumatic stress, its impact on children, treatment options, and how families and caregivers can help.

Types of Traumatic Events

Childhood traumatic stress occurs when violent or dangerous events overwhelm a child’s or adolescent’s ability to cope.

Traumatic events may include:

  • Neglect and psychological, physical, or sexual abuse
  • Natural disasters, terrorism, and community and school violence
  • Witnessing or experiencing intimate partner violence
  • Commercial sexual exploitation
  • Serious accidents, life-threatening illness, or sudden or violent loss of a loved one
  • Refugee and war experiences
  • Military family-related stressors, such as parental deployment, loss, or injury

In one nationally representative sample of young people ages 12 to 17:

  • 8% reported a lifetime prevalence of sexual assault
  • 17% reported physical assault
  • 39% reported witnessing violence

Also, many reported experiencing multiple and repeated traumatic events.

It is important to learn how traumatic events affect children. The more you know, the more you will understand the reasons for certain behaviors and emotions and be better prepared to help children and their families cope. Learn more about the types of trauma and violence and types of disasters.

 

Signs of Child Traumatic Stress

The signs of traumatic stress are different in each child. Young children react differently than older children.

Preschool Children

  • Fearing separation from parents or caregivers
  • Crying and/or screaming a lot
  • Eating poorly and losing weight
  • Having nightmares

Elementary School Children

  • Becoming anxious or fearful
  • Feeling guilt or shame
  • Having a hard time concentrating
  • Having difficulty sleeping

Middle and High School Children

  • Feeling depressed or alone
  • Developing eating disorders and self-harming behaviors
  • Beginning to abuse alcohol or drugs
  • Becoming sexually active

For some children, these reactions can interfere with daily life and their ability to function and interact with others.

 

Impact of Child Traumatic Stress

The impact of child traumatic stress can last well beyond childhood. In fact, research shows that child trauma survivors are more likely to have:

  • Learning problems, including lower grades and more suspensions and expulsions
  • Increased use of health services, including mental health services
  • Increased involvement with the child welfare and juvenile justice systems
  • Long term health problems, such as diabetes and heart disease

Trauma is a risk factor for nearly all behavioral health and substance use disorders.

 

What Families and Caregivers Can Do to Help

Not all children experience child traumatic stress after experiencing a traumatic event, but those who do can recover. With proper support, many children are able to adapt to and overcome such experiences.

As a family member or other caring adult, you can play an important role. Remember to:

  • Assure the child that he or she is safe. Talk about the measures you are taking to get the child help and keep him or her safe at home and school.
  • Explain to the child that he or she is not responsible for what happened. Children often blame themselves for events, even those events that are completely out of their control.
  • Be patient. There is no correct timetable for healing. Some children will recover quickly. Others recover more slowly. Try to be supportive and reassure the child that he or she does not need to feel guilty or bad about any feelings or thoughts.

Review NCTSI’s learning materials for parents and caregivers, educators and school personnel, health professionals, and others.

 

Treatment for Child Traumatic Stress

Even with the support of family members and others, some children do not recover on their own. When needed, a mental health professional trained in evidence-based trauma treatment can help children and families cope with the impact of traumatic events and move toward recovery.

Effective treatments like trauma-focused cognitive behavioral therapies are available. There are a number of evidence-based and promising practices to address child traumatic stress.

Each child’s treatment depends on the nature, timing, and amount of exposure to a trauma.

Review Effective Treatments for Youth Trauma – 2004 (PDF | 55 KB) at the National Child Traumatic Stress Network (link is external).

Families and caregivers should ask their pediatrician, family physician, school counselor, or clergy member for a referral to a mental health professional and discuss available treatment options.

 

More Ways to Find Help

Many U.S. agencies and other groups offer research and support related to child traumatic stress.

Government Websites

Other Organizations

 

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How to Talk About Mental Health
 
 
Do you need help starting a conversation with your child about mental health? Try leading with these questions. Make sure you actively listen to your child’s response.
 

  • Can you tell me more about what is happening? How you are feeling?
  • Have you had feelings like this in the past? 
  • Sometimes you need to talk to an adult about your feelings. I’m here to listen. How can I help you feel better? 
  • Do you feel like you want to talk to someone else about your problem? 
  • I’m worried about your safety. Can you tell me if you have thoughts about harming yourself or others? 
  • When talking about mental health problems with your child you should:  
  • Communicate in a straightforward manner 
  • Speak at a level that is appropriate to a child or adolescent’s age and development level  (preschool children need fewer details than teenagers) 
  • Discuss the topic when your child feels safe and comfortable 
  • Watch for reactions during the discussion and slow down or back up if your child becomes confused or looks upset 
  • Listen openly and let your child tell you about his or her feelings and worries 


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https://youth.gov/youth-topics/youth-mental-health/warning-signs

Warning Signs

If a youth has a constellation of risk factors, it is important to seek assistance for the young person and his or her family. If a family member or friend is concerned, discussing the issue with another family member, friend, spiritual counselor, family pediatrician, or primary doctor could be helpful. Signs and behaviors to look for include, among others:

  • Marked fall in school performance
  • Poor grades in school despite trying very hard
  • Severe worry or anxiety, as shown by regular refusal to go to school, go to sleep or take part in activities that are normal for the child's age
  • Frequent physical complaints
  • Marked changes in sleeping and/or eating habits
  • Extreme difficulties in concentrating that get in the way at school or at home
  • Sexual acting out
  • Depression shown by sustained, prolonged negative mood and attitude, often accompanied by poor appetite, difficulty sleeping or thoughts of death
  • Severe mood swings
  • Strong worries or anxieties that get in the way of daily life, such as at school or socializing
  • Repeated use of alcohol and/or drugs1

Learn more about promoting, preventing, and treating mental health issues.

1 American Academy of Child and Adolescent Psychiatry, 2011

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https://www.samhsa.gov/find-treatment

Seek immediate assistance if you think your child is in danger of harming themselves or others. 

You can call a crisis line or the National Suicide Prevention Line at 1.800.273.TALK (8255).

Suicide Prevention Lifeline

1-800-273-TALK (8255)
TTY: 1-800-799-4889
Website: www.suicidepreventionlifeline.org (link is external)

24-hour, toll-free, confidential suicide prevention hotline available to anyone in suicidal crisis or emotional distress. Your call is routed to the nearest crisis center in the national network of more than 150 crisis centers.

SAMHSA's National Helpline

1-800-662-HELP (4357)
TTY: 1-800-487-4889

Website: www.samhsa.gov/find-help/national-helpline

Also known as, the Treatment Referral Routing Service, this Helpline provides 24-hour free and confidential treatment referral and information about mental and/or substance use disorders, prevention, and recovery in English and Spanish.

Disaster Distress Helpline

1-800-985-5990
Website: www.samhsa.gov/find-help/disaster-distress-helpline

Stress, anxiety, and other depression-like symptoms are common reactions after any natural or human-caused disaster. Call this toll-free number to be connected to the nearest crisis center for information, support, and counseling.

Veteran's Crisis Line

1-800-273-TALK (8255)
TTY: 1-800-799-4889

Website: www.veteranscrisisline.net (link is external)

Connects veterans in crisis (and their families and friends) with qualified, caring Department of Veterans Affairs responders through a confidential, toll-free hotline, online chat, or text.

 

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If your child is in need of community mental health services you can find help in your area.
      

Give Feedback here @ depressionforums.org and:
 
    U.S. Department of Health & Human Services, 200 Independence Avenue, S.W. Washington, D.C. 20201

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