Although it is normal for a child to be upset when something scary happens, and to exhibit symptoms of stress immediately following the incident, not every child who experiences a traumatic event will develop PTSD.
In order for stress reactions to be diagnosed as PTSD, they need to have lasted for longer than a month, and the incident that triggered them needs to have so overwhelmed the child’s ability to cope that it’s having a negative effect on his or her life, impacting relationships, and keeping him or her from engaging in normal day to day activities they used to be involved in before.
Events that can cause PTSD in children
- Witnessing domestic violence in the home, and/or being physically or sexually abused are the leading causes of PTSD in children.
- Natural or manmade disasters such as fires, floods, tornadoes, explosions, or bombings.
- Being bitten by a dog or other animal.
- Witnessing, or being a victim of, a violent crime such as kidnapping, rape, sniper fire, school shooting, mob violence, or terrorism.
- Being involved in a car accident or plane crash.
- Exposure to murder, or peer suicide.
- Serious illness.
- Sudden loss of a parent or caregiver through separation or divorce.
- Death of a close family member or friend.
Symptoms of PTSD in children
- Sudden vivid memories of the trauma that make the child feel as though it is still happening, and that lead to fear, panic, and symptoms of extreme physiological distress such as trembling or numbness.
- Reliving the incident repeatedly, talking about it constantly, and or re-enacting it in play.
- Frequent flashbacks and nightmares about the traumatic event.
- Avoiding people or places that remind them of, or are associated with, the traumatic event.
- Acting helpless or withdrawn.
- Irritability and/or angry outbursts.
- Being easily startled.
- Being hypervigilant and constantly on the lookout for possible threats.
- Trouble concentrating.
- Not wanting to talk about the incident, dissociating from it, or blocking out the memory of it and denying it happened.
- Younger children may exhibit regressive behaviors such as wetting the bed after having learned how to use the toilet or forgetting how to talk. They may also become unusually clingy and fear being separated from their parent or caregiver.
Why do some children develop PTSD and others do not?
There are no definitive answers as to why some children develop PTSD and others do not, but there are some risk factors that can make a child more vulnerable. The
National Child Traumatic Stress Network (NCTSN) lists three:
The severity of the traumatic event. Did someone die because of it, or get seriously injured? Was the child the victim, or an observer? Was the child separated from his or her parent or caregiver?
Child’s proximity to the event. Was the child actually there, or did they just hear about the incident or see it on TV?
Parent’s reaction to it. Did the parent validate their child’s reaction and take it seriously? Did they believe he or she was telling the truth? How did they respond to their child?
Studies have also shown that children with strong, supportive, nurturing families tend to be more resilient and less likely to develop PTSD than are children with toxic, dysfunctional families, who have been subjected to abuse or neglect (Basem Abbas Al Ubaidi).
What to do if your child has PTSD
- Comfort your child and do whatever you can to help him or her feel safe. Reassure them that the event is over and that he or she was not to blame for what happened,
- Be loving, and supportive. Acknowledge and validate your child’s fears, and give him or her time to learn how to cope with them.
- Try not to treat your child differently or make significant changes to his or her schedule.
- Listen patiently to your child’s retelling of the event, and allow him or her to talk about it in his or her own way. They may have trouble verbalizing what took place and find it easier to express themselves through drawings, or by re-enacting it in play.
- Be understanding of what your child is going through and avoid criticizing or punishing them if they exhibit regressive behavior.
- As much as you are able, protect your child from exposure to frightening situations such as scary TV programs or stories, or reminders of the traumatic event such as visiting the location or seeing pictures of it.
- Engage the support of other family members, friends, and teachers. Children with PTSD tend to have more trouble focusing on schoolwork and may need extra help and/or time to complete their assignments.
- Speak affirming words to your child such as, “You are loved,” “You are precious,” “God loves you,” “You are special,” “You are wonderfully made.” (Psalm 139:4)
- Help your child relax. Show them how to breathe slowly and deeply and do it with them.
- Play and laugh with your child. Do things together that you enjoy, like taking a nature walk, baking cookies, singing, or painting, for example.
- Consult a mental health professional who specializes in treating children with PTSD. Therapy can help increase your child’s confidence and courage, as well as teach him or her how to draw on their strengths to cope with the symptoms triggered by the trauma.
Therapy for children with PTSD
The most common therapy for children with PTSD is called TF-CBT (Trauma-Focused Cognitive Behavioral Therapy). It provides a way for them to share their feelings in a safe environment, tell their story, and get support.
Your child will learn coping and calming skills to help him or her deal with the anxiety triggered by memories of the traumatic event so that it becomes easier for him or her to talk about what they’ve been through. They will also learn how to reframe some of their thoughts about the incident, and let go of any guilt or shame they may be feeling about what happened to them.
When conducting TF-CBT with younger children, the counselor will usually use a combination of talk therapy, drawing, and a story or play activities that enable the child to re-enact the traumatic event.
Therapy with older children or teens often includes:
Play therapy This type of therapy helps to treat the younger children who are unable to deal with trauma directly.
Prolonged exposure (PE) activities to help the child confront his or her trauma-related thoughts and situations rather than continue to avoid them. Avoidance will keep them stuck in their cycle of PTSD.
Eye Movement Desensitization and Reprocessing Therapy (EMDR), which combines cognitive behavioral therapy with directed eye movements to get the brain to reprocess the memory of the trauma and reduce its distressing effects on the child.
Christian counseling for children
Christian counseling involves a combination of Biblical principles and clinical intervention. If you have questions or would like to set up an appointment, please contact me or our scheduling department to connect with one of the other faith-based counselors in our online counselor directory. We would be happy to meet with you to discuss therapy options for your child.
About Child Trauma. The National Child Traumatic Stress Network (NCTSN).
Basem Abbas Al Ubaidi (July 31, 2017). Cost of Growing up in Dysfunctional Family. Journal of Family Medicine and Disease Prevention, Vol. 3, Issue 3.
“Post-traumatic Stress Disorder in Children.” Centers for Disease Control and Prevention, cdc.gov/childrensmentalhealth/ptsd.html.
WebMD Editorial Contributors (March 12, 2021). “What to Know About PTSD in Children.” WebMD.
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