What Are the Signs of Trauma in Children

The experiences during the formative years (from birth to age eight) of childhood are meaningful as they lay the foundation for the rest of your child’s life. While it is often said that children are resilient, it’s that trauma looks different in children compared to adults. 

Trauma during childhood is associated with numerous mental disorders and physical illnesses among children, adolescents, and adults, and a growing number of experts call it a public health crisis (Parks, 2020).

Unresolved trauma (unprocessed/unaddressed trauma) from traumatic events can shape children leaving a lasting negative impact long into life. Children must get the help they need to resolve sources of conflict, prevent long-suffering and begin healing. 

Common signs of trauma in children

Trauma is any disturbing event or experience perceived as life-threatening or causing great (psychological/physical/emotional) harm. Trauma can be a single event (natural disaster, car accident, illness, loss) or reoccurring experiences (abuse, racism, neglect, bullying).

The reoccurrence of traumatic experiences or stress is also known as complex trauma. Children may also experience trauma due to witnessing (or having knowledge of) harm to a parent or loved one, for example, in situations of intimate partner violence.  

Childhood trauma can occur when a disturbing event or experience occurs; however, not all disturbing events will result in trauma for children. 

What makes an event traumatic can vary from child to child depending on the severity of the event and additional factors like

• The age of the child. A toddler’s experience with trauma will differ from a teen’s experience. 
• The developmental stage of the child. A toddler with limited communication skills may not express trauma in a way that is easy to recognize.  
• The child’s environment (parents/caregivers). Were caregivers supportive of the child? Did parents acknowledge or ignore trauma? Did they react with strong emotions? 

How a child responds after exposure to a traumatic event differs according to their developmental stage and chronological age. It is essential to know the signs of trauma in children, as the impact of unresolved trauma can last for years. 

Some of the most common signs of childhood trauma are.

• Fear (fear when being separated from parent)
• Frequently crying or tearful
• Regressive behaviors (going back to an earlier stage of development, a sign of stress)
• Bedwetting
• Difficulty concentrating
• Expresses concerns about their safety
• Easily frightened/scared
• Sleep disturbances 
• Recreating trauma during play (younger children, toddler/elementary)
• Weight loss or gain
• Expresses sadness
• Low frustration tolerance
• Sexualized behaviors
• Risk-taking (increase in reckless behaviors not otherwise common)
• Self-harm (cutting)
• An intense outburst of anger
• Disassociating (withdrawn, shut down, daydreaming)

Here are common causes of childhood trauma

Childhood trauma can take place at any age and is very common. The more adverse childhood experiences (ACES) a child encounters, the higher risk for mental health, physical health, behavioral, educational, and relational issues later in life. 

The American Pediatric Association (2021) estimates that roughly one-half (34 million) American children,18 years or younger, have faced at least one potentially traumatic early childhood experience.

The National Child Traumatic Stress Network (NCTSN) defines complex child trauma as exposure to multiple traumatic events (abuse and household dysfunction) and the pervasive impact on the child, disrupting a child’s attachment with caregivers, development, and sense of self.

A study by Canady (2020) found that complex trauma exposure can cause biological aging (the gradual deterioration of cells). The three signs of biological aging are early puberty, cellular aging, and changes in brain structure. 

There is no direct cause of childhood trauma, as what is traumatic to one child might not be to another. Some children are considered at high risk of encountering childhood trauma based on family environment, previous trauma history, and conditions of poverty causing prolonged traumatic stress. 

Additional causes of childhood trauma are

• Exposure to violence (community, school)
• Loss of a parent (death, incarceration)
• Natural disasters
• Fires
• Divorce
• Neglect of needs (physical, emotional)
• Chronic illness/Threat of illness (Pandemic)
• Abuse (sexual, physical, emotional)
• Witness to violence
• Racism (prolonged trauma)
• Bullying
• War/threats of terrorism
• Abandonment

How to help a child with trauma

Although trauma can be complex, the way to help a child doesn’t have to be. Several resources are available to help you and your child, from professional help with a trauma-informed therapist to self-help books. Getting informed on childhood trauma is an excellent place to start. 

For severe and complex trauma cases, seeking professional help from a trauma-informed therapist is best. Trauma-informed therapy is a holistic approach emphasizing safety in addressing trauma by highlighting a person’s strengths to improve behaviors and thoughts.

Additional forms of therapy that can help children recover from trauma include 

• Play therapy– Children, especially younger children, learn through play. Play therapy can assist children in expressing their feelings related to trauma in a safe format.
• Family therapy– Parental family involvement is vital to help a child recover from a traumatic experience. Family therapy supports children in learning new ways to cope with trauma symptoms.  
• Art, music, therapy & other expressive interventions– Expressive arts can reduce poor health and mental health outcomes for children exposed to ACEs, moving it into the forefront of trauma-informed care practices (Pliske et al., 2021). 
• Bibliotherapy can be an excellent resource for both parents and children. There are self-help books that can assist parents in supporting their child who has experienced trauma. Children’s books exploring trauma topics can help children by validating their feelings.
  • Some recommendations include
    • What Happened to You? by Bruce D. Perry, Oprah Winfrey
    • The Body Keeps the Score by Bessel Van Der Kolk
    • Trauma Through a Child’s Eyes: Awakening the Ordinary Miracle of Healing by Peter A. Levine Ph.D., Maggie Kline 
    • The Power of Showing Up. by Dan Siegel, Tina Payne Bryson 
    • The Invisible String by Patrice Karst
    • Once a Terrible Thing Happened by Margaret M Holmes
    • The Day My Daddy Lost His Temper: Empowering Kids That Have Witnessed Domestic Violence (The Empowering Kids Series) by Dr. Carol Santana McCleary PsyD
    • Kaddish for Grandpa in Jesus’ Name Amen by James Howe
    • Help Your Dragon Cope with Trauma by Steve Herman

After most traumatic incidents children encounter have passed, the goal is to ensure safety. This healing process can begin by staying consistent and present with your child’s needs (emotional and physical), as this provides structure and space for them to express themselves. 

Parents can further help children by engaging their community for support. Support might include the following.

• Reaching out to trusted family members and sharing safety plans 
• Practicing self-care by enlisting support from your network when you need a break. If you have unresolved trauma, it can be triggered by your child’s experience.  
• Advocating for your child at their school. Difficulty concentrating is, at times, a symptom of childhood trauma. If needed, request school support services (guidance counselor, school social worker, etc.). 

Next steps

While the focus is often on the traumatic event, the healing journey is about everything that takes place after the trauma. Your support in their recovery is vital for parents, loved ones, and caregivers of children who have experienced trauma. 

The support of family and caring community members can serve as a protective factor for children who have experienced trauma. Research has shown that early intervention for children can minimize the adverse effects of trauma in their adult life.  

Parents can utilize the resources listed below to assist their children if they have been exposed to trauma. 

The National Child Traumatic Stress Network

SAMHSA

Choosing the right therapist for your child

Marriage and Family Therapist: Family Friendly Mental Health Therapist Child Mind Institute – Talking to Kids about Traumatic Experiences

If you know or suspect child abuse, please report it, as doing so could save a life. Contact The Childhelp National Child Abuse Hotline at 1800-442-445.3

References

Canady, V.A. (2020). Experiencing childhood trauma ages the body and brain faster. Mental Health Weekly, 30: pp. 7–8.

The Center for Child Trauma Assessment, Services, and Interventions http://cctasi.northwestern.edu/

Forkey, H., Szilagyi, M., Kelly, E., et. al (2021), Trauma-Informed Care. Pediatrics 148 (2)

Parks, P. J. (2020). Childhood Trauma. Reference point Press.

Pliske, M. M., Stauffer, S. D., & Werner-Lin, A. (2021). Healing from adverse childhood experiences through therapeutic powers of play: “I can do it with my hands.” International Journal of Play Therapy, 30(4), 244–258.

Mellisa Gooden M.A., LMFT-QS, LMHC-QS, CCTP, CCATP