How to tell if your child is traumatized

Every child has moments of sadness in response to life’s disappointments, but how can you tell if your child has been traumatized?

Unlike adults, children are not always able to express their emotions in words. Therefore it is critical to pay attention to significant behavioral changes, particularly those that occur following an injury, illness, death of a loved one, or catastrophic event such as a natural disaster or major accident. Divorce, separation, or other disruptions to family life, such as moving to another city or changing schools, can also be difficult for children to tolerate and could lead to problems adjusting.

Children who experience a major loss or other traumatic event respond in many different ways. Some may have difficulty sleeping, or develop a fear of the dark. Others might have a loss of appetite, throw tantrums, or be more irritable or impatient than usual. Children are incredibly resilient, and such symptoms usually subside within a few weeks or months without any clinical intervention or counseling. However, if your child displays any of the following symptoms for six months or longer, you may want to have them assessed by a licensed mental health professional.

• Sleep disturbance: sleeping too much or too little, avoids going to bed at night, nightmares or terrors, restless sleep, sleepwalking, or talking in sleep, refusing to get out of bed or having difficulty waking up in the morning
  


• Change in appetite: eating more or less than usual, loss of appetite, refusing food, hording or hiding food
  


• Irritability or tantrums: excessive arguing or complaining, hysterical crying and screaming in response to changes to daily routine or minor disappointments
  


• Worry or anxiety: fear about personal safety or the safety of loved ones, persistent fantasies involving death, illness, or other distressing events
  


• Violent or aggressive behavior: throwing objects, destruction of property, hitting, kicking, punching, yelling, or threatening siblings, other children, adults, or pets
  


• School refusal: not wanting to go to school, refusing to do homework or engage in other academic activities
  


• Loss of interest: dropping out of sports or other extracurricular activities, not wanting to interact with friends or other children, indifferent towards toys or other things once found enjoyable
  


• Regressed behaviors: bed soiling, thumb sucking, wanting to be held constantly, separation anxiety
  


• Acting out behavior: lying, cheating, stealing, promiscuity or inappropriate sexual activity
  


• Somatic complaints: headaches, stomach aches, or other aches and pains not caused by a medical condition
  


• Repetitive play: Re-enacting the traumatic event over and over through play
  Phobia: sudden development of irrational fears that interfere with daily functioning
  


• Suicidal ideation or attempts: talking about wanting to die or wishing they were dead, engaging in high risk behavior or self harm such as cutting, scratching, burning, or hitting, suicidal threats
  


• Alcohol or drug abuse: drinking or using illegal drugs, taking more than recommended amount of prescribed medication, overuse of over-the-counter medication
  
  It is important to remember that some children might not display any of the above symptoms in response to trauma and seem to go on with life as if nothing happened. This is not unusual and should not be cause for alarm, nor is it necessary to encourage a child to “talk about” the event. Trying to make children talk about their feelings or a distressing event may seem like a good idea, but it can cause more harm than good. Imagine for a moment something painful or difficult that has happened in your life. Now imagine someone asking you about it on a daily basis. Do you really want to be reminded of it all the time? For many children, talking about a distressing event can cause them to experience it all over again which may be re-traumatizing. With children, it is better to let them share if they need to, calmly listening to whatever they have to say and using reflective or mirroring statements to let them know you hear them without adding interpretation or asking probing questions.