Trauma Symptoms In Children: How To Recognize Child Traumatic Stress

When people imagine a person living with post-traumatic stress disorder (PTSD), they may picture a military veteran who has returned from an overseas deployment or a woman who has fled an abusive boyfriend or husband. However, traumatic events can happen to anyone – including children. As much as individuals may not want to think about horrible experiences that traumatize kids, recognizing the signs and symptoms of traumatic stress in children can be the first step toward alleviating them and finding help. 

Examples of traumatic events that can affect a child’s development and mental health

A traumatic event may be described as any event that results in actual or threatened death, danger, or serious injury to a person or to someone they care about, such as a family member. However, over time, understanding of psychological trauma, particularly trauma experiences that impact young children, has become more nuanced. 

Complex trauma can include neglect, domestic violence, sex trafficking, physical, emotional, or sexual abuse, and other forms of harm that can make a child believe they are not safe anywhere, not even in their own home. Complex trauma may be more likely to result in long-term mental health impacts like PTSD. 

While complex trauma may be one of the most problematic forms of childhood trauma, other traumatic events that do not necessarily fall under the umbrella of complex trauma can also result in a childhood PTSD diagnosis, including: 

• Injury
• Being a survivor of or witness to a crime
• Serious illness
• Experiencing racism, prejudice, or other forms of discrimination
• Living with a family member who has a substance use disorder or severe mental illness
• Separation from primary caregivers, including through immigration, deportation, or incarceration
• Being bullied
• Living in an unsafe neighborhood
• Experiencing high levels of family conflict that is not adequately addressed, including parental separation or divorce

PTSD symptoms in children

Symptoms of traumatic stress, whether they rise to the level of a PTSD diagnosis or not, can manifest in different ways in children than in adults. Younger children, in particular, may display unique symptoms. The American Academy of Child and Adolescent Psychiatry recommends talking to a mental health professional to understand your child’s unique situation. However, the following symptoms may be common indicators of a childhood traumatic stress disorder.

Physical symptoms

Trauma often manifests physically in the body. Below are a few physical symptoms: 

• Physiological reactions to reminders of the trauma, like sweating, shaking, vomiting, heart palpitations, or losing control of bodily functions
• Difficulty falling or staying asleep
• A heightened startle response
• Sensory sensitivity, particularly if the trauma involved disturbing imagery, loud noises, sudden movements, or pain
• Diminished appetite, weight loss, and other digestive concerns
• Unexplained pain, like headaches or stomachaches, and other somatic complaints
• Hypersensitivity to physical contact, or, conversely, desensitization to pain or touch, to the point where the child may accidentally injure themselves without realizing
• Lethargy
• Greater susceptibility to infections and diseases like asthma or metabolic syndrome
• Difficulties with balance and coordination

Emotional symptoms

Emotional symptoms of trauma may include the following: 

• Extreme or lasting reactions to reminders of the trauma
• Irritability
• Temper tantrums in younger children and angry outbursts in older kids
• Increased negative emotions, including fear, horror, guilt, anger, sadness, and shame
• Anhedonia, or the inability to feel pleasure or happiness
• A sense of detachment
• Numbness
• Restlessness
• Decreased emotional regulation ability and being difficult to console
• Anxiety and increased fearfulness, particularly in new situations or situations where the child is separated from their caregiver
• Depression and a sense of hopelessness, especially in older children
• Difficulty identifying emotions and internal experiences
• Low self-esteem
• Decreased tolerance for frustration

Behavioral symptoms

Children who have experienced a traumatic event may start to act differently, with behavioral symptoms such as the following: 

• For older children, talking about the trauma over and over without seeming to find any reassurance through discussing it
• For younger children, reenacting the trauma through play, often without seeming to comprehend their actions
• Avoiding people, places, items, thoughts, memories, emotions, and situations related to the trauma
• Decreased impulse control
• Social withdrawal
• Lower participation in school and a corresponding decline in academic performance; younger children may refuse to go to school altogether, especially if the school was the site of the trauma
• Acting helpless
• Denying that the trauma happened
• Seeking out danger, or, conversely, becoming obsessed with their safety and the safety of their loved ones
• Excessive crying or screaming
• Behaving aggressively towards peers, teachers, or caregivers to the point where they may have difficulty forming friendships and other healthy relationships
• Fixating on certain symbols, words, or concepts that may or may not be related to the trauma
• Fidgeting
• Decreased participation in activities that used to bring joy, like playing with friends or participating in sports
• For older children, developing mental health concerns like eating disorders or substance use disorders or engaging in risky behavior like self-harm or unsafe sex

Cognitive symptoms

Cognitive symptoms of trauma in children might include the following: 

• Loss of memory related to key aspects of the trauma
• Forming core negative beliefs about themselves, other people, or the world, like “Bad things have happened to me because I’m a bad person,” “Nobody can be trusted,” or “The world is not a safe place”
• Difficulty with paying attention and staying organized, which can sometimes cause a misdiagnosis of attention-deficit hyperactivity disorder (ADHD)
• A lack of sense of self or separateness
• For younger children, losing recently acquired developmental skills and struggling to develop new skills
• A fascination with death
• Trouble problem-solving
• Daydreaming to the point where they enter a dissociative state
• Believing other people are unpredictable or unreliable
• A lack of age-appropriate curiosity
• Difficulty anticipating consequences of actions or events
• Hypervigilance

Worried your child may be displaying symptoms of childhood PTSD?

Talk to a compassionate therapist

Support for processing traumatic experiences

Although it may be distressing to recognize that your child is displaying symptoms of traumatic stress, help is available for both children and their parents and caregivers. Therapists trained in working with children who have experienced trauma may help your child process their traumatic memories, and family therapists can help the entire family unit figure out ways to move forward and heal.

Even if you did not experience the trauma alongside your child, you might want to try therapy yourself to address the stress and emotional upheaval of caring for a child with PTSD. However, attending an additional in-person therapy appointment may be too much to add to your schedule. With online therapy through a platform like BetterHelp, you can speak to a therapist from the convenience of your own home. You can receive customized support while your child is at school to be the best version of yourself to care for them and help them through this difficult time. In addition, you can attend support groups weekly with other parents. 

Research has found that online therapy may be as effective at alleviating mental health concerns as traditional in-person therapy, including when providing support for people and families impacted by trauma. One recent study found that cognitive-behavioral therapy (CBT) delivered in an online format had similar outcomes in addressing PTSD symptoms when compared to in-person CBT.