Violence or disasters can cause trauma in young people. Trauma is hurt or harm. It can be hurt to a person’s body. It can be harm to a person’s mind. The National Institute of Mental Health (NIMH) works to help children who experience trauma. Other Federal agencies also provide help.

Parents and family members play important roles. They help children who experience violence or disaster. They help children cope with trauma. They help protect children from further trauma. They help children get medical care and counseling. They also help young people avoid or overcome emotional problems. These problems can result from trauma.

This article provides steps parents can take. It gives information on:

Coping with Trauma after violence and disasters
What is Trauma?
Helping Young Trauma Survivors
How Parents Can Help
Help for all people in the First Days and Weeks
How Children React to Trauma
Children under 5
Children Age 6-11
Adolescents Ages 12-17
More about Trauma and Stress
Additional Resources

Coping with Trauma After Violence and Disasters

Disasters cause major damage. Hurricanes Katrina and Rita were examples. They occurred in 2005. Many homes were destroyed. Whole communities were damaged. Many survivors were displaced. There were also many deaths.

Trauma is also caused by major acts of violence. The September 11, 2001 terrorist attacks were examples. Another example was the 1999 shootings at Columbine High School in Colorado. The Oklahoma City bombing in 1995 was also an example. These acts claim lives. They also threaten our sense of security.

Beyond these events, children face many other traumas. Each year, they are injured. They see others harmed by violence. They suffer sexual abuse. They lose loved ones. Or, they witness other tragic events.

Children are very sensitive. They struggle to make sense of trauma. They also respond differently to traumas. They may have emotional reactions. They may hurt deeply. They may find it hard to recover from frightening experiences. They need support. Adult helpers can provide this support. This may help children resolve emotional problems.

What is Trauma?

There are two types of trauma — physical and mental. Physical trauma includes the body’s response to serious injury and threat. Mental trauma includes frightening thoughts and painful feelings. They are the mind’s response to serious injury. Mental trauma can produce strong feelings. It can also produce extreme behavior; such as intense fear or helplessness, withdrawal or detachment, lack of concentration, irritability, sleep disturbance, aggression, hyper vigilance (intensely watching for more distressing events), or flashbacks (sense that event is reoccurring).

A response could be fear. It could be fear that a loved one will be hurt or killed. It is believed that more direct exposures to traumatic events causes greater harm. For instance, in a school shooting, an injured student will probably be more severely affected emotionally than a student who was in another part of the building. However, second-hand exposure to violence can also be traumatic. This includes witnessing violence such as seeing or hearing about death and destruction after a building is bombed or a plane crashes.

Helping Young Trauma Survivors

Helping children begins at the scene of the event. It may need to continue for weeks or months. Most children recover within a few weeks. Some need help longer. Grief (a deep emotional response to loss) may take months to resolve. It could be for a loved one or a teacher. It could be for a friend or pet. Grief may be re-experienced or worsened by news reports or the event’s anniversary.

Some children may need help from a mental health professional. Some people may seek other kinds of help. They may turn to religious leaders. They may turn to community leaders.

Identify children who need the most support. Help them obtain it. Monitor their healing. Identify Children Who:

Refuse to go places that remind them of the event
Seem numb emotionally
Show little reaction to the event
Behave dangerously

These children may need extra help.

In general adult helpers should:

Attend to children
Listen to them
Accept/ do not argue about their feelings
Help them cope with the reality of their experiences
Reduce effects of other sources of stress including:
Frequent moving or changes in place of residence
Long periods away from family and friends
Pressures at school
Transportation problems
Fighting within the family
Being hungry
Monitor healing
It takes time
Do not ignore severe reactions
Attend to sudden changes in behaviors, speech, language use, or in emotional/feeling states
Remind children that adults:
Love them
Support them
Will be with them when possible

How Parents Can Help:

After violence or a disaster parents and family should:

Identify and address their own feelings — this will allow them to help others
Explain to children what happened
Let children know:
You love them
The event was not their fault
You will take care of them, but only if you can; be honest
It’s okay for them to feel upset

DO:

Allow children to cry
Allow sadness
Let children talk about feelings
Let them write about feelings
Let them draw pictures

DON’T:

Expect children to be brave or tough
Make children discuss the event before they are ready
Get angry if children show strong emotions
Get upset if they begin:
Bed-wetting
Acting out
Thumb-sucking
If children have trouble sleeping:
Give them extra attention
Let them sleep with a light on
Let them sleep in your room (for a short time)
Try to keep normal routines (such routines may not be normal for some children):
Bed-time stories
Eating dinner together
Watching TV together
Reading books, exercising, playing games
If you can’t keep normal routines, make new ones together
Help children feel in control:
Let them choose meals, if possible
Let them pick out clothes, if possible
Let them make some decisions for themselves, when possible.
Help for all people in the First Days and Weeks

Key steps after a disaster can help adults cope. Adults can then provide better care for children. Create an environment of safety. Be calm. Be hopeful. Be friendly, even if people are difficult. Connect to others. Listen to their stories. But, listen only if they want to share. Encourage respect for adult decision-making.

In general help people:

Get food
Get a safe place to live
Get help from a doctor or nurse if hurt
Contact loved ones or friends
Keep children with parents or relatives
Become aware of available help
Become aware of where to get help
Understand what happened
Understand what is being done
Move towards meeting their own needs
Avoid certain things:
Don’t force people to tell their stories
Don’t probe for personal details.

Do not Say:

“Everything will be OK.”
“At least you survived.”
What you think people should feel
How people should have acted
People suffered for personal behaviors or beliefs
Negative things about available help
Don’t make promises that you can’t keep
(Ex: “You will go home soon.”)

How Children React to Trauma

Children’s reactions to trauma can be immediate. Reactions may also appear much later. Reactions differ in severity. They also cover a range of behaviors. People from different cultures may have their own ways of reacting. Other reactions vary according to age.

One common response is loss of trust. Another is fear of the event reoccurring. Some children are more vulnerable to trauma’s effects. Children with existing mental health problems may be more affected. Children who have experienced other traumatic events may be more affected.

Children Age 5 and Under

Children under five can react in a number of ways:

Facial expressions of fear
Clinging to parent or caregiver
Crying or screaming
Whimpering or trembling
Moving aimlessly
Becoming immobile
Returning to behaviors common to being younger
Thumb sucking
Bedwetting
Being afraid of the dark.
Young children’s reactions are strongly influenced by parent reactions to the event.

Children Age 6 to 11

Children between six and 11 have a range of reactions. They may:

Isolate themselves
Become quiet around friends, family, and teachers
Have nightmares or other sleep problems
Become irritable or disruptive
Have outbursts of anger
Start fights
Be unable to concentrate
Refuse to go to school
Complain of unfounded physical problems
Develop unfounded fears
Become depressed
Become filled with guilt
Feel numb emotionally
Do poorly with school and homework.

Adolescents Age 12 to 17

Children between 12 and 17 have various reactions:

Flashbacks to the traumatic event (flashbacks are the mind reliving the event)
Avoiding reminders of the event
Drug, alcohol, tobacco use and abuse
Antisocial behavior i.e. disruptive, disrespectful, or destructive behavior
Physical complaints
Nightmares or other sleep problems
Isolation or confusion
Depression
Suicidal thoughts.
Adolescents may feel guilty about the event. They may feel guilt for not preventing injury or deaths. They may also have thoughts of revenge.

More About Trauma and Stress

Some children will have prolonged problems after a traumatic event. These may include grief, depression, anxiety and post-traumatic stress disorder (PTSD). Children may show a range of symptoms:

Re-experiencing the event
Through play
Through trauma-specific nightmares/ dreams
In flashbacks and unwanted memories
By distress over events that remind them of the trauma
Avoidance of reminders of the event
Lack of responsiveness
Lack of interest in things that used to interest them
A sense of having “no future”
Increased sleep disturbances
Irritability
Poor concentration
Be easily startled
Behavior from earlier life stages.

Children experience trauma differently. It is difficult to tell how many will develop mental health problems. Some trauma survivors get better with only good support. Others need counseling by a mental health professional.

If, after a month in a safe environment:

Children are not able to perform normal routines
New symptoms develop
Then, contact a health professional.

Some people are more sensitive to trauma. Factors that may influence how someone may respond include:

Being directly involved in the trauma, especially as a victim
Severe and/or prolonged exposure to the event
Personal history of prior trauma
Family or personal history of mental illness and severe behavioral problems
Lack of social support
Lack of caring family and friends

On-going life stressors such as moving to a new home, or new school, divorce, job change, financial troubles.
Some symptoms may require immediate attention. Contact a mental health professional if these symptoms occur:

Flashbacks
Racing heart and sweating
Being easily startled
Being emotionally numb
Being very sad or depressed
Thoughts or actions to end life