Research shows that a significant number of children in the United States are exposed to events that can result in emotional trauma. Community samples estimate that as many as two-thirds of children in this country have been exposed to some kind of traumatic event by the time they turn 16. Witnessing violence in the community is one of the most common kinds of trauma exposure: estimates of children who witness community violence range from 39 percent of children to as high as 85 percent. Sexual abuse is another common form of trauma for children, and estimates of the number of children exposed to sexual abuse range from 25 percent to 43 percent. Accidental injuries and injuries from violence also affect a large number of children each year and can result in emotional trauma. Approximately 400,000 children suffer violent injuries each year, and about 7.9 million children suffer injuries from accidents such as car crashes, falls or near-drownings. Furthermore, the majority of children who are exposed to traumatic events experience more than one exposure, which can put them at even higher risk for prolonged psychological trauma.
Treatment Options Not Well Studied
Despite the fact that so many children are at risk for emotionally traumatic experiences, most of the established knowledge about psychological trauma and post-traumatic stress disorder concerns adults. Because our knowledge of emotional trauma in children is lagging, psychological trauma in children often goes untreated. When treatment does occur, the approaches can vary greatly depending on the doctor involved. Most of the treatment approaches used for children have not been carefully studied, so their true effectiveness is unknown. Cognitive behavioral therapy (CBT) is one of the few that has been well studied and found to be a largely effective trauma treatment option for children and adolescents.
Distress Following Trauma
Recognizing ongoing psychological trauma in children can be difficult, partly because almost all children have short-term symptoms of distress following a traumatic incident. Many children have trouble sleeping, develop separation anxiety, display anger or irritability, lose interest in their activities and schoolwork and develop new fears. Most children bounce back fairly quickly from their experiences and return to their pre-incident personalities, behaviors and interests. However, some children continue having symptoms for a longer period of time and may need clinical attention to recover normal functioning. Parents may not recognize when a short-term disruption has become a long-term problem or may come to accept the changes as irreversible without realizing that they are due to psychological distress that needs to be clinically addressed.
Trauma From Hidden Sources
Some parents or guardians may not even be able to connect changes in a child’s behavior with a clear source of trauma. Children, particularly young children, can have great difficulty revealing a traumatic experience to an adult if the adult did not witness the experience. Sexual abuse and bullying are two sources of trauma that children may be too frightened or ashamed to reveal and which therefore may go undetected for very long periods of time. Parents or guardians in this situation are likely to notice personality and behavior changes in their children that are symptomatic of psychological trauma. But without being aware of the inciting event or events, they may not realize that these changes have a specific source and need clinical attention.