Does Your Child Have PTSD?

Symptoms of PTSD in Children

Researchers and clinicians are beginning to recognize that PTSD may not present itself in children the same way it does in adults. Criteria for diagnosis now include age-specific features for some symptoms.
 
Symptoms in Very Young Children
Very young children may have few symptoms of PTSD. This may be because eight of the symptoms require a verbal description of one's feelings and experiences. Instead, young children may exhibit more generalized fears, such as:
 
  • Stranger or separation anxiety
  • Avoidance of situations that may or may not be related to the trauma
  • Sleep disturbances
  • A preoccupation with words or symbols that may or may not be related to the trauma.
     
These children also may display post-traumatic play in which they repeat themes of the trauma. In addition, children may lose an acquired developmental skill (such as toilet training) as a result of experiencing a traumatic event.
 
Symptoms in Elementary School-Aged Children
Clinical reports suggest that elementary school-aged children may not experience visual flashbacks or amnesia for aspects of the trauma. However, they do experience "time skew" and "omen formation," which are not typically seen in adults.
 
Time skew refers to a child missequencing trauma-related events when recalling the memory. Omen formation is a belief that there were warning signs that predicted the trauma. As a result, children often believe that if they are alert enough, they will recognize warning signs and avoid future traumas.
 
School-aged children also reportedly exhibit post-traumatic play or reenactment of the trauma in play, drawings, or verbalizations. Post-traumatic play is different from reenactment in that post-traumatic play is a literal representation of the trauma, involves compulsively repeating some aspect of the trauma, and does not tend to relieve anxiety.
 
An example of post-traumatic play is an increase in shooting games after exposure to a school shooting. Post-traumatic reenactment, on the other hand, is more flexible and involves behaviorally re-creating aspects of the trauma (for example, carrying a weapon after exposure to violence).
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