Even Young Children can Experience PTSD

When you think of PTSD (posttraumatic stress disorder), soldiers
returning from combat may come to mind. 
But years of research suggest many others experience PTSD, too, even
young children, though their symptoms may differ from those of older children, adolescents and
adults.

PTSD
in adults and children can occur after exposure to a traumatic event — living
through one, witnessing one in person, or learning about a traumatic event that
involved a family member. A traumatic event can include a violent experience in
the home or community, a fire, a natural disaster, a car accident, or the sudden
death of a family member. The younger a child is, the greater the impact. The loss
of a parent or being removed from a parent, for example, feels like a threat to
a child, according to child psychiatrist Judith Cohen, M.D., medical director
of the Center for Traumatic Stress in Children & Adolescents at Allegheny General Hospital in
Pittsburgh.

Many
children experience trauma — an estimated 14 to 43 percent, according to the
National Center for PTSD. Of those, as many as 15 percent of girls and 6
percent of boys develop PTSD. Children with PTSD may experience distressful thoughts, ­and memories of the trauma may occur without warning. They may also have trouble
sleeping and nightmares (though they may not seem clearly tied to the event). Traumatized
children may try to avoid people or objects that are reminders of the event and
they may act more irritable, have angry outbursts, or be easily startled.
They may regress, wet the bed or talk baby-talk, and they may experience physical symptoms,
such as headaches and stomachaches. The symptoms can cause major distress and
can impact how a child behaves or relates to family members.

To help a child heal from PTSD, treatment involves working with
the child and parents and caregivers, creating a feeling of safety, helping the
child to understand the condition, and encouraging the youngster to talk about his
or her feelings (through art and play), to help develop
relaxation and coping skills. Rehabilitation begins with building trust and it needs
to be fun and engaging for young children, according to Dr. Cohen. Several different types of treatment are
available for children with symptoms of PTSD and early intervention can be
important in helping little ones cope with and heal from the effects of trauma.

For more information on understanding and helping children of all
ages heal from traumatic events visit the National
Child Traumatic Stress Network.

By Debbie Cohen, health writer, APA

15 Tips for Talking to Kids about Ebola

By David Fassler, M.D.

Child and adolescent psychiatrist 

Parents and teachers may find themselves faced with the challenge of
discussing the evolving Ebola epidemic with children. Although these may
be difficult conversations, they are also important. There are no “right” or “wrong” ways to talk
with kids about Ebola, but here are some suggestions if you need help. 

1. Provide an open and supportive environment where children
know they can ask questions. At the same time, it’s best not to force children
to talk about Ebola unless and until they’re ready.

2. Answer questions honestly. Kids will usually know,
or eventually find out, if you’re “making things up." It may affect their trust in you or your reassurances in the future.

3. Use words and ideas children can understand. Gear
your explanations to the child’s age, language, and developmental level.

4. Help kids find accurate and up to date
information. Print out Fact Sheets from
the CDC, CNN, WHO and kidshealth.org.

5. Be ready to repeat information and explanations
several times. Some information may be
hard to accept or understand. Asking the same question over and over may also
be a way for a child to ask for reassurance.

6. Acknowledge and validate the child’s thoughts, feelings,
and reactions. Let them know that you think their questions and concerns are
important and appropriate.

7. Remember that kids often personalize situations.
For example, they may worry about their own safety and the safety of family members. They may also worry
about friends or relatives who travel or live far away.

8. Be comforting, but don’t make unrealistic promises. It’s
fine to let children know that they are safe in their home or at school. But you can’t promise that there will be no cases of Ebola in your state or
community.

9. Let kids know that there are lots of people helping
the families affected by Ebola. This time is a good opportunity to show children that when something scary or
bad happens, there are people to help.

10. Children learn from watching their parents and
teachers. They will be very interested in how you react to news about Ebola. They also learn from listening to your conversations with other adults.

11. Don’t let kids watch too much television with
frightening images. The repetition of such scenes can be disturbing and confusing.

12. Children who have experienced serious illness, loss, or other traumatic events in the past are particularly vulnerable to graphic
news reports or images of death. These children may need extra support and
attention.

13. Watch for physical symptoms including headaches and
stomachaches. Often times, kids express anxiety through physical aches and pains.
An increase in such symptoms without apparent medical cause may be a sign that
a child is feeling anxious or overwhelmed.

14. Children who are consumed with questions or worry about Ebola should be evaluated by a trained and qualified mental health professional. Other signs that a child may need additional care include:
ongoing sleep problems, frequent fears
about illness or death, or reluctance to leave parents or go to school. If such
behaviors continue, ask your child’s pediatrician, family physician, or school
counselor to help you contact a mental health professional. 

15. Although parents and teachers may follow the news and
the daily updates with interest and attention, most kids just want to be kids. They may not want to think about what’s happening across the country
or elsewhere in the world. They’d rather play ball, climb trees, or ride bikes.

Public health emergencies are not easy for anyone to
comprehend or accept. Understandably, many young children feel frightened and
confused.  As parents, teachers, and
caring adults, we can best help by listening and responding honestly and comfortingly. Fortunately, most children, even those who have experienced loss or illness, are quite resilient.  However, by creating an open environment where
they feel free to ask questions, we can help them cope with stressful events
and experiences.

David Fassler, M.D., is a child and adolescent psychiatrist
practicing in Burlington, Vermont. He is also a Clinical Professor of
Psychiatry at the University of Vermont.

Tweet