From the Guidelines
Post-traumatic stress disorder (PTSD) in young children can cause significant emotional, behavioral, and developmental problems, and early intervention with trauma-focused cognitive behavioral therapy (TF-CBT) is crucial to prevent long-term mental health problems. Children with PTSD may experience nightmares, flashbacks, and intrusive memories of the traumatic event, as outlined in the diagnostic criteria for PTSD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) 1. They often show heightened anxiety, fear, and hypervigilance, becoming easily startled and having difficulty feeling safe. Sleep disturbances are common, including trouble falling asleep or staying asleep. Children may develop regressive behaviors, returning to earlier developmental stages like bed-wetting or baby talk. They frequently avoid reminders of the trauma and may withdraw from previously enjoyed activities. Concentration problems can affect school performance, while irritability and angry outbursts may disrupt relationships. Physical symptoms like headaches and stomachaches often occur. Young children might express their trauma through repetitive play that reenacts aspects of the traumatic event.
According to the most recent and highest quality study, the most effective therapies for children who have experienced trauma are evidence-based treatments (EBTs) with demonstrated efficacy, such as TF-CBT, play therapy, and family therapy 1. Office-based guidance to promote regulation after trauma is also essential, including restoring safety, routines, relaxation techniques, time-in or special time, small successes, emotional container, cognitive triangle, distraction, and positive parenting techniques 1. These approaches can help reduce the stress response after trauma, restore a sense of order, and promote healthy development.
Key aspects of treatment include:
- Restoring safety and reducing the stress response after trauma
- Implementing routines and relaxation techniques to promote regulation
- Providing time-in or special time to enhance the child-caregiver relationship
- Fostering small successes and celebrating progress
- Using emotional container and cognitive triangle techniques to manage emotions and thoughts
- Implementing distraction and positive parenting techniques to promote healthy behaviors.
Overall, early intervention with evidence-based treatments and office-based guidance is crucial to prevent long-term mental health problems and promote healthy development in young children with PTSD.
From the Research
Effects of PTSD on Young Children
- The effects of PTSD on young children can be severe and long-lasting, with studies suggesting that children as young as 3-8 years old can develop PTSD symptoms after experiencing a traumatic event 2.
- Research has identified several factors that can predict the development of PTSD in young children, including the length of hospital stay after a traumatic event 2.
- The prevalence of PTSD in young children can be significant, with one study finding that 8.6% of children developed acute PTSD symptoms in the first month after a traumatic event, and 10.1% developed symptoms at 3 months 2.
Treatment Options for Young Children with PTSD
- Several treatment options are available for young children with PTSD, including trauma-focused cognitive behavioral therapy (TF-CBT) 3, 4, 5.
- TF-CBT has been shown to be highly efficacious in treating PTSD in children and adolescents, although questions remain about the effective treatment components 4.
- Other treatment options, such as cognitive processing therapy and prolonged exposure, have also been shown to be effective in reducing PTSD symptoms in children and adolescents 6.
- Pharmacotherapies, such as selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, can also be used to treat PTSD in children and adolescents, although they are typically used when evidence-based psychotherapies are not available or are ineffective 6.
Importance of Early Intervention
- Early intervention is critical in treating PTSD in young children, as it can help prevent the development of chronic PTSD symptoms 4, 2.
- Studies have shown that early diagnosis and treatment of PTSD in young children can lead to better outcomes and reduced symptoms 2.
- Further research is needed to develop effective treatment protocols for young children with PTSD and to identify the most effective treatment moderators 3, 5.