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PTSD in Children

Rona Akerman, Clinical Social Worker and Therapist, specializing in the treatment of trauma, loss, and bereavement
15 June 2025

Post-trauma, or post-traumatic stress disorder (PTSD) in children, is a condition that can develop following exposure to a traumatic, radical, and intense event. Unlike adults, the signs of PTSD among children vary depending on their age and developmental stage. Moreover, for children experiencing trauma, the presence and behavior of adults are extremely important—both in helping them understand the event and their reactions and in providing hope and belief in the possibility of recovery.

The primary symptoms of PTSD in children include:
  • Social avoidance.
  • Nightmares.
  • Temper tantrums.
  • Trouble falling asleep.
  • Regression, for example, returning to bedwetting, thumb sucking and increased dependence on a parent.

However, because children are adaptable, they have a high potential for recovery from trauma. Most children will recover spontaneously as they grow and process the traumatic memory.

Several important factors should be considered to comprehend the effect a traumatic event has on children, including their age, the intensity of exposure to the traumatic event, and the source of the trauma. The role of the parents and other significant adults is essential for helping children manage the trauma. Adults need to create a safe environment, listen without pressure, maintain a daily routine, and provide tools for emotional regulation.

Treating post-trauma in children focuses on restoring a sense of safety and control while tailoring the approach to individual needs. The main goal is to help children return to their regular activities. This involves providing a sense of safety, understanding, and hope for a better future. If the distress persists, it is recommended to consult with professionals to obtain appropriate therapeutic assistance.

Like adults, children also experience trauma that may develop into post traumatic stress disorder (PTSD). It is essential to understand the unique, age-related symptoms of PTSD in children, as these can vary depending on their age and developmental stage. Additionally, for children experiencing trauma, the presence and behavior of adults are extremely important—both in helping them understand the event and their reactions and in providing hope and belief in the possibility of recovery.

If a child experienced a traumatic event, you are likely going through a difficult time. First, know that you are not alone and that guidance, support, and treatment can reduce distress and promote the chances of recovery. Just as a physical injury requires proper bandaging, the soul needs appropriate care, particular attention, and dedicated care for healing. To help you and your children, this article provides information on recognizing potential signs of distress in children, explores varied treatments, and offers recommendations for coping.

Post-traumatic stress disorder (PTSD) in children: An overview

The symptoms of PTSD in children are the same symptoms in adults, but their expression is different and related to their world. Because children are adaptable, they have a high potential for recovery from trauma, and they flexibly move between different life situations. For these reasons, it is not always easy to identify the presence of PTSD in them. In most cases, symptoms appear only partially.

These are some of the potential symptoms that may indicate the presence of the disorder following an exposure to a traumatic event:

  • Avoidance

    Withdrawal, isolation, and detachment from emotions and activities, such as classes and meetings with friends. A preference to stay at home, in a safe space, in the company of safe figures.

  • Intrusiveness

    Recurrent, uncontrollable experience of the traumatic event through thoughts, images, and memories. This can include nightmares, flashbacks, and distress in response to triggers like play that resembles the event (or parts of it), or environmental stimuli, among other things.

  • Hyperarousal

    This can manifest in tantrums, uncontrollable anger, difficulty in self-regulation, difficulty falling asleep and sleeping, a tendency to panic or fear, and more.

  • Regression in developmental stages

    This can lead to a return to bedwetting, thumb-sucking, and increased dependence on a parent or other caregiver.

The more the child is in the presence of a significant, supportive adult on whom they rely, who can help them understand and process reality in an age-appropriate way, the less the negative impact of the traumatic event on the child. Furthermore, because young children have limited verbal self-expression, it is advisable to pay close attention to their reactions and behaviors, such as body language and facial expressions, which are frequent communication channels for them. Additionally, play, including imaginative play that reconstructs the events, is one way children express distress and unload feelings.

The impact of trauma on daily life and functioning

Most children will recover from trauma spontaneously in such a way that the event becomes a part of their life experience, integrated rather than disruptive. Some will even develop resilience and post-traumatic growth, marked by increased internal strength (a greater sense of meaning in life), improved interpersonal relationships, and the setting of personal goals and change of habits.

Other children may develop post-traumatic stress disorder, manifesting in some or most symptoms. This disorder has a broad impact that extends beyond the affected child. The family, friends, and acquaintances also experience the child’s distress and suffering. Therefore, it is essential that they, too, receive support in coping with the new situation.

Several factors must be considered to understand the impact of a traumatic event on children:
  • Age: Younger children are at increased risk of developing post-traumatic stress disorder (PTSD) following exposure to a traumatic event.
  • Developmental stage: This refers to the child’s physical (chronological) and emotional development stage, impacting their ability to cope.
  • Degree of Exposure: The intensity and proximity of the exposure to the traumatic event affect the severity of the trauma’s effect.
  • Type of trauma: The source (cause) of the trauma influences its impact on the child; for example, did the event result from natural causes or human actions? Was the person responsible someone familiar or a stranger?
  • How adults explain and discuss the event: The way in which the event is mediated by a parental or a therapeutic figure, perceived by the child as reliable and stable, affects the processing of the event.
  • Danger to a close relative: The degree of perceived risk to a significant adult in the child's life during the event influences the intensity of the child's reaction.

Principles for treating childhood Post-Traumatic Stress Disorder (PTSD)

There are several essential principles to know regarding the treatment of children who have experienced a traumatic event:

The treatment of post-trauma in children must always involve the parents or other close figures in the child's life. The goal of the treatment is to enable these figures to gain the tools and guidance regarding PTSD to understand how to help and alleviate the child’s distress.

The treatment aims to focus on reducing PTSD symptoms and help children regain a sense of safety and control over their bodies, minds, and emotions. Cognitive-behavioral therapy will teach children techniques, exercises, and methods to help them overcome their difficulties and diminish distress. During all stages of development, children aspire for independence. Therefore, knowing that they have ways to help themselves fosters a sense of control.

To understand the child’s reactions and symptoms and tailor therapeutic care, their age at the time of the traumatic event must be considered. For example, babies and toddlers do not retain a narrative memory of the event but rather remember feelings and experiences. Elementary school children may talk less about the trauma but often express their emotions through their behavior (concentration problems, aggressions, withdrawal, and more). During adolescence, the need for autonomy and separation from parents increases. This makes social support (alongside parental/family support) particularly valuable.

The most important principle in working with children who have experienced trauma is to normalize their reactions to their experiences in light of the objective circumstances and to instill a message of hope and a sense of restored security. The adult’s attitude towards the child is the most important factor, and it should ideally convey confidence and hope for a better future. The adult (unlike the child) knows that the current feelings, thoughts, and behaviors in the present moment do not necessarily determine the future (certainly not!). The adult carries the awareness of possible change and movement, and with it, the understanding of potential transformation and hope for the child living in the here and now.

Practical tips for parents coping with children's trauma

If your child has been exposed to a traumatic event, here are some recommendations for you as a parent to know and implement:

  • Creating a sense of security and control: It is essential to validate and acknowledge your child’s difficult experience and their experiences following the event. Restoring their sense of safety and protection is of utmost importance. It is advisable to maintain consistent routines, such as meal times, sleep, and other activities. In case of a change of plans, it is recommended to inform the child beforehand. It is advisable to promote their independence, for example, by allowing them to choose and decide in small daily matters (what to wear, what to eat).
  • Listening and communication: It is important to mediate what happened for the child in a language and in a way that is age-appropriate. Avoid pressuring them to talk, but when they are willing to do so, be available and validate their feelings.
  • Helping children cope with fears: It is advisable to help your child find a calming technique that works for them, such as breathing exercises, a comforting object, a small light, or similar.
  • Recommended activities: Physical activity can help reduce stress. Therefore, it is advisable to encourage your child to choose an activity they enjoy. Consider going out to explore nature, playing games together, or engaging in other family activities that provide enjoyment and distraction.

It is important to point out that every child progresses at their own pace and in their own way. It is a process with ups and downs. However, if needed, seek counseling from professionals to receive assistance, guidance, treatment, and support. Remember that parents, too, require support, so self-care is essential for the well-being of your children.

Most importantly: Be alert

We are born with a need for attachment and dependence on a dominant caregiver. Children who have experienced traumatic events need a parental presence to help them regain feelings such as safety, protection, and trust. If the parent is the perpetrator or the trauma involved the loss of a parental figure, the recovery process becomes significantly more challenging. However, the presence of a supportive, stable, and available figure will definitely promote the healing process.

The younger the child is, the more likely they are to develop post-traumatic symptoms due to their limited maturity and ability to interpret and understand reality. However, most children exposed to traumatic events do not develop full PTSD. Children are naturally resilient due to their capacity for flexibility, learning, and adaptation to frequent changes. These qualities help them overcome adversity and develop competence and resilience.

Children’s reactions to trauma may sometimes be elusive and not always clearly expressed and linked to the event itself. Consequently, it is our role as adults to maintain alertness regarding children’s emotional state and to identify the appropriate circumstances for professional consultation and intervention.