Until now, research in children's crisis reactions has been limited. The diagnosis of post-traumatic stress is not adapted to children's expression because it requires the person who has experienced the trauma, to be able to describe their symptoms. In recent years, a number of researchers, have focused on the development of assessment tools which increasingly rely on symptoms that are observable for parents and professionals. The National Centre of Psychotraumatology has developed a tool for examining children down to the age of 6 through cartoon-like images. This gives the children a chance to express their symptoms.
Below, you can read about normal crisis reactions in 3-6-year-old children.
The reactions depend on the child's age, stage of development, and the traumatic incident – it is therefore possible that reactions not listed below may occur, just as the child does not necessarily have all the reactions. The focus is on reactions that can be observed by parents and other adults close to the child.
Immediately after the event, the child may react with restlessness, confusion, anger or/and crying. Some children, however, protect themselves against the shock by experiencing an emotional paralysis. From the outside, it thus seems like they are not reacting to the event. This does not mean that the child is no affected, but rather that it is in a state of shock.
Fear of separation – in the time following a traumatic event, it is normal for children to be afraid of being separated from their parents. Without them, they feel unsafe and presumably guard themselves against reliving the horrors of the incident. They may temporarily become very clingy and fussy in search of physical closeness. If a child feels that its parents are about to leave, the child may become very nervous and react with anger.
Sleep problems - fear of being alone also appears at bedtime. It may be necessary to stay with the child until it falls asleep, just like the child may wake up several times a night crying inconsolably. Nightmares are also common. Child insecurity can also be expressed through fear of the dark, monsters and other fantasy creatures.
The child becomes more dependent on others- it is very common for children who are insecure to return to behaviour that they had otherwise grown out of, e.g. sucking on their thumb, baby talk, wetting the bed or pants, etc.
Mood swings - the child may talk, unaffected by the traumatic experience, one moment, and be deeply unhappy the next. Irritability and anger are also common reactions.
Anxiety and panic - The child may experience severe anxiety when reliving the sights, sounds, scents or bodily sensations, as experienced in the situation.
Sometimes the anxiety is connected to something specific and other times; it is generalised.
Physical complaints - many children's anxieties and worries transform into stomach- or headaches. These symptoms may thus be signs that the child has a lot of difficult emotions and thoughts that feel like 'knots' in the stomach.
Questions and thoughts about the event - children at this age tend to think very concretely and are much better at confronting a trauma than adults. It is therefore not uncommon for a child to talk about a traumatic event bluntly, and that it has noticed specific details. Note that the youngest children in this age group, do not yet understand that some things are irreversible and will, therefore, wonder why the deceased do not come home again or why they are not going back home to the house that has burnt down. Older children often have a lot of questions about the incident and what happened.
How can you help your child?
To help the child feel safe, the person who takes care of it must signal that the world is once again safe and secure. To make the child feel safe again, you can:
- Give the child lots of physical closeness and hugs. It is a natural reaction for the child to want its parents close by all the time. Try to meet that need if possible. It may be necessary to find a solution that makes it possible for the child to sleep close to his or her parents. It may also be necessary to stay with the child until it falls asleep.
- Maintain daily routines - once everything is back to normal, the child will quickly feel safe. Consider whether there is a need for a few days at home or a period of shorter days in kindergarten. Make sure that the kindergarten teacher pays special attention to whether or not the child feels unsafe.
- Help the child through slow adaptation - small children, who easily become anxious and panic at e.g. loud noises, need help to overcome that anxiety. This requires small steps, one at a time. Let the child be close to you as you slowly approach 'the danger'. Respect the child's boundaries, but do not completely avoid the things that cause anxiety. Remain calm to signal to the child that there is no danger. A child psychologist can help with some suitable exercises.
- Have patience - it can be demanding to take care of a child who is irritable, fussy, afraid of being alone and feels unsafe at night. It is, therefore, important to be patient and remember that the situation will return to a normal state again. Slackening on the requirements of the child for a while may be necessary. Use the support you have nearby.
- Talk to the child - young children will not forget a violent incident just because you do not talk about it. On the contrary, they have a great need to talk about what has happened and find some meaning to it. Talk to the child and explain what has happened in a way and a language adapted to its age. Be prepared for the conversation to be repeated many times before the incident is clear to the child. During the first time following the incident, it may also be necessary to repeatedly assure the child that you are there for them and will come and pick them up again every time you drop them off at kindergarten.
When to seek help?
Most small children who are otherwise confident and happy will get over a single, traumatic event. For some, the after reactions, however, can be lengthy. Therefore, you should always seek professional guidance or treatment if the child is not significantly better within a month.
Seek help if the child, after a longer period of time:
- Does not return to its old self, but behaves atypically.
- Seems sad, distant, uninterested in playing, is silent and difficult to get to smile.
- Has many conflicts with their parents, teachers or peers.
- Behaves aggressively and has violent outbursts of anger.
- Has a difficult time concentrating on playing, drawing or similar activities.
- Is anxious and depressed.
- Has nightmares or sleep problems.
Small children cannot yet express their feelings and memories through words. It is, therefore, important that you follow your gut feeling if you feel that something is wrong with your child.
The child will often become violently anxious when reliving the sights, sounds, smells or bodily sensations they experienced in the situation.
For example, a child who has been involved in a car accident may protest violently when put in a car seat or strapped into a pram.
Sometimes the anxiety is specific, sometimes it's generalised.
If your child seems sad, distant, uninterested in playing, is silent and difficult to make smile, you should contact your doctor, health visitor or municipality and ask for professional help from a child psychologist.
NOTE: Is your child older than 6 years? See the next age step here.
This page has been created with inspiration from:
- Red Barnet - Save the Children
- U.S. Department of State - Children´s Reaction to Trauma.
- New Yourk State Education Department - Crisis Counseling Guide
- National Organisation for Victim Assistance - Reactions of Children and Adolescents to Trauma.
- Center for Traume- og Torturoverlevere Region Syddanmark - Centre for Trauma and Torture Survivors in the Region of Southern Denmark