The United States is a highly diverse society comprising many different racial and ethnic groups. There is no doubt that because of poverty and discrimination, racial and ethnic minority youth and families are more likely to be subjected to traumatic events, and immigrant youth and families may be particularly at risk. Cultural context and background, will also affect how individuals perceive a traumatic event and its impact.
Signs and symptoms of ‘trauma’ may or may not be immediately identifiable, yet, childhood trauma occurs much more often than you think. A research study, released on the APA[American Psychological Association] website, revealed that more than 2/3 of children reported experiencing at least 1 traumatic event by age 16. In marginalized, traditionally underserved communities[typically low-income], as a standard, it is most wise to assume a child has experienced an Adverse Childhood Experience[ACE] at least once. This supports utilizing a trauma-sensitive approach to assessments, evaluations and engagement. We must also challenge ourselves to exercise cultural humility when engaging diverse audiences, particularly children.
Race and ethnicity, poverty status, and gender affect children’s risk of exposure to trauma. It is more common than not for children and adolescents to be exposed to more than a single traumatic event. Children exposed to chronic and pervasive trauma are especially vulnerable to the impact of subsequent trauma, being retraumatized.
Many commonly identified ‘trauma-inducing’ events, for some children, are not ‘uncommon’, in their lives. Because of culturally-biased assumptions, “immaculate perceptions”, the signs and symptoms of trauma can go unnoticed. Signs of trauma may be misperceived and children frequently get labeled a ‘bad’ or problem child. The remarkableness of a child may go unacknowledged. Without a multi-cultural or trauma-sensitive lens, signs of trauma may be totally dismissed or attributed to ‘personality’ and challenging or disruptive behaviors to genetics, absent ‘hope’ for change, growth, improvement, resilience or recovery.
It is important to recognize the signs of traumatic stress and its short- and long-term impact. These signs may be expressed differently in each child; the reactions influenced by their developmental level, ethnicity/cultural factors, previous trauma exposure, available resources, and preexisting child and family problems. However, nearly all children and adolescents express some kind of distress or behavioral change in the acute phase of recovery from a traumatic event. Depending upon developmental level, signs of trauma may include these:
- Fear being separated from their parent /caregiver
- Cry or scream a lot
- Lose weight or eat poorly
- Have nightmares
ELEMENTARY SCHOOL CHILDREN
- Become anxious or fearful
- Feel guilt or shame
- Have difficulty concentrating
- Have difficulty sleeping
MIDDLE AND HIGH SCHOOL CHILDREN
- Begin abusing alcohol or drugs
- Develop eating disorders or self-harming behaviors
- Feel depressed or alone
- Become involved in risky sexual behaviors
There IS hope! Children can and do recover from traumatic events. Parents and loved ones play an important role in their recovery. Not all children will experience traumatic stress after experiencing an otherwise traumatic event. Once again, it can’t be overstated that you, as a caring adult, play an important role in the recovery process.
Traumatized children may internalize the event and engage in negative self-talk such as telling themselves:
You can help change the narrative for children with your support, by teaching those critical self- affirming thoughts, such as:
POSITIVE SELF-TALK“People care about me.”
“It’s NOT my fault.”
“I am strong.” and most important:
” I am a good kid who had a bad thing happen.”
The body has its own alarm system that is designed to keep us safe from harm. When it is activated, it prepares the body to run away or fight[fight or flight]. At any perceived sign of trouble, the system is activated. Children will often feel angry, scared, irritable or become withdrawn.
HEALTHY STEPS CHILDREN CAN TAKE IN RESPONSE TO THEIR ALARM:
- Recognize what activates the alarm and how their body reacts
- Decide whether there is real trouble and seek help from a trusted adult
- Practice deep breathing and other relaxation methods[ children at every age can practice relaxation]
Trauma is a risk factor for nearly all behavioral health and substance use disorders. The impact of child traumatic stress can last well beyond childhood. Childhood stress survivors may experience:
- Learning problems, lower grades, more suspensions and expulsions
- Long-term health problems like heart problems and diabetes
- Involvement with child welfare and juvenile justice systems
- Increased use of medical and mental health care services
- Assure the child that he or she is safe.
- Explain that he or she is not responsible. Children often blame themselves for events that are completely out of their control.
- Be patient. Some children recover quickly while others require more time to recover. Reassure them that they don’t need to feel guilty or bad about any feelings or thoughts they’ve had.
- Seek the help of a trained professional. When needed, a mental health professional trained in evidence-based trauma treatment can help children and families cope and move toward recovery. Ask your pediatrician, family physician, school counselor, or clergy member for a referral.
A critical part of children’s recovery is having a supportive caregiving system, having access to effective treatments and service systems with professional staff who are trauma-informed. Although children are shaped by their life experiences, most children recover from traumatic events. Some even find new strengths and skills for coping. Conveying information about common reactions to trauma can often be helpful, not only to the child but also to the people around him or her, including parents, teachers, coaches, clergy, and community leaders. Knowing what to expect and what reactions are most common can relieve worries that the child will not recover or will be damaged forever. This information can also be useful before a traumatic event, and thus can be used in a preventative format.
Parental expectations need to be consistent with what is typical for your child’s age. As a key member of your child’s support system, try to understand his or her behavior and distress as normal reactions to abnormal events. You can better support your child during the recovery period.
Helping children, families, and communities re-establish routines and roles can help return normalcy to a child’s life, providing reassurance and a sense of safety. Resuming regular mealtimes and bedtimes, returning to school, renewing friendships and leisure activities, and playing in a safe environment can all help. Different strategies are called for at different times and for different levels of symptom severity. For instance, because most children experience distress immediately after a traumatic event, a supportive, problem-focused approach may be useful in the acute phase of recovery. Later on, however, that same level of distress experienced by a child may indicate that a more intensive, trauma-focused approach is needed, such as one that emphasizes both skills training and the opportunity for the child to review the trauma.
Although behavioral problems are readily noticed by parents and teachers, children’s anxiety and depressive symptoms are not. Thus, it is good practice to assess anxiety and depression by asking children directly and obtaining children’s own reports on those symptoms. Children can and do recover from trauma. The difference is that successful recovery hinges upon the watchful eye and warm approach of family, adult caregivers, and trusted loved ones. If severity is beyond their capacity, professional help is next and often, the best, source of relief.
Just do not EVER give up hope for your child, any child’s, recovery from trauma! If you must ask, ‘What’s wrong with you?’ about a child–don’t. Stop and ask yourself, ‘What happened to you?’ Recovery begins there.