When a child experiences a traumatic event, it can have lasting effects on their mental and physical health. Post-traumatic stress disorder (PTSD) is a condition that can develop after a person experiences or witnesses a traumatic event. Early childhood trauma, such as abuse, neglect, or exposure to violence, can increase a child's risk of developing PTSD later in life. As a parent, it's important to understand the risk factors and symptoms of PTSD in children, and to know how to get help if needed. In this article, we'll explore what PTSD is, what children are at risk, and how parents can help prevent or treat the condition. We'll also discuss the potential effects of childhood trauma on mental health later in life.

Our intent is that by understanding the impact of trauma on a child's life, we can encourage prevention programs, support the mental health of our children, and create a better future for everyone.

Understanding PTSD

What is PTSD?

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after a person experiences or witnesses a traumatic event. It doesn't always occur right away though, but take months or even years to start showing symptoms. Traumatic events can include physical or sexual abuse, natural disasters, violent personal attacks, car accidents, invasive medical procedures, and many more difficult things (American Psychiatric Association, 2013). PTSD can also occur in individuals who have experienced traumatic events repeatedly or over a prolonged period, like those who have been exposed to ongoing abuse or combat veterans (National Institute of Mental Health, 2019).

What is Complex PTSD?

Complex PTSD (C-PTSD) is a type of PTSD that can occur after prolonged exposure to trauma, like child abuse or neglect that goes on for some time. Children who experience early childhood trauma are at a higher risk for developing C-PTSD, which can cause more severe and persistent symptoms than traditional PTSD (Courtois & Ford, 2013). C-PTSD is when someone experiences both symptoms of PTSD and other mood or behavioral symptoms like extreme moods or personal isolationism. Some countries medical protocols consider C-PTSD to be a separate disorder from PTSD, but the DSM-5 does not at this time.

Risk factors for PTSD

Not every child who experiences a traumatic event will develop PTSD,  but certain factors can increase a child's risk. These factors include a family history of mental health problems, experiencing previous trauma, a lack of social support (family and friends), and exposure to multiple or ongoing traumatic events (National Institute of Mental Health, 2019). Kids who experienced a traumatic event that threatened death or serious injury, or who witnessed harm to others, are at a higher risk for developing PTSD (American Psychiatric Association, 2013).

Children who are at risk for PTSD

Kids who experience physical abuse or sexual abuse, neglect, or other adverse childhood experiences (ACEs) are at a higher risk for developing PTSD. ACEs can include things like family violence (this includes watching a parent be abused, even if the child isn't physically abused), natural disasters, having a parent sent to prison, being attacked by an animal, and many other things. Children who experience emotional neglect or bullying neglect are also at a higher risk for developing PTSD. It's also important to keep in mind that kids who have developmental issues or who experience stressful events like a move or change in school may be more vulnerable to developing PTSD (Centers for Disease Control and Prevention, 2020).

An ACE score is the total points added up  for someone, based on questions related to the different types of abuse, neglect, and other markers of a tough childhood they experienced. According to the Adverse Childhood Experiences study, the rougher your childhood, the higher your score is likely to be and the higher your risk for later health problems becomes.

You can take the ACE quiz for free through NPR.

link to take the NPR ACE quiz

"Using data from the Adverse Childhood Experiences Study, an analysis by Anda, Felitti, Brown et al. (2006) confirmed that the risk of negative outcomes in affective, somatic, substance abuse, memory, sexual, and aggression-related domains increased as scores on a measure of eight ACEs increased (https://www.ncbi.nlm.nih.gov/books/NBK207191/)."

Symptoms and Diagnosis of PTSD in Children

Symptoms of PTSD in Children

The symptoms of PTSD in children can vary, but they're generally sorted into four categories: re-experiencing the traumatic event, avoidance, negative changes in thinking and mood, and hyperarousal or increased physical symptoms. Re-experiencing symptoms can include flashbacks, nightmares, or intrusive thoughts. Young children may act-out the traumatic experience with toys repeatedly in a subconscious effort to process the event. Avoidance symptoms may include avoiding certain places or activities that remind the child of the traumatic event. Negative changes in thinking and mood can include feelings of guilt, shame, or detachment from others. Hyperarousal symptoms may include things like an increased difficulty with sleeping, increased irritability, or being easily startled (American Psychiatric Association, 2013).

Diagnosis of PTSD in Children

To diagnose PTSD in children, mental health professionals use the same criteria as for adults, but they usually modify the questions or use different tools due to the developmental differences (National Institute of Mental Health, 2019). In some cases, a child's symptoms may not meet the full criteria for PTSD but should still receive treatment for the trauma-related stress. A child psychiatrist or other mental health expert can do an evaluation to determine the most appropriate diagnosis and treatment plan for the child (National Institute of Mental Health, 2019).

Age of Diagnosis for PTSD in Children

Children of any age can be diagnosed with PTSD, but younger kids that have difficulty expressing their feelings may display their symptoms through play or behavioral problems whereas teenagers are usually more capable of articulating their symptoms and experiences, so really listening to what they say and asking key questions is important. It's important for parents to be aware of their child's symptoms and to seek help from a mental health professional if they suspect their child may be struggling with PTSD or trauma-related stress (National Institute of Mental Health, 2019).

Treatment Options for Childhood Trauma and PTSD

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a commonly used treatment for PTSD in children. CBT helps children learn coping skills to manage their symptoms and to challenge negative thoughts and beliefs related to the traumatic event. This therapy can be done individually or in a group setting and may involve both the child and the parents or caregivers (National Institute of Mental Health, 2019).

According to a study by Deblinger et al. (2017), CBT has been shown to be an effective treatment for children with PTSD. The study found that children who received CBT had significant reductions in their PTSD symptoms, and these reductions were maintained over a six-month follow-up period.

Cognitive Processing Therapy (CPT)

Cognitive Processing Therapy (CPT) is another form of therapy that has shown promise in treating PTSD in children. This therapy helps kids process their traumatic memories, thoughts, and feelings about the event in a safe and supportive environment. It can also help kids learn coping skills to manage their symptoms. (National Institute of Mental Health, 2019).

A study by Cohen and Mannarino (2015) found that CPT was effective in reducing PTSD symptoms in children who had experienced sexual abuse. The study found that kids who received CPT had significant improvements in their PTSD symptoms and were less likely to meet criteria for PTSD diagnosis at the end of treatment.

Play Therapy

For younger kids, play therapy can be an effective way to help them process their experiences and emotions related to the traumatic event. Play therapy allows kids to express themselves through play and can help them develop coping skills and a sense of control over their emotions (American Psychological Association, 2013).

A study by Landreth and Bratton (2006) found that play therapy was an effective treatment for children who had experienced traumatic events. The study found that kids who received play therapy had significant reductions in their PTSD symptoms, as well as improvements in their overall mental health.

"Play becomes the digestive enzyme that metabolizes trauma..."

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Other Treatment Options

Other treatment options for childhood trauma and PTSD may include medications, like antidepressants or anti-anxiety medications, as well as family therapy or other forms of therapy. It's important for parents to work with a mental health professional to determine the most appropriate treatment plan for their child (National Institute of Mental Health, 2019).

In a review of treatment options for childhood trauma, Olafson et al. (2017) found that a combination of CBT and family therapy was the most effective treatment for PTSD in children. The review also found that medication may be helpful in reducing some symptoms, but should not be used as the only treatment for PTSD in children.

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Coping Skills and Treatment Options for Childhood Trauma

Coping skills can help a child manage their symptoms of PTSD and other mental health problems related to childhood trauma. Coping skills can include things like relaxation techniques, such as deep breathing or meditation, and physical activity, like exercise or sports. Having a trusted adult or professional to talk with can also be really helpful for symptom management.

Treatment options for childhood trauma-related PTSD may include psychotherapy, medication, or a combination of both. Cognitive processing therapy (CPT) and cognitive-behavioral therapy (CBT) are two types of psychotherapy that have been found to be effective in treating PTSD in children (National Institute of Mental Health, 2021). In addition, some children may benefit from Eye Movement Desensitization and Reprocessing (EMDR) therapy, which has been shown to be effective in treating PTSD in adults and may also be effective in children (Wilson et al., 2018).

It is important to note that treatment options for childhood trauma-related PTSD should be tailored to each individual child's needs and circumstances. In some cases, referral to a child psychiatrist or other expert may be necessary. Parents play a crucial role in helping their child access mental health services and encouraging prevention programs in their local school system or community.

It is also important to recognize that not every child who experiences early childhood trauma will develop PTSD or other mental health problems. However, children who have experienced trauma are at an increased risk for developing mental health problems and would likely benefit from early intervention and support regardless.

Long-term Effects of Childhood Trauma

It's probably not surprising information, but childhood trauma can have long-term effects on a person's mental and physical health. Studies have shown that individuals who have experienced childhood trauma, like abuse or neglect, have an increased risk of developing mental health conditions, like depression, anxiety disorders, and PTSD (Felitti et al., 1998; Green et al., 2010). Childhood trauma has also been linked to an increased risk of physical health problems, like heart disease and other chronic illnesses (Anda et al., 2006).

Childhood trauma can also affect a person's brain development and cognitive functioning, leading to difficulties with learning, memory, and emotional regulation (Teicher et al., 2016). These developmental issues can continue into adulthood and affect a person's ability to function in their normal daily life.

Adults who have experienced childhood trauma may also exhibit symptoms of unresolved trauma, including flashbacks, nightmares, and feelings of guilt or shame (van der Kolk et al., 1996). These symptoms can be disruptive to daily life and can lead to other mental health problems, like depression, substance abuse and/or suicidal thoughts.

However, it is important to note that not everyone who experiences childhood trauma will develop long-term effects. Factors like genetics, family support, and access to mental health services can play an important role in an individual's ability to recover from trauma (National Child Traumatic Stress Network, 2021).

Symptoms of Unresolved Childhood Trauma

Childhood trauma can have long-lasting effects that may persist into adulthood if left untreated. Some common symptoms of unresolved childhood trauma may include:

  1. Anxiety and Depression: Children who have experienced trauma are more likely to develop anxiety and depression later in life (Kessler et al., 2005). They may experience feelings of worthlessness, hopelessness, and may struggle with social interactions.
  2. Emotional Dysregulation: Unresolved childhood trauma can also lead to difficulty regulating emotions. Individuals may experience intense and unpredictable emotions that can significantly affect their normal day-to-day life.
  3. Physical Symptoms: Trauma can have a real and significant impact on the body, leading to physical symptoms like headaches, digestive issues, and chronic pain (Briere & Scott, 2015). For more information on the physical symptoms of trauma, consider reading or listening to "The Body Keeps The Score" by Bessel van der Kolk.
  4. Substance Abuse: Individuals who have experienced childhood trauma may be more likely to turn to drugs or alcohol use as a way to cope with their feelings and memories (Dube et al., 2003).
  5. Interpersonal Problems: Childhood trauma can impact a persons' ability to form healthy relationships. They may struggle with trust, intimacy, and might have difficulty maintaining close connections with other people (https://www.ncbi.nlm.nih.gov/books/NBK207191/).

It is important to note that not everyone who experiences childhood trauma will develop these symptoms. However, if you or someone you know is experiencing these symptoms, it may be helpful to seek support from a mental health professional.

Resources That May Be Helpful For More Information:

The National Child Traumatic Stress Network

SAMHSA Understanding Child Trauma

SAMHSA Understanding Child Trauma pdf:

Principles of Trauma Therapy by John Briere and Catherine Scott

The Body Keeps The Score by Bessel van der Kolk M.D.


In Conclusion

To sum it up, childhood trauma can seriously affect a person's mental health and overall wellbeing for the rest of their life. As parents, caregivers, educators, and healthcare providers, it's crucial to know the signs of PTSD and seek help when needed. Although not all kids who experience a traumatic event will develop PTSD, it's essential to acknowledge the possibility of long-term consequences and take steps to prevent and treat trauma as soon as possible in order to minimize the chance of developing PTSD.

The good news is that there are effective treatments available for PTSD and other mental health conditions caused by childhood trauma. Early intervention and access to mental health services can significantly improve outcomes for children and adults who have experienced trauma.

By educating ourselves and others about the impact of childhood trauma and working to prevent and address it, we can make a real difference in the lives of our children and communities. Let's keep raising awareness, supporting prevention programs, and advocating for mental health resources for those who need them. Together, we can create a safer and healthier future for everyone.


Briere, J., & Scott, C. (2015). Principles of trauma therapy: A guide to symptoms, evaluation, and treatment (2nd ed.). Sage Publications.

Dube, S. R., Felitti, V. J., Dong, M., Giles, W. H., & Anda, R. F. (2003). The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900. Preventive Medicine, 37(3), 268-277. doi: 10.1016/s0091-7435(03)00123-3

Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of general psychiatry, 62(6), 593-602. DOI: 10.1001/archpsyc.62.6.593

Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., ... & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European archives of psychiatry and clinical neuroscience, 256(3), 174-186. https://doi.org/10.1007/s00406-005-0624-4

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., ... & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American journal of preventive medicine, 14(4), 245-258. https://doi.org/10.1016/S0749-3797(98)00017-8

Green, J. G., McLaughlin, K. A., Berglund, P. A., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2010). Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. Archives of general psychiatry, 67(2), 113-123. https://doi.org/10.1001/archgenpsychiatry.2009.186

National Child Traumatic Stress Network. (2021). Trauma Types


Wilson, G., Farrell, D., Barron, I., Hutchins, J., Whybrow, D., & Kiernan, M. (2018). The Use of Eye-Movement Desensitization Reprocessing (EMDR) Therapy in Treating Posttraumatic Stress Disorder. Front Psychol, 9: 923. Published online 2018 Jun 6. doi: 10.3389/fpsyg.2018.00923

National Institute of Mental Health. (2021). Post-Traumatic Stress Disorder. https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

Trauma-Informed Care in Behavioral Health Services. Chapter 3. https://www.ncbi.nlm.nih.gov/books/NBK207191/