Information for parents and carers
This page is to help you to identify what a traumatic event is. It will explain some of the normal reactions to traumatic events and some simple strategies to use to help support your child and advice on when to seek additional help.
What is a traumatic event?
A trauma or traumatic event is an event which makes someone feel very frightened, out of control and they think there is a threat of serious harm or death to themselves or someone else.
Examples of very frightening events are things like being badly hurt in an accident, seeing someone else getting hurt, becoming acutely unwell, undergoing intrusive or frightening treatment. Most traumatic events involve some sort of threat to life or threat of injury. It is important to remember that these events would cause distress and upset to almost everyone.
How do children and young people react after a traumatic event?
Everyone reacts to traumatic events in a different ways and there is no right or wrong way for children to react. The things you may notice are likely to fall into four categories.
- Re-experiencing trauma e.g. having nightmares or flashbacks.
- Heightened awareness e.g. being alert or easily startled and watching for signs of danger.
- Avoidance e.g. not wanting to talk or think about the event or go to places or do things that remind you of the event.
- Mood changes e.g. feeling low, numb or irritable.
As a parent/carer it can be very difficult for you to see your child distressed by what has happened. This can be particularly difficult if you were involved in the frightening event and are experiencing a traumatic stress response yourself. One of the most helpful things you can do is to remind yourself that the distress is normal. It can sometimes be difficult for parents to know how to help.
Listed below are some of the most common reactions that you may see in a child after a traumatic event, these are categorised by developmental stage, however these reactions can be seen at any age and stage.
Children under 5 years
- Sleep – Changes to sleep including, difficulties settling to sleep, waking with nightmares or crying out in their sleep.
- Regression of behaviour – They return to younger behaviour such as bed wetting or thumb sucking. For toddlers this maybe loss of skills they have developed.
- Changes to their behaviour – You might notice an increase in tantrums, being clingy and separation anxiety.
- Changes to eating pattern – e.g. eating much less or more than usual.
- Being tearful or “clingy” (children want to stay close) – For no clear reason.
- Changes to play – e.g. acting out the event or parts of the event or withdrawing from play they have previously enjoyed.
What you can do to help your child?
- Reassurance – Give your child reassurance let them know that they are safe and that the event is over. If it is not over, e.g. ongoing procedures in hospital, help them to understand what is coming next using basic language with an appropriate amount of notice. Try to help them with coping strategies for what is coming up.
- Boundaries and consistency – It is important to maintain normal boundaries, rules and discipline. Children gain a sense of safety from consistent boundaries.
- Normal routines – Routines are also an important part of helping your child feel safe and providing them with an environment that is familiar and predictable.
6-11 year olds
In addition to the symptoms above experienced by younger children you may also notice changes in:
Nightmares – Your child may wake with bad dreams or nightmares. These may be directly related to the events or they may be seemingly unrelated but have similar themes e.g. mirror feelings that the child experienced in the event or worry about themselves or someone else being hurt.
Concentration – Your child’s ability to concentrate particularly with school work or focused task may not be as good. They may be more easily distracted than usual.
Communication about the event – Your child may want to repetitively talk, draw or act out the event with play.
Alternatively your child may not want to talk about the event at all and may actively avoid anything that reminds them of it.
Experiencing flashbacks of the event – For a few moments it can feel as though they are reliving the experience in their mind, like watching an action replay. They will feel very anxious during a flashback.
Being easily startled and appearing frightened – At the slightest noise or by specific stimuli that previously did not frighten them.
Complaining of physical symptoms – If your child is complaining of physical aches and pains which have no medical cause it could be that this is a psychological response to the trauma.
What you can do to help your child?
Allow your child to talk, draw or play about the event, this is their way of processing what has happened. If it is too difficult for you to do this with them because the event has also had an impact on you, ask another family member or friend to do this with your child. Make sure your child knows that it is okay for them to talk about what has happened if they want to. Sometimes people worry that talking about what has happened will make it worse. We know that it is most helpful for children to know it is okay to talk about it if they want to. This can help children to process what has happened.
If you child is experiencing nightmares, try to get them to talk or draw about them in the day time when they feel safe to do so. Give them reassurance about these nightmares, tell them that they are safe and the nightmare is not real. It might also be useful to allow your child to sleep with a nightlight or landing light on for a short period of time. Usually these dreams will reduce quickly. It is very important to try to keep your child bedtime routine as normal as possible, as changes in routine can increase distress.
Flashbacks – Encourage your child to talk to you about the flashbacks, explain to them that the flashbacks are not real and normal after the experience they have had. Give them reassurance that they are safe.
Inform you child’s school about the event and what has happened, ask them to let you know if your child’s behaviour changes.
In addition to the symptoms above you may also notice the following:
Mood – Your child might be more moody than usual. Their mood may change quickly or they may be more irritable or angry than usual. You may also notice an increase in anxiety. This might be directly related to the event or about something unrelated.
Withdrawal – Your child may also become withdrawn, not wanting to go to school, out with friends or refusing to do activities they previously enjoyed.
Avoidance – Your child may also noticeably be avoiding things that remind them of the event e.g. places, people, sounds smells or images.
What you can do to help your child?
Talk – Let your child know that it’s ok to talk about the event that happened and that it is normal to experience some trauma symptoms after a traumatic event. If you feel your child is mature enough you may want to read this leaflet together.
Respect privacy – Some children may not want to talk to you about what happened and may prefer to talk to someone else. Knowing that you are there to listen and understand their feelings if they want to talk is what is important.
Looking after yourself – As a parent or carer it can be very difficult for you to see your child distressed by what has happened. This can be particularly difficult if you were involved in the frightening event and are experiencing a traumatic stress response yourself. One of the most helpful things you can do is to remind yourself that the distress is normal. It can sometimes be difficult for parents or carers to know how to help
If you notice changes in your own behaviour in terms of mood, avoidance, heightened awareness or re-experiencing it will be important for you to find someone to talk too. This could be a friend or family member or a trained professional, your GP would be able to help you with accessing professional help.
When should I seek extra help?
All of the ideas discussed in this leaflet are common reactions to traumatic events. We usually see with a bit of care and attention that these difficulties resolve over time e.g. nightmares reduce gradually over a few weeks. You should talk to someone (GP, school nurse, health visitor, medical team involved in the care of your child) if your child’s symptoms do not get better within a few weeks or if you are very worried about them interfering with daily life or you think they are getting worse.
This has been produced by the Department of Psychology in Healthcare. Clinical Psychologists are based at the RVI and Freeman Hospitals. If you have any further concerns about the issues discussed, please discuss these with your GP or medical team