What Are The Signs Of Posttraumatic Stress Disorder (PTSD) In Very Young Children And Toddlers?
Because the linguistic development of very young children and toddlers is so restricted, they are unable to articulate their distress in anything other than a very rudimentary way; therefore, in order to infer whether they are suffering from PTSD, it is necessary to observe their behavior and emotional expression.
These behavioral and emotional reactions to trauma will, of course, vary between individuals, both in terms of the number displayed and their intensity. Clearly, all else being equal, the greater the number of symptoms and the more severe such symptoms are, the greater the imperative for therapeutic intervention.
Possible signs of PTSD in very young children and toddlers include the following :
- disrupted sleep pattern
- physical symptoms such as stomach aches and headaches
- developmental regression; the child may regress to an earlier stage of development and, as a result, lose some learned skills (e.g. toilet training).
- post-traumatic play: this can manifest itself as a repetitive play that mirrors the events of the original trauma. For example, a child involved in a car crash may repetitively play with toy cars in a way that reenacts the accident. Also, traumatized children may dramatically reduce their ‘exploratory’ play.
- over-sensitive startle response; the child may become extremely startled and fearful in response to unexpected events, including trivial ones that would not have bothered him before the trauma, especially, of course, if the unexpected event triggers memories (on either a conscious or unconscious level) of the original traumatizing experience.
- obsessive preoccupations; the child may become obsessed by a particular toy or cartoon character, for example.
- acute separation anxiety; represented as an intense fear of being separated from the primary caregiver.
- self-blame; this can manifest itself by the child developing a wholly irrational belief that the traumatic event or experience was his fault.
- reactions as if the traumatic experience is recurring, which, in extreme cases, can manifest itself losing awareness of present surroundings (also referred to as ‘dissociation’)
- habitual avoidance of activities, places, and other reminders associated with the original traumatic experience
- loss of motivation to participate in activities that brought pleasure and captivated interest prior to the trauma (for example, loss of interest in playing games)
- mood changes, including outbursts of rage and anger, extreme tantrums, aggression, irritability, marked reduction in expression of positive emotions
- deterioration in relationships with significant others such as parents, caregivers, and peers, increased wariness of strangers, ‘clinginess.’
- impaired concentration
- socially withdrawn behavior
- fears of things that might seem unconnected to the trauma but are actually representative and symbolic of it; for example, a fear of an imaginary monster (that represents, on an unconscious level, someone who has harmed the child).
David Hosier BSc Hons; MSc; PGDE(FAHE).
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