There are almost 6 million children each year who suffer some form of abuse. These are the cases that Child Protection Services get involved in. I bet you this number is almost double. Especially when it comes to child sexual abuse. Most cases of any type of sexual abuse/assault go unreported. According to the National Center for PTSD:
If you add the numbers up according to current statistics that would mean that there are between 9 and 16 million children a year who suffer some form of abuse. That's not including the number of unreported cases. If two-thirds of child abuse is unreported that would make the statistics higher. It would mean that between 27 and 48 million children a year suffer some form of abuse. According to the latest census http://quickfacts.census.gov/qfd/states/00000.html there are almost 75 million children under the age of 18 in the US. If we count just the numbers reported it means that between 12 and 21 percent of children 18 and younger suffer some form of abuse. If we include those numbers of unreported abuse. It would mean between 33 and 64 percent of children 18 and younger experience some form of abuse. These are high statistics and in my opinion pretty mind boggling.Child protection services in the U.S. get around 3 million reports each year. This involves 5.5 million children. Of the reported cases, there is proof of abuse in about 30%. From these cases, we have an idea how often different types of abuse occur:
Also, 3-10 million children witness family violence each year. Around 40-60% of those cases involve child physical abuse. (Note: It is thought that two-thirds of child abuse cases are not reported.)
- 65% neglect
- 18% physical abuse
- 10% sexual abuse
- 7% psychological (mental) abuse
To give an example of children who suffer severe trauma (I use the terminology multiple traumas). My children were being raised in a violent home, because of that they were definitely neglected and at times physically abused. Both of their parents had undiagnosed mental health issues and the whole extended family system they were around were violent. Or I should say tolerated violence. They have PTSD and at times for each of them it still is hard. They are learning their triggers and they wrestle with admitting they have PTSD because it means they were affected by their environment when they were really young. They have shared frustration because they don't remember a lot of the violence so they think they weren't affected. I am grateful they don't remember a lot of the violence. I am also grateful that they have a life that is violence free. Their children will be the first generation in five generations that will be raised without violence.Children and teens that go through the most severe traumas tend to have the highest levels of PTSD symptoms.
Some effects of trauma are:
I think that children with behaviors such as aggression in school are labeled as some sort of behavior problem. When if the school knew that it was possible that the child displaying aggressive behavior may be due to some type of trauma the child would be better served. Once a child is labeled a problem it takes away from what the child may have experienced. Their experience gets pushed to the back because their behavior seems to be the immediate issue. PTSD is very complex and more needs to be done to educate those who work with children. The sooner PTSD symptoms can be addressed the better life the child will have in the long run. Rosie
- fear, worry, sadness, anger, feeling alone and apart from others, feeling as if people are looking down on them, low self-worth, and not being able to trust others
- behaviors such as aggression, out-of-place sexual behavior, self-harm, and abuse of drugs or alcohol
PTSD in Children and Teens
This fact sheet provides an overview of how trauma affects school-aged children and teens. You will also find information on treatments for PTSD in children. To learn about PTSD in very young children, please see our fact sheet Very Young Trauma Survivors: The Role of Attachment.What events cause ptsd in children?
Children and teens could have PTSD if they have lived through an event that could have caused them or someone else to be killed or badly hurt. Such events include sexual or physical abuse or other violent crimes. Disasters such as floods, school shootings, car crashes, or fires might also cause PTSD. Other events that can cause PTSD are war, a friend's suicide, or seeing violence in the area they live.Child protection services in the U.S. get around 3 million reports each year. This involves 5.5 million children. Of the reported cases, there is proof of abuse in about 30%. From these cases, we have an idea how often different types of abuse occur:
- 65% neglect
- 18% physical abuse
- 10% sexual abuse
- 7% psychological (mental) abuse
How many children get PTSD?
Studies show that about 15-43% of girls and 14-43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3-15% of girls and 1-6% of boys develop PTSD.Rates of PTSD are higher for certain types of trauma survivors. Nearly 100% of children get PTSD if they see a parent being killed or if they see a sexual assault. PTSD develops in 90% of sexually abused children, 77% of children who see a school shooting, and 35% who see violence in the area they live get PTSD.
What are the risk factors for PTSD?
Three factors have been shown to raise the chances that children will get PTSD. These factors are:- How severe the trauma is
- How the parents react to the trauma
- How close or far away the child is from the trauma
Other factors can also affect PTSD. Events that involve people hurting other people, such as rape and assault, are more likely to result in PTSD than other types of traumas. Also, the more traumas a child goes through, the higher the risk of getting PTSD. Girls are more likely than boys to get PTSD.
It is not clear whether a child's ethnic group may affect PTSD. Some research shows that minorities have higher levels of PTSD symptoms. Other research suggests this may be because minorities may go through more traumas.
Another question is whether a child's age at the time of the trauma has an effect on PTSD. Researchers think it may not be that the effects of trauma differ according to the child's age. Rather, it may be that PTSD looks different in children of different ages.
What does PTSD look like in children?
School-aged children (ages 5-12)
These children may not have flashbacks or problems remembering parts of the trauma, the way adults with PTSD often do. Children, though, might put the events of the trauma in the wrong order. They might also think there were signs that the trauma was going to happen. As a result, they think that they will see these signs again before another trauma happens. They think that if they pay attention, they can avoid future traumas.Children of this age might also show signs of PTSD in their play. They might keep repeating a part of the trauma. These games do not make their worry and distress go away. For example, a child might always want to play shooting games after he sees a school shooting. Children may also fit parts of the trauma into their daily lives. For example, a child might carry a gun to school after seeing a school shooting.
Teens (ages 12-18)
Teens are in between children and adults. Some PTSD symptoms in teens begin to look like those of adults. One difference is that teens are more likely than younger children or adults to show impulsive and aggressive behaviors.What are the other effects of trauma on children?
Besides PTSD, children and teens that have gone through trauma often have other types of problems. Much of what we know about the effects of trauma on children comes from the research on child sexual abuse. This research shows that sexually abused children often have problems with- fear, worry, sadness, anger, feeling alone and apart from others, feeling as if people are looking down on them, low self-worth, and not being able to trust others
- behaviors such as aggression, out-of-place sexual behavior, self-harm, and abuse of drugs or alcohol
How is PTSD treated in children and teens?
For many children, PTSD symptoms go away on their own after a few months. Yet some children show symptoms for years if they do not get treatment. There are many treatment options, described below:Cognitive-Behavioral Therapy (CBT)
CBT is the most effective approach for treating children. One type of CBT is called Trauma-Focused CBT (TF-CBT). In TF-CBT, the child may talk about his or her memory of the trauma. TF-CBT also includes techniques to help lower worry and stress. The child may learn how to assert him or herself. The therapy may involve learning to change thoughts or beliefs about the trauma that are not correct or true. For example, after a trauma, a child may start thinking, "the world is totally unsafe."Some may question whether children should be asked to think about and remember events that scared them. However, this type of treatment approach is useful when children are distressed by memories of the trauma. The child can be taught at his or her own pace to relax while they are thinking about the trauma. That way, they learn that they do not have to be afraid of their memories. Research shows that TF-CBT is safe and effective for children with PTSD.
CBT often uses training for parents and caregivers as well. It is important for caregivers to understand the effects of PTSD. Parents need to learn coping skills that will help them help their children.
Psychological first aid/crisis management
Psychological First Aid (PFA) has been used with school-aged children and teens that have been through violence where they live. PFA can be used in schools and traditional settings. It involves providing comfort and support, and letting children know their reactions are normal. PFA teaches calming and problem solving skills. PFA also helps caregivers deal with changes in the child's feelings and behavior. Children with more severe symptoms may be referred for added treatment.Eye movement desensitization and reprocessing (EMDR)
EMDR combines cognitive therapy with directed eye movements. EMDR is effective in treating both children and adults with PTSD, yet studies indicate that the eye movements are not needed to make it work.Play therapy
Play therapy can be used to treat young children with PTSD who are not able to deal with the trauma more directly. The therapist uses games , drawings, and other methods to help children process their traumatic memories.Other treatments
Special treatments may be needed for children who show out-of-place sexual behaviors, extreme behavior problems, or problems with drugs or alcohol.What can you do to help?
Reading this fact sheet is a first step toward helping your child. Learn about PTSD and pay attention to how your child is doing. Watch for signs such as sleep problems, anger, and avoidance of certain people or places. Also watch for changes in school performance and problems with friends.You may need to get professional help for your child. Find a mental health provider who has treated PTSD in children. Ask how the therapist treats PTSD, and choose someone who makes you and your child feel at ease. You as a parent might also get help from talking to a therapist on your own. Please see our Where to Get Help page for treatment resources.
Sources
This fact sheet is based on a more detailed version, located in the "Professional" section of our website:PTSD in Children and Adolescents.
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