Educator's Guide to
Post-Traumatic Stress Disorder in Children

By Leah Davies, M.Ed.

Post-Traumatic Stress Disorder (PTSD) in children is a disabling condition that follows a terrifying event that a child learned about, witnessed or experienced. Some examples are motor vehicle accidents, plane crashes, violent attacks, sexual abuse, kidnapping, murder, suicide, illness, death, riot, war or a natural disaster. Children who have suffered any form of abuse or who have had other previous traumatic experiences are more likely to develop this condition.

PTSD can happen at any age and can occur suddenly or develop gradually. The symptoms usually appear within the first three months after a traumatic event. For a PTSD diagnosis, the symptoms need to last more than a month. (For Diagnostic Criteria, view PTSD Support Services.) Symptoms may continue for years, or decrease and return later after an event triggers unpleasant memories.

According to the National Center for PTSD, there are three factors that increase the risk of a child developing PTSD. They are: how severe the traumatic event is, the parental reaction to it, and the physical proximity of the child to the event. Children who have experienced the most severe traumas are at the greatest risk. When the families of distressed children are supportive and/or when children are further removed from the trauma, they are less likely to exhibit symptoms of PTSD.

PTSD symptoms in children can include:

  • recurring nightmares
  • sleeplessness
  • fearfulness
  • irritability
  • agitation
  • intense vigilance
  • avoidance
  • separation anxiety
  • change in school performance
  • emotional numbness
  • social withdrawal
  • lost of interest in activities
  • angry outbursts
  • difficulty concentrating
  • guilt
  • worry for others
  • physical complaints

Children with PTSD often have persistent, frightening thoughts and are preoccupied with danger. They may reenact the traumatic event in repetitive play, retell it often, or use art to illustrate what happened. However, unlike most children, their reactions are compulsive and do not seem to reduce their level of anxiety.

Some children are able to recover from a traumatic event by themselves, while others cannot. Children with severe symptoms can recover by participating in therapy with trained mental health professionals who have expertise in treating PTSD victims. Medication to alleviate serious symptoms may be prescribed by a psychiatrist. Taking medicine can assist children in coping with school and other daily living activities while treatment continues. Support groups or group therapy can be useful in helping children learn that they are not the only ones who have PTSD. Groups also provide a safe atmosphere in which children can share personal feelings.

A child's teacher and/or school counselor can play an important role in recognizing and facilitating a child’s recovery from a severe traumatic event. Although it is usually necessary to seek outside professional help, consider these ideas for providing support to the child and the child's parents if you suspect PTSD:

    Help the Child at School
    • Provide a familiar, calm, consistent environment
    • Create an atmosphere in which the child feels safe to reenact or discuss a trauma, or express his or her feelings without judgment -- yet do not pressure the child to do so
    • Be aware of certain activities that may trigger the child’s anxiety or regression and safeguard against them
    • If you suspect that the child is a danger to him or herself or others, seek help immediately

    Elicit Parental Cooperation
    • After observing and recording the child's behaviors, share the information with the parent
    • Listen to the parent's ideas concerning the child and any exposure he or she may have had to a traumatic event * If deemed appropriate, encourage the parent to seek a professional opinion concerning the child's condition

    Ways To Help a Parent
    • Stress that the parent should consider the child's developmental level when discussing a traumatic event
    • State the importance of keeping a child's routine as normal as possible, and that the child may need extra love, support and reassurance to feel safe
    • Encourage the parent to listen if the child wants to talk, but not to force him or her to do so
    • Stress the importance of reassuring a child that his or her feelings are normal
    • Emphasize that the child needs to hear that he or she is not to blame for what happened
    • Comment that distressed children often exhibit regressive behaviors such as those of a younger child, so being critical of a child's immature actions could be detrimental
    • Since feeling out-of-control is a common symptom, propose that the parent provide opportunities for the child to make simple decisions for him or herself
    • If the parent seems distraught, suggest that he or she try to find emotional support, so that the parent can be available to help the child
    • Keep lines of communication open between the parent and school personnel  

Used by permission of the author, Leah Davies, and selected from the Kelly Bear website []. 11/02

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