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Even a Minor Accident Can Cause Childhood Trauma

Sarah is teaching her five-year-old daughter Ami to ride her new bike. Although Sarah is a very alert and watchful mum, Ami is just out of reach when the bike’s front wheel hits some loose gravel and careens into a nearby tree. The five-year-old is momentarily knocked unconscious. Sarah consoles her at the time, but the caring mum does not realize how stunned and frightened the little girl really is, how disoriented and somehow “different” she feels.

Some months later, Sarah clearly believes that Ami is no longer “herself.” Ami has been having more nightmares than usual, the normally outgoing little girl seems withdrawn, fearful, clingy, and complains often of tummy aches that have no apparent origin. Sarah suspects that all of the symptoms are connected. She is right. They are. Ami’s changes in behavior can all be traced back to the day of the fall from her bike.

How to Tell If Your Child Has Been Traumatized

Any unusual behavior that begins shortly after a severely frightening episode may indicate that your child is traumatized. Compulsive, repetitive mannerisms, such as repeatedly zooming a toy car into a doll, are an almost sure sign of unresolved trauma. Other signs of traumatic stress include tantrums, uncontrollable rage attacks, hyperactivity, thrashing while asleep, bedwetting, inability to concentrate in school, excessive belligerence, or fearful shyness.

To determine whether an uncustomary behavior is a traumatic reaction, try mentioning the frightening episode and notice how your child responds. A traumatized child will not want to be reminded of the event. Or, once reminded, will become excited or fearful and unable to stop talking about it. A traumatized child may also respond with silence.

Understanding Trauma

Trauma is mysterious and frightening, primarily because it is not well understood. The secret to understanding trauma is to realize that we are members of the animal kingdom and as animals we have a built-in adaptive response to threat or injury. Call it the survival instinct or an adrenalin rush, we respond to threat just like other biological creatures do and that means our bodies must complete a primitive process: preparing for the event, reacting to it, then discharging the accumulated energy once the threat has passed. This condition is called Post Traumatic Stress Disorder and can result in a number of symptoms and behaviors.

Unlike animals, humans tend to override these primitive responses. Whether or not a person will be traumatized depends largely on the individual's ability to complete that critical process and release the heart-pounding rush of nervous energy. If we do not, we get “locked in” and cannot move past the event that triggered the body’s reaction.

Anyone at any age can be traumatized by a threatening event, but those at greatest risk are infants and young children. Moreover, events that seem relatively benign to adults can affect a child deeply. Even a fall from a swing or a tumble from a bike can result in a debilitating trauma.

So how, as parents, do we deal with trauma in children? Can we prevent it? Can we cure it?

Preventing Trauma in Children: The Trauma Steps for Children

Accidents and falls are a normal part of growing up. For Sarah, witnessing Ami’s fall from her bicycle would not have necessarily indicated to her that it was a potentially traumatizing incident. But here are some steps that parents, like Sarah, can take immediately after such an event in order to prevent unresolved trauma from afflicting a child later on:

  1. Attend to your own responses first. Acknowledge your concern and fear for your child. Being overly emotional or smothering may frighten your child as much as the accident itself.
  2. Keep your child still and quiet.
  3. Encourage a sufficient interlude of safety and rest, particularly if your child shows signs of shock or daze. Help your child know what to do by modeling relaxed, quiet and still behavior yourself.
  4. Gently guide your child's attention to the sensations he or she may be feeling: ask how she feels ''in her body.'' Be a little more specific with your next question: ''How do you feel in your tummy (head, arm, leg)?'' If she mentions a distinct sensation, gently ask about its location, size, shape, color, weight, for example. In response to her answer, gently guide her to the present moment: ''How does it feel now?''
  5. Allow a minute or two of silence between questions. This will permit your child to process and complete her response before her attention is distracted by another question.
  6. Do not stir up discussion about the accident. There will be plenty of time for telling stories about it or drawing pictures of it later.
  7. Validate your child's physical responses throughout this period. Children often begin to cry or tremble as they come out of shock. This is good! The physical expression of distress needs to continue until it stops on its own, or at least levels out.
  8. Your task at this time is to let your child know that crying and trembling are normal, healthy reactions.

Finally, attend to your child's emotional responses. Once she appears safe and calm, or even later, set aside time for storytelling or for reenacting the incident.

Past Trauma Can be Healed and Resolved with Similar Steps

Healing trauma is in many ways similar to preventing it, but helping your child move through an established traumatic reaction may be time-consuming and require several processing sessions. It is vital that you do it, because as incredible as it may seem, traumatic symptoms can remain dormant for a significant period of time—sometimes decades—before surfacing and delayed reactions to a childhood trauma can be triggered later in life by seemingly insignificant events.

Of course, not every childhood accident produces a delayed traumatic reaction. Some have no residual effect at all, but erring on the side of caution is always wise when dealing with children and infants.

To learn the simple but powerful tools that you can use to keep your children safe from danger andto help them “bounce back” after feeling scared and overwhelmed, read the ground-breaking book, Trauma-Proofing Your Kids. It simplifies this often mystifying and complex subject, empowering parents to raise truly confident and joyful kids despite stressful and turbulent times.

And for an in-depth understanding of how children respond to trauma and their innate ability to rebound with the appropriate support, there is Trauma Through a Child’s Eyes. Rich with case studies and hands-on activities, this book offers parents both insight and hope.

Trauma-Proofing Your Kids
Peter A. Levine and Maggie Kline
North Atlantic Books, 2008

Trauma Through a Child's Eyes: Awakening the Ordinary Miracle of Healing
Peter A. Levine and Maggie Kline
North Atlantic Books, 2007

Research Writings from Peter A. Levine, MD, can be reviewed by clicking Memory, Trauma and Healing.

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