Though caring adults wish they could shield children from trauma and from it's bigger, meaner cousin, post-truamatic stress disorder (PTSD), the truth is that we can't. But we can become educated about childhood trauma and PTSD to become better advocates on behalf of kids touched by these mental illnesses.
Previous posts in this series explored how I became a PTSD advocate, basic definitions of childhood trauma and PTSD, myths and misconceptions about PTSD in kids, and most recently, causes of PTSD in children.
Today's focus is on a question that often makes parents and professionals scratch their heads:
Why are some kids who experience trauma resilient enough to recover quickly while others get stuck in the trauma and develop PTSD?
According to Dr. Linda Gantt, executive director at Intensive Trauma Therapy, Inc. (ITT), four risk factors increase the likelihood of PTSD developing in children who have experienced a traumatic, scary event, including invasive medical procedures common for many kids with special needs.
Risk Factor #1: Unexpected, Unpredictable, or Emergency Situations
Children hit out of the blue with scary events are much more likely to develop PTSD than children who are warned and prepared ahead of time for them. Of course, by nature most traumatic events are unexpected, unpredictable emergencies.
Most, but not all. Children can be prepared ahead of time for scheduled invasive medical or dental procedures. They can also be prepared for major life changes which are not scary to adults but over which children have no control or say–like moving to a new town.
Risk Factor #2: Age of the Child when Trauma Occurs
Contrary to popular thought, the younger a child is when trauma occurs, the more likely it is to cause PTSD. Why? Well, the reason is similar to what was discussed in the above paragraph. The younger the child, the more unexpected, unpredictable and emergency-like a frightening or physically painful event will seem because very young children are less able to understand an explanation and be prepared for it.
Risk Factor #3: Repeated, Significant Trauma
This risk factor is a little more intuitive. It makes sense that kids who experience repeated, significant trauma are more likely to develop PTSD. It also makes sense for this risk factor to affect kids who experience events that are emotionally upsetting and confusing than physically painful or frightening.
Think about kids who move from foster home to foster home, bounce from school to school, or are in the hospital for repeated invasive medical procedures. Eventually these kids start looking over their shoulders, in a heightened state of alert, expecting the next terrible thing to happen because such is the ingrained pattern of their lives.
Risk Factor #4: Partial Awakening During Medical Procedures
This fourth risk factor applies to medically-induced trauma only. Children of any age who partially awaken (also known as "going light") during medical procedures are much more likely to develop PTSD than children who remain completely anesthetized during surgery. Patients who partially awaken can hear and sometimes feel what's happening to them, but they are unable to move or speak. They experience a total lack of control.
If total lack of control is the hallmark of this risk factor, perhaps it does have implications beyond medical procedures. Perhaps children who who have experienced a total lack of control elsewhere in their lives are also more likely to develop PTSD–like children who go through repeated, unexpected, unpredictable, or emergency situations.
How to Combat These Risk Factors
So much for the bad news. The first bit of good news is this: once the risk factors are known parents and care givers can employ strategies to minimize those risk factors so kids who are traumatized don't develop PTSD. And here's the second bit of good news: PTSD in children is a very treatable mental illness. Future posts in this series will explore this good news in greater detail. Until then, if you suspect your child may have PTSD, here are a few websites to explore:
Jolene Philo's first child, Allen, was born with a life-threatening birth defect that required 7 surgeries from birth to age five. She taught students with special needs in a variety of settings during her 25 years in education. Her book, Different Dream Parenting: A Practical Guide to Raising a Child with Special Needs was released by DHP in November of 2011. She also blogs about special needs at www.DifferentDream.com.