Reprinted from Early Childhood News - November/December 1995 Issue
The actual article was in color and included photographs.

The Healing Touch:
Helping Children Cope With Post-Traumatic Stress
by Tim Bete

Angela awoke to a shrill, continuous noise that hurt her ears. The sound frightened her and she wished that it would go away. By the light of a street lamp Angela could see that there were clouds in her room. She had never seen clouds in her room before. The clouds made her cough. "Moooom!" Angela yelled...but no one came. Angela began to cry. Several minutes later the door to her bedroom burst open. Angela looked up, hoping to see her mother, but instead saw a monster standing in the doorway. More clouds came into the room with the monster. Angela could hear it breathe. It sounded like the Darth Vader monster from the movie her brother liked. The monster wore a mask. The monster was coming for her. Angela screamed, but the monster picked her up anyway. "Moooom!" she cried as the monster carried her through the clouds and outside into the street. Angela's mom was waiting for her. The heavy-breathing monster handed Angela to her mom, who hugged her tightly.

Angela was overwhelmed by the clouds and the monster and all of the bright flashing lights. Usually her mom woke her in the morning and then they ate breakfast together. Angela had never seen these things before...and they terrified her.

Every day newspapers carry stories of devastating tragedy. Earthquakes in California, floods in the Midwest, hurricanes in Florida, house fires, car accidents - these events affect real people, and they often change their lives forever. While the traumatic event may be over quickly, the stress caused by the experience may linger for weeks, months, or even years. Stress that lingers after a shocking event is over is called post-traumatic stress or PTS.

As adults, we know that earthquakes, floods, and fires do not happen to us personally every day and are unlikely to repeat. For children, who are exploring the world for the first time, traumatic events are not easily rationalized or forgotten. The child who wakes in the night to the sound of a smoke alarm and a smoke-filled room is likely to expect the same event to occur whenever she goes to sleep at night.

Whether flood, fire, or car accident, events that cause severe trauma have one thing in common; they make children feel as if their world is out of control. Activities that had previously been normal, everyday occurrences (e.g., driving to your center, playing at home, sleeping at night) become frightening. Children who are experiencing post-traumatic stress need help from the people who represent stability in their lives. As an early childhood professional, you can make a significant difference in how quickly children who have experienced trauma recover.

When Angela's mom dropped her off at child care, Angela didn't want her to leave. Eventually Angela went off to play with her friends. Angela didn't eat her snack that morning and during nap time she refused to lie down. When the other children were building a house with blocks, Angela became quite upset, shouting, "Get the baby! The house is on fire!"

Susan had been a teacher at the child care center for five years and had known Angela since she started coming to the center last year. Susan knew about the house fire and noticed that Angela was not acting like her normal self. Having worked at a child care center in San Francisco during an earthquake, Susan was familiar with the symptoms of post-traumatic stress. Susan met with other caregivers in her center to explain what Angela was going through and how they could help her...

Recognizing Post-Traumatic Stress in Children
While many different types of events can cause post-traumatic stress in children, the symptoms are usually similar. Common symptoms include these:
1. Sleep Disturbances. Because the brain continues to play back the stressful event, children may have nightmares and trouble sleeping during nap time or at night.
2. Flashbacks. Intrusive memories may occur at any time and may be triggered by an object or event that reminds the child of the experience. For example, hearing a siren may remind a child of the day her house caught on fire.
3. Separation Anxiety. Traumatic experiences may cause or increase separation anxiety, especially if a parent or adult wasn't present during the stressful event. Children who have experienced a trauma may appear clingy and not want to leave their parent when being dropped off at the center.
4. Emotional Detachment. While some children appear clingy, others may seem emotionally detached, sitting with a blank stare. They appear quiet, but their hearts may be racing as they attempt to cope with memories of the traumatic event.
5. Regressive Behavior. Taking on behaviors that had previously been outgrown is a common coping mechanism for children. Children who have been traumatized may wet their beds, regress to baby talk, suck their thumbs, or reacquire some other habit.
6. Loss of Appetite. Traumatized children may show little interest in food.
7. Sickness Without Known Cause. Children may get headaches or stomachaches without any apparent cause.
8. Fixation on the Event. Play, artwork, and speech may revolve around the traumatic event. For example, the child may become fixated with playing with toy fire trucks after her house was on fire. This fixation is an attempt to understand and eventually control the event by replaying it over and over again.
9. Hyperactivity or Aggressiveness. Children may not be able to sit still or may become aggressive with other children with whom they had previously been friendly.

How You Can Help
Unlike adults, children often do not have the verbal capacity to discuss the events that have traumatized them. Because children deal with trauma differently than adults, your approach to helping them needs to be suited to their unique needs. The good news is that you can have a profound effect on helping to stabilize a child's world and in bringing predictability and peace back into his or her life.

Children who have experienced trauma need to "conquer" the experience to bring order back into their lives. The need to conquer the experience is usually seen in reenacting the experience in play or artwork and, if the child has the verbal ability, in talking about the experience. Allow children to replay the event, especially the scary parts that they are trying to understand.

Make extra time to listen to the child's story or to hear the child explain his or her drawings of the event. Listen to all aspects of the story, even the more gruesome ones. Acknowledge that the event was scary and don't interrupt the child while he or she is speaking.

Young children need extra nurturing and cuddling. Reassure them that their memories of the scary event won't hurt them and that the event won't happen again. Focus on the normal routine. Children who have experienced trauma may not be interested in doing a lot of exploring. They have been over-stimulated and are looking for security. Read stories and play games that are familiar to the child. Predictable routine is much more comforting than additional change.

Children look to adults when in crises. By acting as a positive role model during crises you will teach children that while things seem out of control, it is possible to remain calm and take action. It is important for you to be prepared in the event of natural disaster or other emergency situations.

It was four weeks after the fire in Angela's house. Susan watched Angela taking her nap. Angela looked much more peaceful than a month ago, when she wouldn't even lie down on her mat. Susan had spent a lot of extra time with Angela...listening to her endless stories of the fire, cuddling her when she heard a siren and became upset, being patient and nurturing. Susan could see that her extra effort had paid off. Angela was calmer! She didn't talk as much about the fire these days. She didn't even appear interested when a fire truck had driven past the center earlier in the day. Susan smiled to herself. Her healing touch had helped to bring peace and stability back into Angela's life.

Tim Bete is editor of Early Childhood News.