how chronic illness can cause trauma in children

Often we hear about trauma and think of those who have been in an abusive situation, experienced a natural disaster or military service members who have experienced combat. Children living in poverty, those with intellectual and developmental disabilities and those who are gender diverse may be more at risk for trauma-related symptoms. Children with a chronic illness or life-threatening injuries can also have trauma-related symptoms.

Children who receive invasive or painful procedures, or long-term treatment because of a chronic illness, accident, or injury are at higher risk to develop trauma related symptoms. Research also shows that children's perceptions of the event are important. If the event is thought of and remembered as frightening, life threatening, or painful, children can be at greater risk for developing symptoms.

According to the National Child Traumatic Stress Network:

• Childhood injuries are common 
• Many ill or injured children and their families (up to 80%) experienced some traumatic stress reaction following life threatening illness, injury or procedures
• Between 20-30% of parents and 15-25 % of siblings experience persistent stress reactions
• Every four seconds, a child is related for an injury in an emergency department (from the Centers for Disease Control and Prevention)
• 15,000 children younger than 20 years are diagnosed with cancer each year in the United States.

These events can cause stress reactions in children, their parents, and other family members. They may impair daily functioning and affect how children stick with treatment, and how they recover. 

Post-traumatic stress symptoms:

Children who have post-traumatic stress symptoms generally experience:

Impact of development

The way children cope and deal with symptoms of medical or other trauma also vary based on the child’s developmental level.

• Preschool children who have experienced a trauma may have more difficulty separating or may regress behaviorally (i.e., begin having accidents, become more clingy, or start using baby-talk).
• School-aged children may experience significant guilt or believe that they caused the trauma to occur (i.e., I did not wear my helmet like my mom told me and now I’m being punished). They tend to become more concerned for their own and loved one’s health and safety. School-aged children are also likely to have increased somatic complaints following a trauma (i.e., headaches, stomachaches, general pain) as they show their emotional pain through physical symptoms.
• Adolescents often struggle with trying to “fit in” and may feel self-conscious about their experience. They may isolate themselves more and struggle with ways to be more independent in the face of a medical condition requiring them to be more dependent on parents and caregivers.
• Preschool, school-aged children, and adolescents may all have difficulty concentrating and learning once they return to school following the experience of a medical trauma.

The intensity of post-traumatic stress symptoms experienced in combination with the child’s developmental stage have the ability to greatly impact academic, emotional, social, physical, and behavioral functioning.

How parents can help:

The first thing parents need to do is recognize that their child is having difficulty or impairment in some area of functioning as a result of medical trauma. Once parents are aware, one of the best ways to manage these symptoms is to talk to your child about how they are feeling or what they experienced. Younger children tend to have more difficulty describing what they are experiencing emotionally but may benefit from drawing a picture, playing out the experience, or telling a story. Regardless of age or developmental level, family support and involvement is essential.

The good news is you do not have to deal with this alone. The psychology staff at Dayton Children’s has specialized training to treat children of all ages and developmental stages who are dealing with frightening or life-threatening illnesses, injuries, and/or accidents. We can work with children and their families to teach specific coping skills that will decrease post-traumatic stress symptoms. Talk to your doctor if you think your child might be experiencing post-traumatic stress symptoms. Also, remember you do not have to wait until symptoms significantly interfere with your child’s functioning, often times long-term impact can be reduced by getting treatment early.