At each age level, there are common reactions to traumatic events. Below are the common youth reactions at various age levels, followed by appropriate adult responses to support young people as they process trauma.
AGE 2 to 6: Reaction
- Generalized fear
- Cognitive confusion, e.g., not understanding that the danger is over
- Helplessness, passivity, e.g. may become mute, withdrawn, and still
- Anxious attachment to caregiver, e.g., clinging, not wanting to be away from caregiver, not wanting to sleep alone
- Sleep disturbances; night terrors
- Regressive reactions, e.g., toileting, dressing, speech
- Engaging in reenactments and play about the event; sometimes with magical qualities/character of the event
- Incomplete understanding of death; e.g., permanency of death, association with sleep, a desire to “fix up” the deceased
- Difficulty identifying and expressing what is wrong; e.g., periodic sadness
AGE 2 to 6: Adult Response
- Need rapid reassurance that they will be okay and taken care of
- Reestablish familiar adult protection
- Give repeated concrete clarification of what has happened and anticipate their concerns
- Provide support, rest, comfort, food, and opportunities to play
- Provide consistent care taking; e.g., assurance of being picked up at school, keeping a regular meal schedule, bedtime and when caregivers will be home
- Be as tolerant as possible with regressive behavior; it is temporary
- Try to remove the association of what happened with specific trigger/reminders; e.g., playgrounds, cars
- Explain the reality of death in age appropriate terms, when the child is open; e.g. a private moment, or while reading
AGE: 6 to 10: Reaction
- Impaired concentration and learning difficulties affecting performance at school
- Radical change in behavior, e.g., quiet child becomes active; active child, lethargic
- Somatic complaints, such as headaches
- Retelling the event with great detail and “savior” endings
- Preoccupation with their behavior during or leading up to the event with feelings of guilt and responsibility
- Specific fears triggered by reminders or while alone
- Fear of being overwhelmed by their own feelings
- Increased difficulty controlling their own behavior and feeling frightened by this lack of control
AGE: 6 to 10: Adult Response
- Allow enough “free” supervised time for play or expression through art, music, or dance
- Encourage your child to let you or the teacher know that they may be having a hard time concentrating while at school
- Try to be patient with any behavior changes
- Reassure the child that s/he will be safe and there are people around to help
- Help your child associate emotional and physical sensations s/he may have had during the event and suggest ways of helping her/him feel better; e.g., changing the subject, doing something else
- As with play, allow time to talk; acknowledge the normalcy of the reaction, what secret images s/he may have, and what specific reminders s/he may have
- The supportive presence of adults will help the child not to be so overwhelmed, and help remind her/him that feelings lead to actions s/he may not like or cannot control. Help her/him to establish a sense of control by doing something proactive, such as organizing a collection drive, making cards to send to those in need, or making red, white and blue ribbons for friends and classmates to wear.
AGE 10 to 14: Reaction
- Become more childlike in attitude
- Be very angry at the unfairness of the event
- Manifest euphoria and excitement at survival
- “See” symbolic meaning to things that led up to the event and assign symbolic reasons for survival
- Suppress thoughts and feelings to avoid confronting the event
- Be self-judgmental about their own behavior
- Manifest psychosomatic illness
AGE 10 to 14: Adult Response
- Try to respond to the emotions that are underlying the behavior and reinforce more mature behavior by including them in the resolution of problems.
- Encourage talking about the event in private moments. Discussions in front of others can lead to emotional reactions.
- Encourage supervised/supportive discussions about the event with peers if peers have been part of the event. Peers can inflame the reaction if not given some support and guidance.
- Provide realistic assessments of personal responsibility and “what could have been done”
- Help keep things in perspective e.g. “These feelings will not last forever.” “You can shape your own future.”
- Help them establish a sense of control by allowing them to do something pro-active such as organizing a collection drive (which the schools has done) or make and send cards to the family.
AGE Adolescent to Adult: Reaction
- Feel anger, shame, betrayal and act out these feelings in school or the community.
- May want to move into the adult world to get away from traumatic events and establish a sense of control over their world.
- Very judgmental about their behavior and that of others.
- Eating and sleeping disorders.
- May have an enhanced sense of immortality or an increased sense of hopelessness.
- Depressions
- Alcohol and drug use may become a problem.
- May engage in high-risk behavior
- May have a fear of being labeled “abnormal”.
AGE Adolescent to Adult: Adult Response
- Acting out may be a way of “pushing the event away”. Help them understand that might be what is going on.
- Encourage postponing major decisions in order to allow time for emotions to settle down and to grieve if necessary.
- Speak to emotions that are underlying the behavior. “This must be a very frustrating, angry time.”
- Help them understand the adult nature of what they are feeling, encourage peer understanding and support.
- Help them not to overreact to the impact this may have on their lives, help them grow from it, not lost in it.
- Acknowledge the “depressed” feeling that may come and that is survivable and normal.
- Acknowledge the anger they may be feeling, and explain how it can contribute to their sense of being “out of control” and “wanting to do something”.
- Encourage them to do something pro-active such as donating blood, if old enough, or volunteering to help at the Red Cross or other organizations.
For all ages:
- Give reassurances and hugs
- Assure them they and their families are safe (if this is the case)
- Limit their exposure to graphic details
- Let them talk and reassure them and solicit their ideas and feelings
– Best practices compiled by Michael B. Murphy (Former Washtenaw County Crisis Manager)