Trauma in children and adolescents_Anderson_Patricia_Crisis 302_L25125080

Running Head: TRAUMA AND ITS EFFECTS ON CHILDREN AND ADOLESCENTS 1
Trauma and its effects on children and adolescents
Patti Anderson
Liberty University

TRAUMA AND ITS EFFECTS ON CHILDREN AND ADOLESCENTS 2
Abstract
Everyone faces trauma at some point in their life. It is an unfortunate fact. Even more
unfortunate is the fact that many who experience trauma are innocent children and adolescents.
The effects of trauma upon their lives is unmatched and is proven to cause physical changes in
the brain which can lead to relational and psychological issues later on. The study of traumatic
events and their effects on humanity has grown in the last fifty years partially due to women’s
movements and increasing social issues. Child neglect, physical abuse, mental abuse, and
natural events, all contribute to the trauma that children and adolescents are facing. Learning
about these events and offenses and how to treat them is vital to the victims of abuse and for the
protection of generations to come. Trauma is a fact of life but with this fact comes the
responsibility to learn how victims are affected and how to help them heal from the pain of
trauma.

Trauma can be defined in many ways and everyone who experiences trauma will give
you a different definition. Their responses to the traumatic events will also vary. Trauma can be
defined as anything a person may experience that is a threat to their psyche and/or physical well-
being causing a disruption in their normal coping methods. In the case of most children, they are
unaware that what they are experiencing a traumatic situation and they are too young to
understand the psychological and emotional impacts it will have on them. This lack of
knowledge and maturity can be devastating and very damaging. Children and adolescents
respond to trauma and stress in ways that come naturally to them but they also learn coping skills
from their family, especially their parents. The stages of childhood and adolescence are very
influential and very foundational times in a child’s life. If physical pain is inflicted there will be
emotional suffering and vice versa. No matter what traumatic event is faced, every person,
especially children and adolescents, requires the appropriate understanding and the appropriate
treatment in order to heal and grow into healthy and functional adults.
History of Trauma
Children and adolescents experience many different types of trauma. Some of the most
commonly studied trauma since the 1970’s has been, “child neglect, childhood physical abuse,
childhood sexual abuse, and rape, as well as intimate partner or domestic violence, both in
heterosexual and in same-sex relationships” (Kammerer & Mazelis, 2006, p. 2). These traumas
have been stressed due to women’s rights movements and a rise in domestic violence. There are
also traumas that come from natural disasters and other unexpected external forces. Worldwide
tragedies seem to be on the rise in the last 50 years with increased earthquakes, tsunamis,
hurricanes, and terrorist attacks. In 2009 there were 49 earthquakes worldwide of magnitude 6.0
or higher, 17 of which exceeded magnitude 7.0, and one greater than 8.0 (Little, Akin-Little &

Somerville, 2011, p. 449). With this increase in trauma comes the need to educate people on
surviving trauma and especially concentrating on helping children to learn how to cope with
disaster, partially because of its influence on their healthy maturity as adults. If not educated or
counseled early on, children can become adults who present with disorders such as PTSD (post-
traumatic stress disorder), bipolar disorder, disassociation, and anxiety disorders, and others.
Lisa Cataldo explains that:
Early childhood trauma, whether it is a single devastating event or an accumulation of
experience, can interrupt or even prohibit the development of the basic “givens” of
selfhood-a sense of continuity in time, a fundamental trust in the ongoingness of the
world, and a sense of the general reliability of others (Cataldo, 2013, p. 2).
It is estimated that 68% of children in the United States have faced a potentially traumatic event
(PTE) and more than half had experienced multiple traumas (Mannarino & Cohen, 2009, p.1).
Most children are resilient and have the capacity to cope with trauma but not all of them cope
well.
Although the attention that has been given to studying childhood and adolescent trauma
and its effects has increased over the years there is still a lot to learn about treatment and
prevention. Unfortunately, studies from the early 2000’s indicated that it is no longer possible to
address childhood and adolescent trauma based on one singular type of incident but that
treatment must be formulated to address many different types of trauma. Mannarino & Cohen
point out that, “These findings implied that the negative mental health sequelae from childhood
trauma may primarily be the result of the cumulative impact of poly-victimization rather than
exposure to any specific type of trauma” (Mannarino et al., p. 2).

Besides the number of traumas a person has experienced there must also be the
consideration of many other factors such as age, vulnerability, health, economic status, and
location. Over the years most of these dynamics have increased and added to the difficulties of
providing proper and sufficient recovery from trauma. Usher and Grigg recognize that, “For
example, younger children, teens, and older adults appear to be vulnerable in distinct ways and
are subject to a higher proportion of emotional and physical difficulties when compared with the
general population” (Usher & Grigg, 2011, p. 3).
The Victims
It is unfortunate that before the age of 4 children will experience some sort of trauma.
Roberts, Ferguson and Crusto suggest that, “Twenty-six percent of healthy children will witness
or experience a traumatic event, such as abuse or neglect before the age of 4 years” (Roberts,
Ferguson & Crusto, 2012, p. 1). These types of trauma can effect emotions, skills, and
relationships. They can also lead to long-term mental health issues and even include such
ailments as heart disease, anxiety related issues, cancer, and PTSD (post-traumatic stress
disorder) if not addressed early on in the crisis. In a community-based cross-sectional study
conducted by Roberts, Ferguson and Crusto, 170 children from age 3-5 were examined and
studied for 22 months to see what types of trauma they would experience and how they would
respond. Their care-givers reactions and interactions were also addressed. It was found that the
children who faced trauma were likely to have a less positive health-related quality of life and
less healthy psychosocial health (Roberts et al., p. 1). A child experiencing just one incident in
which the life or well-being of themselves or another is jeopardized, increases their chances for
future health issues. Their inability to cope with stress and anxiety is increased which attributes
to decreased psychological functioning as well. The recognition of trauma and the interaction by

parents was either extremely helpful or hurtful to the child’s response. Parents and care-givers
play a huge role in teaching children how to handle crisis in their lives.
Children at these young ages are very vulnerable and easily influenced by everything
they experience. They are cognitively, behaviorally, spiritually, emotionally, and
psychologically still developing and forming the foundation of their being. As Alisic, Boeije,
Jongmas, and Kleber suggest:
They might appraise threatening situations in a different way because their frame of
reference is less clearly defined. In addition, they have not yet fully acquired the ability to
reflect on and verbalize complex emotions, which can influence their way of working
through trauma and experiencing change (Alisic, Boeije, Jongmas, & Kleber, p. 479).
Children are in their formative years until age 4 or 5 so this time is critical. If faced with a
traumatic situation, children of this age group must receive the proper love, compassion,
intellectual support, and sensitivity needed to get them through as positively as possible. Even
events such as divorce, the death of a grandparent, or childhood friends getting injured, can have
a powerfully negative effect on children and should not be taken lightly (Little et al., 2011).
As with small children the incidents of trauma in adolescence is increasing. Natural
disasters such as hurricane Katrina displaced more than one million people, many of whom were
children and adolescents and unfortunately, the cases for sexual abuse are also on the rise. In
1998 it was estimated that, “sexual abuse ranged from 3% to 37% for boys and 8% to 71% for
girls with an average of 17% for boys and 28% for girls (Little et al., p. 450). Worldwide, the
percentages vary but sexual abuse is not studied as in depth in other countries like it is in the
United States.

It has been found that some parents, possibly due to their own mental health issues, do
not recognize when a traumatic event has happened to their child. When there is sexual abuse in
the home a parent who is dealing with their own anxiety, depression, or bipolar disorder, could
miss the signs of a child who is being abused or has faced some sort of trauma. Sharon Johnson
tells us that, “Studies find that parents underreport youth symptoms and number of past traumas”
(Johnson, 2014, p. 2). Youth who experienced more stress at home, ran away from home and put
themselves at risk for a traumatic event were more likely to report a traumatic event. Therefore,
we can assume that problems at home and communication with parents (as is typical with youth)
can lead to traumatic events. Because of these types of studies, it is evident that building strong
family units can have positive impacts on children now and in the future.
Homicide and sex-trafficking are also causes of trauma that must be addressed.
Homicide claimed roughly 53,000 children in 2002 in the United States and in 2004, “218
million children were involved in child labor, of whom 126 million were in hazardous work and
estimates from 2000 suggest that 1.8 million children were forced into prostitution and
pornography” (Little, et al., p. 450). The emotional needs after such horrendous experiences are
high. Child sex-trafficking is an offense that is gaining more attention and many steps are being
taken to help reduce and hopefully eliminate it. Justice Ventures International is committed to
helping blot out human trafficking and human slavery. They estimate that there are 30 million
people worldwide who are in slavery (Justice Ventures International, 2014). That is just under
the total population of Canada. Children as young as 4 may be enslaved to pay off a debt owed
by their parents and some are even given over for sex trafficking. These children, once rescued,
will face almost insurmountable odds as they try to recover from the trauma they have
experienced. Adolescents who are caught in slavery will also need specialized treatment because

of the severe impact on their development. We know that adolescents deal with a huge amount
of emotions and quite often find normal everyday challenges to be overly burdensome.
Adolescents can have a very hard time with trauma. They may lash out physically or verbally
which can add more stress to an already stressful situation. Their involvement with peers and
adults is important during trauma. They need to be able to vent and express their feelings. Being
able to talk to kids their own ages who have experienced similar traumas can be vitally important
too. Even their spiritual development can suffer after such horrendous events.
A child’s spirituality will most likely be affected and/or altered due to the trauma. The
added misfortune of tragedy and trauma in a young person’s life may alter their belief system
and their view of God, if they have been introduced to God. Instead of seeing God as a God of
love they may begin to question why God would allow trauma in their lives and why didn’t he
stop it. These questions can cause their hearts to harden and become bitter toward God,
hindering the development of a healthy spiritual life and the opportunity to gain strength from
their faith. Lisa Cataldo expresses her feelings about God allowing trauma as, “Even in my most
post-modern, psychoanalyzed, liberal Christian self, there is a part of me who would rather be a
sinner in a world ruled by God than an innocent in a world ruled by the devil (Cataldo, p. 803).
Even she would rather have God in her life with suffering than to be in a world without suffering
ruled by the devil. But, this concept does not invalidate the pain of what a child or an adolescent
is experiencing in their grief. Not everyone will end up with a healthy view of God after the
tragedies they have experienced. The common questions people ask are, “Why did God allow
it? Why didn’t he stop it if he knows everything?” “Why didn’t he intervene?” Because of
these types of questions it is important to not only touch on the physical, emotional,
psychological aspects of trauma but also the spiritual, even with children and adolescents.

Teaching them that God still loves them but that he hates the actions that were taken against
them is vital to their healing and spiritual growth. Mannarino and Cohen express, “Moreover, it
is this combination of traumatic stress and loss that uniquely characterizes childhood traumatic
grief (CTG) but that has also posed challenges to researchers and clinicians alike in terms of
definitional issues, clinical description, and treatment (Mannarino, p. 23).
Treatment
America has seen more than its share of tragedy and a lot of it has been in schools.
Unfortunately, those affected by school shootings are mostly children and adolescents. Because
their coping skills vary depending on age, cognitive ability, emotionally stability, availability of
effective caregivers, other stresses in life, and their early life experiences, they must be watched
closely and require dedicated supervision. One nurse who dealt with the shooting at Sandy Hook
elementary has this advice, “When it comes to speaking to children about traumatic events,
death, and loss, it is our responsibility to help parents to understand what is developmentally
appropriate for a child to process. Therapeutic modalities include play therapy, expressive art
therapy, and somatic therapies” (Roberto, 2014, p. 2). She also suggests that being able to
recognize what stage of grief a child is in is important along with establishing trust and tapping
into coping mechanisms that the child may have been successful in using in the past. Children
aged 1-5 years may experience sleep disturbances, separation anxiety, fear, clinginess, regress to
younger ages, and show a need for more dependability and stability. This age is very influential
and foundational to the child’s development in all areas (psychologically, physically,
emotionally, behaviorally, and cognitively). It is an age that requires very close monitoring and
evaluation.

Since there is a need for more stability during times of crisis, it is suggested that parents
consider keeping the same schedule for home life and other functions outside the home. Keeping
a routine can be very helpful in replacing a sense of normalcy in the trauma victim. One primary
concern at this age is that the child can interpret trauma and they can sense discord among family
members but they are not able to vocalize their concerns regarding either and therefore must be
given other options for venting their frustrations and expressing their feelings. There are many
ways to help a child with expressing themselves and play is one of them. Also, allowing them to
draw their feelings and emotions on paper can be very helpful.
“Trauma survivors must make sense of their traumatic experiences throughout their lives.
At each new developmental stage, they must re-negotiate the meaning of the trauma in light of
new developmental capacities and their ever-growing knowledge of themselves and their world”
(Maltby & Hall, 2012, p. 9). Children in primary school may also have sleep disturbances such
as nightmares, they may not feel like they are safe, they may complain of physical pains (such as
stomach aches), isolate themselves, and may also have anger outbursts and decline in their
school performance. All of these are signs of a child not dealing well with trauma. Treatment
for a child of this age is again geared toward drawing, playing, and can possibly include verbal
discussions about how they are feeling etc. At this age children are beginning to understand life
more cognitively but that in itself can be scary to them. They need much reassurance, extra
quality time spent with their caregivers, and a more relaxed expectations regarding school
performance. “Following trauma exposure, caregivers play a critical role in influencing
children’s developmental trajectories as effective parenting practices provide a protective
environment surrounding youngsters” (Roberts et al., p. 2164). Although there are programs
and other services to assist children with their trauma the most help is found in the family unit.

The amount of love and understanding they receive from their immediate families can be a huge
factor in whether they are successful or not.
Outside the home treatment options are varied. There are government run programs,
church programs, school programs, and private programs. All of these can help immensely in
allowing the child to grieve, process, acknowledge, and plan their future success after a traumatic
event. As was touched on earlier, a type of trauma that seems to be on the rise and which does
major damage in multiple ways to its victims is sex slavery and sex trafficking. Becca Johnson
gives us a good look at what
services are available for those
victims of sex-trafficking due to
the multiplicity of its offenses. As
is clearly seen, sex trafficking
affects the victim in many ways
(Johnson, 2012, p. 372).
Therefore, the treatment needed is wide and varied. It is a complex and very damaging trauma
which will require community support and involvement. Recovery and treatment will involve
many facets of the treatment programs and resources available. Mental health will play a role as
will developing an immediate safety plan and plans for future progress and success (Johnson,
2012).
At first, child victims of trauma may simply need the basics of life provided to them such
as love, safety, shelter, water, and food. People who attempt to counsel those who have been
caught up on sex trafficking must attempt to meet these vital needs but must also take extra care
in the way they speak, move, and handle themselves when around the victim. These victims tend

to be overly delicate and sensitive and may interpret things incorrectly. Again, because of the
multiplicity of offenses with sex trafficking, it is vital for counselors and everyone involved to be
extra careful to insure the victim’s safety in all manners. Adhering to a major point in
counseling, those who are dealing with children of trauma must make sure they “do no harm” but
rather offer the empathy, compassion, and love that is needed. Spirituality and faith can also
play a role in survivors of all trauma. In the Bible, the book of Matthew (25:35-36) shows us
how to treat others. We treat them as we would treat Jesus.
Conclusion
Shelly Rambo, in a theological discussion regarding trauma states, “One thing that you
come to see in the process of dealing with this material is that trauma is not something you really
ever “get over”, but rather one develops the capacity to “bear it” (Shelly Rambo, 2011, p. 227).
Since children and adolescents deal with trauma differently due to their age and their capacities
at that age, it is important that they have the support and influence of adults who have been
successful in dealing with trauma and stress. It is vitally important that a young child be assured
of their security and safety during and after a traumatic event. They need routine and boundaries
and most importantly, love. They also may need more attention emotionally and physically for a
while; more hugs, more talking, more time. Most importantly they must have a caregiver who is
capable of giving them what they need immediately, during, and after the trauma.
Adolescents are very easily influenced and they, too, must have a caregiver who is in
tune with their needs and willing to assist in meeting those needs. An adolescent’s spirituality
can be a great coping tool when dealing with traumatic situations. However, spirituality may be
questioned during trauma so having the appropriate answers to their questions can help retain the
use of this coping mechanism. They will need peers, parents, and spiritual leaders to help assist

them in coping with their traumatic event. If trauma is not dealt with effectively initially it can
lead to major coping skills issues, dissociative disorders, anxiety disorders, PTSD, and other
psychological or behavioral issues. Trauma is not something you can tell someone to “just get
over”, even in children. Trauma is real. It hurts. It damages. It can destroy. There is hope after
trauma but that hope is seeded in genuine care and concern for those who are traumatized and
also in the effectual use of educational resources, community resources, and religious
organizations. It takes a community to raise our children but it also takes a community to save
our children from the unfortunate effects of trauma and crisis. James 1:27 reminds us that,
“Religion that is pure and undefiled before God, the Father, is this: to visit orphans and widows
in their affliction, and to keep oneself unstained from the world.” Christians have a huge
responsibility to help those in affliction. We must look after our children and care for them during crisis
and always.

References
Alisic, E., Boeije, H. R., Jongmans, M. J., & Kleber, R. J. (2011). Children's Perspectives on
Dealing With Traumatic Events. Journal Of Loss & Trauma, 16(6), 477-496.
doi:10.1080/15325024.2011.576979
Cataldo, L., (2014), “I know that my Redeemer Lives”, Family Process, Vol. 53, No. 2, 2014
FPI, Inc. doi: 10.1111/famp.12050
Johnson, B. C. (2012), Aftercare for survivors of human trafficking. Social Work and
Christianity, 39(4), 370-389. Retrieved from
http://search.proquest.com/docview/1221237353?accountid=12085
Johnson, S., (2013), Comparing factors associated with maternal and adolescent reports of
adolescent traumatic event. Article first published online: 11 NOV 2013 DOI:
10.1111/famp.12050 Family Process, Vol. 53, No. 2, 2014
Justice Ventures International, http://www.justiceventures.org/why_justice/
Kammerer, N., & Mazelis, R., (2006), Expert panel meeting; “After the Crisis”: Healing from
Trauma after Disasters, Bethesda, MD., April 24-26, 2006. Retrieved from
http://gainscenter.samhsa.gov/atc/text/papers/trauma_paper.htm
Little, S.G., Akin-Little, A., & Somerville, M. P., (2011), School Psychology
International, response to trauma in children: An examination of effective intervention
and post-traumatic growth. ISSN 0143-0343, 10/2011, Volume 32, Issue 5, pp. 448 –
463. Retrieved from http://spi.sagepub.com/content/32/5/448

References
Maltby, L. E., & Hall, T. W. (2012). Trauma, attachment, and spirituality: A case study. Journal
of Psychology and Theology, 40(4), 302-312. Retrieved from
Mannarino, A. P., & Cohen, J. A. (2011). Traumatic loss in children and adolescents. Journal Of
Child & Adolescent Trauma, 4(1), 22-33. doi:10.1080/19361521.2011.545048: Retrieved
from http://search.proquest.com/docview/863699264?accountid=12085
Rambo, S., Jones, S., Rivera Rivera, M., & Copeland, M. (2011). "Theologians engaging
trauma" transcript. Theology Today, 68(3), 224-237. doi:10.1177/0040573611416539
Roberto, A. (2014). Recovery lessons from the Sandy Hook trauma. American Nurse Today,
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Usher, K., & Grigg, M. (2011). Responding to traumatic events. Australian Nursing
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