Childhood Trauma

2020 Guide to Understanding the Impacts

Overview of Childhood Trauma

According to the Substance Abuse and Mental Health Services Administration, an estimated two-thirds of children have experienced some kind of trauma by the age of 16. 1 Childhood trauma can take many forms, including physical and sexual abuse, loss of a loved one, or life-threatening illness. So, there are many ways that a child may be affected at an early age.Early trauma can lead to many mental and physical health concerns. Children who have experienced trauma may be more likely to have problems in school and suffer from substance abuse problems later in life.2 Without treatment and safe places in their lives, they may have lifelong difficulty establishing trusting relationships with others.

Causes of Trauma

According to the American Psychological Association, a traumatic event is one that “threatens injury, death, or the physical integrity of self or others and also causes horror, terror, or helplessness at the time it occurs.”1Examples of traumatic events include:

Car Accidents

Community and School Violence

Domestic Violence

Medical Trauma

Natural Disasters

Physical Abuse

Sexual Abuse

Being in Military Family, Deployment, Loss of a Parent, or an Injury


Traumatic Losses

Trauma Happens Early

An estimated 66 percent of children report experiencing a traumatic event before age 16, according to the American Psychological Association.1Many researchers study trauma caused by community violence. Community violence is exposure to acts of violence in public areas by individuals who don’t have a relationship with the victim. Statistics related to childhood trauma experiences include:

An estimated 39 to 85 percent of people report witnessing community violence. Of those, 66 percent are estimated to be victims of community violence themselves.

An estimated 25 to 43 percent of young people have experienced sexual abuse

In 2006, an estimated 400,000 children in the United States experienced injuries related to seuxal violence.

The Substance Abuse and Mental Health Services Administration (SAMHSA) surveyed young people ages 12 to 17 years old.1 Some of the key findings include:

8% Experienced a Sexual Assault
17% Experienced a Physical Assault
39% Witnessed Community Violence

Not only are young people bullied physically, but they are also bullied on the Internet and their phones. According to SAMHSA, an estimated one in six school-aged children reported experiencing cyberbullying.3

While a young person might not realize it at the time, some of the trauma they experience can stick with them.

Behavioral and Psychological Trauma Symptoms

Children are not always good at sharing or understanding the emotions they feel after a traumatic experience. As a result, parents or loved ones may observe other unexpected changes.1 Examples of these symptoms include:

Anger and Rage
Complaining they feel unwell without actually being ill
Loss of interest in activities they once enjoyed
Problems concentrating
Reporting new fears of being afraid of many everyday activities
Seperation anxiety, having problems being away from parents/authority figures
Struggling in school
These symptoms can affect a child’s relationship with their family, friends, teachers, and peers.

Symptoms by Age

Sometimes, the symptoms can vary based on the child’s age. The following are some examples of childhood trauma symptoms a person may show depending on their age:


  • Having strong separation anxiety
  • Crying or screaming more frequently
  • Refusing to eat
  • Having nightmares

Elementary Preschoolers

  • Starting to act anxious
  • Acting afraid of many things
  • Having problems sleeping, such as having frequent nightmares
  • Having teachers notice the child doesn’t concentrate like they used to

Middle and High Schoolers

  • Reputing feeling depressed and alone
  • Engaging in self-harm, such as cutting
  • Starting to abuse alcohol and drugs
  • Engaging in risky behaviors, such as sexual activity

Listen Closely to What the Child Says

Often, young people who are going through trauma report feeling bad about themselves and can say things like:

  • “I’m a bad kid”
  • “No one understands me”
  • “It’s all my fault”
  • “Is something wrong with me?”

Recognizing childhood trauma and providing treatment as soon as possible can help reduce the likelihood of troubling side effects like long-term health problems and increased risks for behavioral and substance abuse disorders..3

The Connections Between Childhood Trauma and Addiction

Several studies have connected childhood trauma with increased risks for addiction to drugs and alcohol.4 According to The National Child Traumatic Stress Network, teens who have experienced physical/sexual assault or abuse were three times more likely to experience substance abuse problems compared to those who had not.3

Another survey of young people who were receiving treatment for substance abuse found that 70 percent of participants experienced trauma in the past.3

PTSD and Addiction

Doctors have also connected post-traumatic stress disorder in children with increased risk for substance abuse problems.4 According to the National Child Traumatic Stress Network, an estimated 59 percent of young people with PTSD later develop a substance abuse disorder.

Unfortunately, doctors have found that trauma can be a two-way street. Those who experienced trauma are at greater risk for substance abuse.4 On the other hand, those who abuse substances have a greater risk of experiencing traumatic events.


Doctors know that some people turn to substance abuse as a means to self-medicate. This means they try to escape their problems by using drugs or alcohol instead of seeking medical treatment for help. Having a history of PTSD increases the chance of self-medicating. If there is a triggering event that reminds them of their past trauma, they are more likely to turn to drugs and alcohol as a way to try and feel better.

Substnace Abuse Disorder Before Trauma

According to The National Child Traumatic Stress Network, an estimated 45 to 66 percent of young people had a substance abuse disorder before they experienced some kind of trauma, such as sexual or physical abuse. Unfortunately, a person with a substance abuse disorder typically has an even harder time coping with their recovery. Some experts say this is because people who abuse substances may have a hard time coping with stress and trauma.

Misdiagnosing PTSD and ADHD 

Children who have experienced trauma may have a difficult time forming relationships with other adults, especially if they grow up without a supportive adult figure in their lives. According to Dr. Nancy Rappaport, a child and adolescent psychiatrist interviewed on the Child Mind Institute website, “These kids don’t have the context to ask for help. They don’t have a model for an adult recognizing their needs and giving them what they need.”5 It also makes it hard for children to accurately describe their feelings.

Trauma or ADHD?

Unfortunately, it is difficult for teachers and other adults to identify past trauma as the root of behavioral changes in children. Many people may misdiagnose the child as having a behavioral disorder like attention deficit hyperactivity disorder (ADHD).5 This can be a problem because a child may be disciplined or punished frequently. But, the ideal method for helping someone who has experienced trauma is to help them understand their emotions and empower them to change their behavior whenever possible.

ADHD or PTSD from Trauma?

Children with PTSD from trauma are chronically agitated and irritable.5 Many times they have trouble sleeping and problems regulating their emotions. They may be extremely afraid of making a mistake or could seemingly overreact when something does not go their way in school. Most of these behaviors can closely resemble ADHD when, in reality, the behavior is a result of past trauma.

Children May Actually Have both ADHD and PTSD from Trauma

A child who has experienced trauma can have ADHD and PTSD. Some symptoms they share include anxiety, impulsiveness, difficulty sharing feelings, and difficulty talking themselves through what they need to do.5 From an early age, this can severely affect a child’s ability to succeed in school – a place they spend much of their time while growing up.

Sometimes, children who have a history of trauma or abuse will provoke teachers and other adults at school. According to the Child Mind Institute, this is a way for children to get attention from adults. “Negative attention is fast, predictable, and efficient,” Dr. Rappaport says. “We need to make positive attention as fast, predictable, and efficient.”

Impacts on Adulthood from Childhood Trauma

Childhood trauma can impact a person, both mentally and physically.

Childhood is a time of mental and physical development. Childhood trauma can impact physical health throughout a lifetime. For example, when a child is exposed to extreme stress in their life, they tend to have a strong stress response. This strong stress response may include rapid heart rate, hyperventilating (breathing very fast), or panic attacks.6 As a result, people may perceive an adult who has experienced childhood trauma as someone who “overreacts” or is very dramatic.6 They could also respond the opposite way and appear very closed off and detached from their emotions.

The stress of childhood trauma can also cause inflammation in the body. Further, a child who has experienced neglect or abuse may not be able to receive needed healthcare from an early age. As a result, they are more likely to have some of the following medical problems:

Chronic Pain
Heart Disease
Lack of Physical Activity

People who suffer from childhood trauma are also more likely to turn to unhealthy habits such as substance abuse and smoking. They are more likely to die an early death when compared to those who did not experience childhood trauma.6 The estimated lifetime costs per victim of child abuse is $210,012. This includes costs related to additional healthcare needs, criminal justice costs, and special education.

Domestic Abuse

An estimated 15 million children in the United States live in a setting where domestic violence occurred.Children who witness domestic abuse or who are victims of domestic abuse are at risk for several different kinds of physical and mental health concerns. According to, children who witness physical violence between parents are also at greater risk of acting violently in their relationships. If a boy grows up seeing his mother abused, he is ten times more likely to abuse his female partner when he grows up. Girls who witness their mother being abused are six times more likely to be sexually abused when they grow up compared to their peers. For this reason, it is important to provide a child with the support they need at an early age to break the cycle of domestic violence and abuse.Researchers have identified both short- and long-term effects of domestic abuse on a young person. These include:

Preschool Children

Preschool children may start to act much younger than they are because they are regressing to behaviors when they felt “safe” before the domestic abuse started. Examples of these behaviors include wetting the bed, crying more frequently, or sucking their thumb. Preschool children who witness domestic violence may also have difficulty sleeping, develop a stutter, or experience severe separation anxiety.

School-age Children

Children this age may start to have a lot of complaints that they feel ill all the time. They will often blame themselves for what is happening and convince themselves that everything is their fault.


Teenagers will often have issues with violence and engage in risky behaviors, such as using drugs, when they live in a household where domestic abuse occurs. They also may suffer from depression.

Recovering form Domestic Violence

While growing up and witnessing domestic violence can change a child in many ways, recovery is possible. A child must learn to deal with their emotions healthily without violence or self-blaming thoughts.5 Establishing a safe place with an adult support system can help. Professional counseling and cognitive-behavioral therapy (CBT) may be especially helpful. This approach can help the child learn healthier ways to deal with stress.

Sexual Abuse

According to the nonprofit organization Darkness to Light, an estimated 1 in 10 children experience sexual abuse before the age of 16.7 It is important to understand that there are a variety of behaviors that researchers consider child sexual abuse. It is also important to realize that a child may not even know they are being sexually abused.Examples of sexual abuse include:

Touching Behaviors

When another person touches a child to stimulate the child or themselves sexually

Non-Touching Behaviors

When another person tries to look at a child while they are naked, show them pornographic materials, or touches themselves in front of a child

Child sexual abuse knows no gender, financial status, or race. Unfortunately, most of the time, children know their abusers. According to Darkness to Light, an estimated 60 percent of children are abused by a trusted person in their family.7

Sexual Abuse Leads to Excessive Use of Drugs and Alcohol

Sexual abuse can dramatically impact a person’s life. An estimated 70 to 80 percent of people who have survived sexual abuse report excessive drug and alcohol use later in life.7 They also are more likely to attempt suicide and have suicidal thoughts.

The longer a sexual abuse victim is allowed to go without treatment, the greater the potential damage to their physical and emotional health. Seeking treatment is vital to helping a person process their emotions and understand how their abuse was not their fault.

Cognitive-Behavioral Therapy for Treating Sexual Abuse

One of the most common approaches to treating those who are victims of sexual abuse is cognitive-behavioral therapy which focuses on helping them realize they are not at fault for their abuse. This therapy type also helps them to understand better why it was wrong for the person to do what they did and start to realize how they can have healthy relationships with other people.

Risk Reduction for Treating Sexual Abuse

Another approach is called risk reduction through family therapy. This approach involves the participation of family members, such as parents or caregivers. It involves education on the effects of sexual abuse and how a person can keep from or turn away from bad coping activities, like drinking or using drugs.

Physical Abuse

In a study of 2,800 middle-aged adults, 10.6 percent of male participants and 12.1 percent of female participants reported a history of childhood physical abuse, according to an article in the journal Child Abuse & Neglect.8 Sadly, childhood physical abuse is one of the most common types of abuse a young person experiences. Childhood physical abuse includes having a parent or loved one hit, slap, shove, or throw things at a young person.Physical abuse as a child can cause a person to distrust other people and cause them to develop low self-esteem. They may stop caring about their future, education, or relationships because they cannot see the possibility of a better life for themselves. They often feel out of control and anxious because they do not know when a family member or caregiver may once again become violent.

Long-Term Health Effects from Physical Abuse

Childhood physical abuse has long-term health effects.8 These include increased risks for:

Chronic Pain Syndrome
Irritable bowel syndrome
Post-traumatic stress disorder

According to the journal article, those who experience childhood physical abuse report having overall physical and mental health that is worse than 90 percent of their peers.8

Recovering from the Effects of Physical Abuse

The first step to treating physical abuse is to remove the child from the abusive situation and into a place where they can feel safe and protected. Therapists may then start to work with the child using cognitive behavioral therapy to help them understand that the abuse was not their fault. If parents were not the abusers, a therapist might use an approach called parent-child interaction therapy.8 This approach involves teaching parents how to best help and speak to a child after they have undergone some form of physical abuse.

Emotional Abuse

An estimated 55,196 children in the United States were victims of childhood emotional abuse in 2008, according to the non-profit organization Prevent Child Abuse America.9 There are many forms of emotional abuse that a child may experience when they are younger. These include:


A parent or caregiver may refuse to let a child interact with other people (especially people their age). This affects the child’s ability to form outside friendships and makes them feel alone and dependent on one or two people.