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.
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.
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.”1
Examples of traumatic events include:
Community and school violence
Being in military family, deployment, loss of a parent, or an injury
An estimated 66 percent of children report experiencing a traumatic event before age 16, according to the American Psychological Association.1
Many 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 sexual 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:
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.
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:
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:
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
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
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.
According to The National Child Traumatic Stress Network, an estimated 45 to 66 percent of young people had a substance use disorder before they experienced some kind of trauma, such as sexual or physical abuse. Unfortunately, a person with a substance use disorder typically has an even harder time with recovery. Some experts say this is because people who abuse substances may have a hard time coping with stress and trauma.
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.
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; however 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.
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.
A child who has experienced trauma can show symptoms of PTSD which may be confused for ADHD. Symptoms that both ADHD and PTSD 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”.
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.
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 WomensHealth.gov, 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 children support at an early age to help 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 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.
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 may also may suffer from depression.
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 in a healthy way 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.
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:
When another person touches a child to stimulate the child or themselves sexually
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. 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 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.
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.
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 avoid negative coping activities, like drinking or using drugs.
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.
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
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.
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.
A caregiver does not treat a child well and makes the child feel like they are not worthy of love, attention, praise, or comfort.
Assaults are not always physical. Instead, a person can experience verbal assaults, where an adult or caregiver makes threats, calls a child names, or puts them down frequently. Hearing these from an authority figure can dramatically impact a child’s self-esteem.
An adult bullies or frightens a child so much the child starts to see the world as only mean and hostile.
An adult places excessive and unreasonable pressure on a child to perform in ways that are impossible to achieve.
Unfortunately, many children may experience emotional abuse along with physical abuse, domestic violence, or sexual abuse. This only increases the negative effects on a child. Families who are experiencing financial problems, mental health issues, substance abuse addiction, and domestic abuse are more likely to have a child who experienced emotional abuse.
Children who experience emotional abuse often act younger than their age. They are unable to control their emotions well, and people may always think they are having “outbursts” of anger or sadness. They often appear to have low self-esteem and lack confidence.
According to Prevent Child Abuse America, young people who experience emotional abuse are at risk for effects such as:
The effects of child emotional abuse cost an estimated $33 billion for things like law enforcement services, foster care, mental health treatments, and hospitalizations.
According to the American Psychological Association, most children eventually return to their normal selves after a traumatic event.1 However, some children have more severe symptoms that continue throughout their lives. Unfortunately, many children who need more care do not get it. This is especially true for those who are in ethnic and racial minority groups.
While doctors have done extensive research on treating trauma in adults, there is not as much research about how to most effectively treat trauma in children. One of the most common approaches therapists use is cognitive-behavioral therapy.1 According to the American Psychological Association, CBT helps reduce some of the effects of childhood trauma. This includes PTSD, anxiety, depression, and behavioral problems.
For children who have gone through trauma, CBT helps a child recognize that some of the thoughts they have related to their trauma are not accurate. For example, if a child blames themselves for the reason they went through the trauma, a therapist would then help a child understand (as much as is appropriate) about the trauma and how the event was not their fault. This therapy approach also helps a child learn how to deal with the emotions they have related to the trauma they have experienced.
If a child has experienced a traumatic event, there are some ways that caregivers and adults in their lives (such as a teacher) can help them start to overcome their trauma.3
Examples of ways a caregiver can help a child after trauma includes some of the following steps:
Consistently emphasize and explain that a child is not responsible for what happened to them. One saying a child can repeat is "I am a good person who had a bad thing happen."
It can take a child time to recover and fully deal with what happened to them.
Seek professional help whenever possible. Talking to a child's teachers or pediatrician may help you find the right therapist or support group that could help a child.
Caregivers can also work with a child to return to as normal a routine as possible. Routines can give a child a sense of safety. Examples of these activities include:
In addition to caring for the child themselves, people can also educate their family members about trauma. The more those who interact with children (like teachers, ministers, parents, and community leaders) educate themselves on trauma, the more likely they are to recognize when a child is going through something and needs help.
There is no “normal” time for a child to recover from trauma. Some children may find after months of counseling that they can feel more like themselves. For others, this process may take years. But continuing to receive help and support from loved ones and medical professionals can help.
While it is difficult for any person to seek substance abuse treatment, it can be especially hard for young people. According to The National Child Traumatic Stress Network, most young people who seek treatment are brought against their will, often because a parent, teachers, or the court system is making them.4
Adults who are past victims of trauma and now struggle with substance abuse may also have difficulty in gaining access to care. This is because they often need comprehensive services that address both the mental health and addiction concerns. It’s understood that a person who has a history of trauma and substance abuse should receive treatment for both concerns at the same time. Unfortunately, some trauma treatment programs will not admit a person who is still abusing a particular substance.
Ideally, when a person seeks treatment for substance abuse with a history of childhood trauma, they will have services that can address both conditions. This is important because if a person has PTSD, they could potentially experience strong flashbacks as they go through the detox process.
Detoxing is when a person stops using drugs or alcohol and substances are removed from the body.. Ideally, a person with a history of childhood trauma will detox in a professional treatment facility. There are several different approaches to detox treatment. This may include:
Where a person stops using a substance completely.
Where a person may take medicines that can reduce the effects of detoxification.
(Those who are addicted to prescription pain medications, such as hydrocodone, oxycodone, or morphine or those addicted to heroin, may opt for this approach.)
Examples include taking methadone or Suboxone to reduce withdrawals and cravings.
Where a person works with a doctor to take smaller and smaller doses of medicine until they can completely stop taking a medication altogether.
Detox is an important part of treating a substance use disorder, but it does not mean that a person is done with their addiction treatment. Instead, a person should continue to participate in therapies that help them better deal with past traumas as well as prevent drug or alcohol abuse relapse.
Following the detox process, a person should continue receiving therapy or participate in support groups. Drug treatment experts call this outpatient behavioral treatment. There are a variety of approaches a therapist may use to help treat a person who has struggled with substance abuse and trauma.2 These include:
This therapy involves helping a person recognize how their thinking is contributing to their addiction and other sources of problems in their lives.
This approach provides incentives for a person to stay sober or engage in behaviors that keep a person feeling well.
This therapy approach is helpful for young people who struggle with drug abuse. It involves having families participating in therapy so they can better support their loved one who is struggling.
This therapy approach involves helping a person find their motivations for staying sober. Some people believe if a person is invested in their sobriety, they are more likely to stick with it.
Sometimes, a person may require inpatient treatment or choose to participate in a residential treatment program. These are programs where a person may stay at a home, apartment, or another facility where the people are also in recovery and are committed.
Some people may also find they benefit from participating in group therapies or support and recovery groups. Examples include Alcoholics Anonymous, and Narcotics Anonymous. These groups are volunteer-led and can provide a place for a person to share their struggles and continue in their sobriety. Some people may participate in these treatment types for many years.
Childhood trauma is not always preventable. Sometimes, a person will witness or be a victim of trauma they have absolutely no control over. When this occurs to a young person, they must understand that what happened to them was not their fault and that it does not make them a bad person.
Parents, loved ones, and educators must also recognize the impacts of trauma on a young person. Instead of automatically thinking the person has a condition like ADHD or other disorders, they should explore some of the possible reasons why a person continues to act a certain way. It is quite possible that for some young people, trauma is the underlying cause.
Treatments are available for those who experience trauma as well as those who struggle with trauma and substance abuse. Fortunately, young people are very resilient. With the right help and support, they can recover and ideally live happier lives.