Trauma Signs and Symptoms

Trauma Signs and Symptoms

Trauma signs and symptoms in young children can take many forms. Understanding these signs and symptoms as trauma related depends upon sensitive information gathering from the child, family, and Early Head Start and Head Start staff. That said, the signs and symptoms listed below must always be considered in the context of a young child’s history, caregiving system, supports, etc. and with recognition that these symptoms could also be symptoms unrelated to trauma.

(birth to 3 years)

  • Eating disturbance
  • Sleep disturbances
  • Somatic complaints
  • Clingy/separation anxiety
  • Feeling helpless/passive
  • Irritable/difficult to soothe
  • Constricted play, exploration, mood
  • Repetitive/post-traumatic play
  • Developmental regression
  • General fearfulness/new fears
  • Easily startled
  • Language delay
  • Aggressive behavior
  • Sexualized behavior
  • Talking about the traumatic event and reacting to reminders/trauma triggers
Scared child

Young children
(3 to 6)

  • Avoidant, anxious, clingy
  • General fearfulness/new fears
  • Helplessness, passive, low frustration
  • Restless, impulsive, hyperactive
  • Physical symptoms (headache, etc.)
  • Difficulty identifying what is bothering them
  • Inattention, difficulty problem solving
  • Daydreaming or dissociation
  • Irritability
  • Aggressive behavior
  • Sexualized behavior
  • Loss of recent developmental achievements
  • Repetitive/ post-traumatic play
  • Talking about the traumatic event and reacting to reminders/trauma triggers
  • Sadness/depression
  • Poor peer relationships and social problems (controlling/over permissive)

Complex trauma, in particular, may affect all domains of a child’s development and functioning. Based on National Child Traumatic Stress Network’s (NCTSN) White Paper (2003), Complex Trauma in Children and Adolescents, the table below identifies each domain of development and possible signs of disruption or impairment. Again, it is essential to consider the young child’s developmental age and stage, specific developmental tasks, and caregiving context.

Domain of Development Signs of Disruption or Impairment
  • Difficulty trusting others
  • Uncertain about the reliability/predictability of others
  • Interpersonal difficulty
  • Social isolation
  • Difficulty seeking help
  • Clingy, difficulty with separations
  • Sensorimotor development problems
  • Hypersensitivity to physical contact
  • Somatization
  • Increased medical problems
  • Problems with coordination and balance
Affect Regulation
  • Problems with emotional regulation
  • Easily upset and/or difficulty calming
  • Difficulty describing emotions and internal experiences
  • Difficulty knowing and describing internal states
  • Problems with communicating needs
Behavioral Control
  • Poor impulse control
  • Self-destructive behavior
  • Aggressive behavior
  • Oppositional behavior
  • Excessive compliance
  • Sleep disturbance
  • Eating disorders
  • Reenactment of traumatic event/past
  • Pathological self-soothing practices
  • Difficulty paying attention
  • Lack of sustained curiosity
  • Problems processing information
  • Problems focusing on/completing tasks
  • Difficulty planning and anticipating consequences
  • Learning difficulties, developmental delays
  • Problems with language development
  • Lack of continuous/predictable sense of self
  • Poor sense of separateness
  • Disturbance of body image
  • Low self-esteem
  • Shame and guilt

Early recognition of these signs and symptoms along with mental health consultation that guides planned and effective strategies to support the child and family in the Early Head Start and Head Start program can help reduce and remediate these symptoms. Some children may need more intensive, therapeutic intervention through trauma-focused therapy designed for clinical work with young children and their families.

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This product was developed [in part] under grant number 1H79SM082070-01 from the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.