Trauma and children - two to five years

Preschool age children can be seriously affected by trauma, just like older children and adults. Life-threatening events such as car accidents, bushfires, sudden illness, traumatic death in the family, crime, abuse or violence in the community can cause trauma. A preschooler’s language is still developing, and they may not have the words to communicate what they feel, so it is important to look for other clues in their behaviour and the way they play to understand if the trauma has had an effect.

Preschoolers know when things are not right

Preschoolers do not understand what has gone wrong but are very sensitive to things not being right. A child’s response to a distressing or frightening experience will depend on their age, stage of development and personality, as well as the impact of the crisis on their parents, primary carers or significant others. Your child may not react in the ways you expect.

Common preschooler reactions to trauma

Children’s responses to trauma can vary, but common reactions include:

• new or increased clingy behaviour, such as following the parent around the house
• new problems with basic skills like sleeping, eating, going to the toilet or paying attention – it may seem like they’ve slipped back (regressed) and got younger
• mood changes – the child might not seem to enjoy daily routines or activities they used to like or may seem more ‘shut down’, listless and withdrawn
• changed behaviour – some children might be more aggressive to parents or playmates
• increased fear – for example, the child may
  • be more jumpy or startle easily
  • develop new fears
  • have more nightmares
  • talk about the frightening event more or have it in their play or drawings
  • not seem to be reassured when talking about the scary event and ask about it again and again
  • be scared that the trauma will happen again, or of other things they did not fear before, like dogs, strangers, being apart from caregivers
• more physical complaints for which no cause can be found, such as tummy ache or headache, being tired and other problems
• blaming themselves – small children are likely to misunderstand the events of the trauma and somehow think it was their fault.
• what parents and carers can do to help preschoolers after a traumatic event.

There are a number of things you can do to help your preschool age child during times of trauma.

• Seek, accept and increase support for yourself to manage your own shock and emotional responses.
• Stay calm. Listen and tolerate the child’s retelling of the event.
• Reassure your child that the event is over, and they are safe. You may have to reassure them over and over again.
• Ask them what they are thinking about the event – often their concerns are based on limited understanding or mistaken ideas, which can be corrected.
• Explain to them how they were kept safe and what you have learned so you can protect them from it happening again.
• Respect the child’s fears and give them time to learn to cope with them. It is important to acknowledge and validate the child’s concerns.
• Protect the child from re-exposure to frightening situations and reminders of trauma. These may include TV programs, stories, movies or other reminders such as visiting or seeing pictures of the location or physical situations.
• Accept and help the child to name strong feelings during brief conversations, but remember that a child of this age cannot talk about these feelings or the experience for long.
• Expect and understand that the child may act in a more babyish way – you may need to make allowances for this and be flexible about basic household rules. ‘Regressing’ to an earlier stage of development is very helpful for the child to allow themselves to be cared for and regain confidence and safety.
• Expect some difficult or uncharacteristic behaviour.
• When to seek help for preschoolers after a traumatic event

Children of preschool age develop skills at different rates and some skills are learnt earlier than others. Trauma can slow things down or get in the way of new things being learnt. It can also cause marked changes in behaviour.

Parents or care-givers should seek help if:

• you are concerned or unsure about how your child is coping
• you are not coping yourself – this makes it harder for you to help the preschooler to cope and you may both need to seek help
• the child has lots of symptoms and things are not settling
• the household has experienced a significant loss and the community around the child is disrupted
• several family members are affected and there does not seem to be enough attention to go around
• the family is struggling to re-establish any kind of routine or predictable pattern in the household and week.

If at any time you are worried about your mental health or the mental health of a loved one, call Lifeline on 13 11 14.

Where to get help

• Your GP (doctor)
• Your maternal and child health nurse
• Your local community health centre
• Paediatrician or Child and Adolescent Psychiatrist – your doctor can refer you
• Phoenix Australia Centre for Post-traumatic Mental Health Tel. (03) 9035 5599
• Centre for Grief and Bereavement Tel. 1800 642 066

General telephone counselling services can provide advice:

• Lifeline Tel. 13 11 14
• GriefLine Tel. 1300 845 745
• beyondblue Tel. 1300 22 4636
• Kids Helpline Tel. 1800 55 1800
• Nurse-on-Call Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days).