Understanding PTSD in Children: Insights from a Recent Lunch & Learn

By Jennifer Humphreys, LMSW, SSW | Family Therapist The Nelson Center for Family Therapy

During our recent Lunch & Learn session, we had a heartfelt and important discussion about Post-Traumatic Stress Disorder (PTSD) in children. As a therapist, it’s crucial to identify the signs early on, as children often experience trauma in ways that differ from adults. By understanding the red flags and learning how to support children through their healing process, we can make a significant difference in their lives.

Red-Flag Statements to Listen For

Parents often unknowingly highlight key signs of PTSD when they share concerns about their children’s behavior. Some statements that could indicate trauma include:

• "He keeps reliving it."

• "She won’t talk about what happened."

• "He plays the same scary story over and over."

• "She seems like she’s not really there."

These are powerful cues that the child may be struggling with something deep and unresolved.

Behavioral Red Flags

In addition to what parents may say, children may show specific behaviors that signal distress:

• Avoidance: Steering clear of people, places, or topics related to trauma

• Irritability and Aggression: Sudden mood changes, outbursts, or tantrums

• Hypervigilance: Being overly jumpy, easily startled, or tense

• Withdrawal: Avoiding play or social interactions with others

• Regression: A return to earlier stages of development, such as loss of language or trouble with emotional regulation

These behaviors aren’t just "acting out" – they are often survival mechanisms, signaling that the child’s internal world is deeply affected.

Mental Health and Physical Cues

PTSD also has psychological and physical manifestations. Some things to watch for include:

• Mental Health Symptoms: Persistent sadness, anxiety, excessive fear, and dissociation (spacing out) during conversations or activities

• Physical Complaints: Frequent headaches, stomachaches, nightmares, insomnia, and unexplained fatigue despite adequate rest

Children may also show regressive behaviors, such as bedwetting or thumb-sucking, which are often signs of distress.

Case Examples of PTSD in Children

Understanding trauma in children is complex. Here are some case examples from my practice that highlight how PTSD manifests:

The Resilient Older Child Who Still Has PTSD: 

Sometimes, children appear to be doing well on the surface—taking on adult-like roles, managing the household, or caring for younger siblings. They’re praised for being "strong" and "responsible." However, this behavior often masks their inner struggles. Just because a child appears to be functioning doesn’t mean they are thriving. Their strength may be a survival mechanism, not a sign of emotional well-being.

Developmental Trauma and Its Effects on Growth: 

When trauma interrupts a child’s development, it’s not just about slowing down their progress—it can result in arrested development, where emotional, social, or cognitive growth stalls. Children who’ve experienced early trauma or neglect may show delays in basic milestones or exhibit behaviors typical of a much younger child. This isn’t laziness or misbehavior; it’s the child’s way of coping with overwhelming experiences.

Therapists may notice that children with trauma appear younger than their actual age in terms of their emotional responses, language, or play. For example, they may speak in “baby talk,” have trouble with self-regulation, or demonstrate clinginess. These behaviors can often be adaptive responses to neglect or overwhelming life events.

Trauma-Informed Approaches to Healing

The key to helping children heal from PTSD lies in a trauma-informed approach that focuses on attachment and co-regulation. Play therapy and dyadic therapy—work with both the child and their caregiver—are particularly effective methods for creating safety and facilitating emotional processing.

At The Nelson Center for Family Therapy, our therapists specialize in trauma-informed care, and we offer various therapeutic approaches, including Mindfulness-Based Cognitive Behavioral Therapy (CBT), which has been found effective for treating PTSD. These approaches help children process their trauma at their own pace and develop healthier coping strategies.

Why It Matters

It’s important to remember that trauma doesn’t just "go away." Children who have experienced trauma need support, understanding, and professional care to navigate their healing journey. By identifying PTSD early and providing the right therapeutic interventions, we can help children heal, grow, and thrive.

If you or a loved one suspects that a child may be struggling with PTSD, don’t hesitate to reach out for support. The Nelson Center’s compassionate therapists are here to help guide families through this difficult process, offering expertise in a safe and nurturing environment.

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Contact Information

Jennifer Humphreys, LMSW, SSW

Family Therapist, The Nelson Center for Family Therapy

(248) 301-1080 (text or call)

therapy@thenelsoncenterforfamilytherapy.com