Your Child’s Wounds May Not Be Visible

Published on: October 21, 2018

Four weeks subsequent to any traumatic event if a child continues to feel the effect of the event then it may lead to Post-Traumatic Stress Disorder (PTSD). Here is the list of emotional and medical treatments that could be given to the child.

By Varisa Kanchanachayphoom, M.D.


While ups and downs, twists and turns, love and loss are a part of everyone’s journey, sometimes life throws at us unforeseeable, life-threatening situations that might be difficult to cope with. Natural

disasters, severe accidents, murder or the suicide of a loved one, extreme physical abuse, or living in a violent household are examples of such traumatic events that can possibly lead to: 

  • Re-experiencing: Flashbacks, dreams, and constantly reliving the event that may trigger physical and emotional reactions as in the initial traumatic situation.
  • Avoidance: Feeling afraid to venture outside, and hence avoid locations, situations, activities or topics of conversations that are reminders of the event. 
  • Negative alteration of cognition and mood: Incapable of feeling optimistic about anything. A tendency to blame oneself or others possibly leading to low self-esteem or feelings of anger, fear and/or guilt. 
  • Hyperarousal symptoms: Easily scared and startled, and always on the lookout for danger, which can have an effect on the concentration span. May also lead to experiencing fitful sleep or even being unable to sleep altogether.

If these feelings persist four weeks subsequent to the event or it comes up later on, they may be signs and symptoms of post-traumatic stress disorder (PTSD). This type of stress can sometimes be so severe that the sufferer is unable to accept and adjust to what has happened. 

While symptoms of PTSD can affect anyone of any age or gender, the emotional state of the parents plays a huge role in a child developing PTSD. This includes the state of your relationship, and the support and encouragement offered to your child. 

Possible factors linked to a child developing PTSD

  • Age of the child
  • Violence they’ve suffered
  • Meaning the event carries 
  • Coping mechanisms and personality of the child
  • Past experiences
  • Environment they inhabit
  • Absence of a social support network
  • Facing emotional and social hardships daily

Treatment and support are vital and should be provided as soon as possible. If these symptoms are overlooked, the child may develop chronic symptoms that last into adulthood and beyond.

What are the initial forms of treatment for PTSD?

  • Keeping a close eye on the child’s emotional wellbeing
  • Speedy rehabilitation of his/her surrounding community
  • Screening for symptoms, behavioral observations, and analysis 
  • Analysis of the extent to which the patient’s life has been affected, to find out whether they are suffering from any other psychological disorders, including depression, anxiety disorder, phobias, or alcohol or drug addiction. 

(Parents and guardians play a key role in carrying out the analysis.)

Emotional support treatment — psychotherapies

  • Trauma-focused cognitive therapy: Talking to the child about the event(s) whilst providing suggestions on how to adjust their beliefs and thoughts as well as relieve any fears that may arise, so they can cope better with any negative feelings they may be experiencing. Parents and guardians can help build the child’s understanding by sharing their own feelings regarding the situation, and how they deal with the resulting emotional distress.
  • Cognitive-behavior therapy (CBT): Individual psychotherapy.
  • Child-parent psychotherapy and family therapy are considered effective in collectively analyzing ways to deal with emotional stress and discomfort as well as working out solutions to issues.
  • Finding ways to adjust the child’s environment by providing teachers, children and anyone involved with knowledge about PTSD. This includes co-prognosis of the condition to work towards bringing the family back to normality as soon as possible. It also means managing the child’s school environment, providing safety and stability at home and within the community, and ensuring preventative measures are in place to stop any repeat of the distressing events occurring.


Although selective serotonin reuptake inhibitors (SSRI) group of medications are effective in the treatment of adult sufferers, studies on their effects on children remain inconclusive. Hence, the use of medication to treat children and adolescents with PTSD should be carefully considered on a case-by-case basis.

What to do when a child displays symptoms of PTSD

  • The child’s parents and caregiver are of the utmost importance in ensuring that the child’s needs are met, that they are offered support and encouragement, and are heard. This will help to ensure that the child feels confident and knows they have someone to depend on. 
  • Avoid asking the child to repeat the event they experienced.
  • Do not refer to the event in a way that may cause the child to feel responsible. 
  • Ensure the child has every chance to partake in everyday activities so that they can make a return to normality as soon as possible.


About the Author

Dr. Varisa earned her diplomate with the Thai Board of Pediatrics and Thai Board of Child and Adolescent Psychiatry. She specializes in evaluating children with concerns related to attention deficit hyperactivity disorder (ADHD), OCD, CMD, autism and developmental delays.

The views expressed in the articles in this magazine are not necessarily those of BAMBI committee members and we assume no responsibility for them or their effects.

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