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.

defining ECMHC

Infants
(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

defining ECMHC

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
Attachment	Difficulty trusting others Uncertain about the reliability/predictability of others Interpersonal difficulty Social isolation Difficulty seeking help Clingy, difficulty with separations
Physical	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
Cognition	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
Self-Concept	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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Tutorial 7 · Recognizing and Addressing Trauma in Infants, Young Children, and their Families

Trauma Signs and Symptoms