Children and PTSD

Hi!
Upon searching the IOM website for "the perfect" topic I found something mentioning Post Traumatic Stress Disorder (PTSD) in war veterans. We always hear about the war Vets and other adults experiencing stress but I thought, "What about children who experience PTSD?" So I used the brief from IOM and twisted it to something that not only completed the assignment, but caught my interest as well.

I remember being a kid myself and hearing from adults as I became older, "Children are resilient! Nothing effects them because they don't have life experience or understand what's going on around them." "Children are prone to develop PTSD if they are the vicitms of kidnapping or rape, school shootings, car accidents, child abuse, or are a friend or relative of someone who has committed suicide or has been killed" (Oliver, 2007). In fact, the younger the child is, the more likely they will experience PTSD. Unfortunately, children are underdiagnosed with the disorder because of false beliefs of resilience. I teach a 3-4yr old class in Sunday School. One child is in foster care and another child's mother is a recovering drug addict and has recently divorced an abusive husband. One child is hyperactive, aggressive, and has developmental delays. The other child is disruptive, disobedient, and refuses to participate in class. This is an example of the s/s children may display if they have experienced a traumatic event.

We have learned in previous classess that children can be best assessed by their behavior. They are less likely to explain in detail what's wrong, but can show us based on abrupt differences in their behavior. As nurses, it's important to know and understand appropriate developmental stages to be able to interrpret abnormalities in children's behavior. It's also important to perform body assessments as appropriate and VS. Nurses must develop trust in the child to help develop an effective plan of care.

With children, treatment includes cognitive and psychopharmacology therapies. We know children have difficulty sitting listening to adults speak and have a hard time expressing themselves in words. Children are able to express themselves best through play. According to Varcarolis, play therapy, dramatic play, therapeutic games, bibliotherapy, and therapeutic drawing can help children express their emotions. Pictures drawn, playing with toys, and telling stories all unconsciously reveal the child's perception and emotions of the traumatic event. Psychopharmacological medications used alongside with therapy can result in better outcomes. Studies are being done regarding the complete "recovery" of PTSD. It has been recommended that nurses and other mental health pros establish appropriate goals and outcomes rather than expecting a child to completely recover.