The information on this site is intended primarily for parents of injured children, but we hope that it will be informative and useful for health care providers as well. We encourage you to explore the information provided on the website about common reactions post injury and what parents and other family members can do to help.

As a healthcare provider there are things that you can do to help injured children and their parents. You can be aware of traumatic stress reactions and risk factors, and provide anticipatory guidance that may help to reduce persistent traumatic stress reactions.

Find tools to help you use AfterTheInjury.org with your patients and their
families: Patient Care Tools

For more information and training tools for pediatric health care providers:
Health Care Toolbox: Your Guide to Helping Children Cope with Illness and
Injury 

Risk factors for persistent traumatic stress

Before the injury:

-Previous traumatic experience

-Prior behavioral or emotional problems

At the time of the injury:

-Extremely frightened

-Exposed to scary sights and sounds

-Separated from his or her parents

-More severe levels of pain

Traumatic Stress Reactions

Avoidance

-Avoiding thinking or talking about the trauma

-Avoiding things associated with the trauma

-Reduced interest in usual activities

-Feeling emotionally numb

-Detached from other people

Re-experiencing

-Thinking a lot about the trauma, even when you don’t want to

-Nightmares and “flashbacks”

-Feeling distressed at reminders of the trauma

Hyper-arousal

-Irritability

-Trouble concentrating

-Trouble sleeping

-Exaggerated startle response

-Extra vigilant – always expecting danger

Dissociation

-Forgetting important aspects of the event

-Feeling in a daze or "spacey"

-Feeling like things aren’t real

General Guidelines for Healthcare Professionals

• Inquire (of child and parent) about potentially traumatic events when taking a history. Ask about children’s injuries or exposure to other traumatic experiences since their last visit.
• Ask about reactions and coping. Listen for ongoing traumatic stress symptoms and any interference with day-to-day activities.
• Promote resilient responses through brief education.
• Refer children and their families with severe or prolonged traumatic stress reactions for a more thorough evaluation with a mental health professional.

For more information and tips for providing anticipatory guidance, download the brochure: Pediatric Injury and Traumatic Stress: The Physical Injury is Healing, But How is Your Patient Coping?


Suggested Reading for Health Care Providers:

Saxe G, Vanderbilt D, Zuckerman B. Traumatic stress in injured and ill children.
PTSD Research Quarterly 2003; 14:1-3

Horowitz L, Kassam-Adams N, Bergstein J. Mental health aspects of emergency medical services for children: Summary of a consensus conference.
Acad Emerg Med 2003; 4: 148-55.

Kassam-Adams N, Fein J. Posttraumatic stress disorder and injury.
Clinical Pediatric Emergency Medicine 2003; 4:148-55

Link to more publications from the Center for Injury Research and Prevention team.

Link to more information about our research.


Useful Measures for Pediatric Traumatic Stress:

Acute Stress Checklist for Children (ASC-Kids)
Kassam-Adams, N. (2006). The Acute Stress Checklist for Children (ASC-Kids): Development of a child self-report measure. Journal of Traumatic Stress, 19: 129-139.

Child Stress Disorders Checklist (CSDC)
Saxe et al. (2003). Child Stress Disorders Checklist: A measure of ASD and PTSD in children. Journal of the American Academy of Child & Adolescent Psychiatry, 42(8): 972-978.

Child PTSD Symptom Scale (CPSS)
Foa E, Johnson K, Feeny N, Treadwell K. The Child PTSD Symptom Scale: A preliminary examination of its psychometric properties. Journal of Clinical Child Psychology, 30(3): 376-384.


Other Resources:

Medline Plus – Post-Traumatic Stress Disorder

National Child Traumatic Stress Network (NCTSN)

Pediatric Medical Traumatic Stress Toolkit for Healthcare Providers from the NCTSN

Psychological First-Aid