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>Pediatric Medical Trauma

May 20, 2011

>This post is the first fruit of my ongoing research to try to understand and to help Joy recover from what I speculated earlier this week might be post-traumatic stress from her surgery in March, followed by a week in the hospital and a month in a body cast.

Those of us who think our kids are experiencing lingering anxiety post traumatic medical procedures are not imagining things. These traumatic events (procedures, treatments, hospitalizations, surgeries, severe injuries, cancer), when they occur in childhood are called Pediatric Medical Trauma (PMT). And yes, as we intuited, experiencing medical trauma can cause Post Traumatic Stress Disorder (PTSD) in kids.

According to this article, symptoms of PTSD are:

  • Re-experiencing the traumatic event(s)
    • dreams and nightmares
    • flashbacks
    • anxious reactions to reminders of the trauma
    • hallucinations
  • Avoidance
    • avoiding close emotional contact with family and friends
    • avoiding people or places that are reminders of the events
    • loss of memory about the event
    • feelings of detachment, numbness
  • Arousal
    • difficulty falling or staying asleep
    • anger and irritability
    • difficulty concentrating
    • being easily startled
  • May have physical symptoms including
    • stomach and digestive problems
    • chest pain
    • headache
    • dizziness

According to The National Child Traumatic Stress Network (NCTSN) PDF,  Medical Events and Traumatic Stress in Children and Families, doctors and therapists who specialize in trauma recognize two manifestations of post-trauma anxiety. When the symptoms of PTSD occur in the first four weeks following the traumatic event(s), they are called ASD or Acute Stress Disorder. When the symptoms linger past the one-month mark they are called PTSD. (p. 17)

Besides the anxiety surrounding the event itself, what becomes of children whose medically-induced trauma is unrecognized and untreated?

“While some children “bounce back” after adversity, traumatic experiences can result in a significant disruption of child or adolescent development and have profound long-term consequences. Repeated exposure to traumatic events can affect the child’s brain and nervous system and increase the risk of low academic performance, engagement in high-risk behaviors, and difficulties in peer and family relationships. Traumatic stress can cause increased use of health and mental health services and increased involvement with the child welfare and juvenile justice systems. Adult survivors of traumatic events may have difficulty in establishing fulfilling relationships, holding steady jobs, and becoming productive members of our society. Fortunately, there are effective treatments for child traumatic stress.” (NCHSN, Defining Trauma)

According to Saxe, Vanderbilt and Zuckerman in their 2003 article, Traumatic Stress in Injured and Ill Children, PTSD in young children is critically understudied:

“(3) Developmental considerations. Developmental issues must be considered. The meaning of an illness or injury, and its treatment, is very different for an infant and toddler, a pre-schooler, a school-aged child, and an adolescent. The appraisal and experience of such critical constructs as pain, disability, life threat, and death is highly developmentally determined and likely affects symptoms and recovery. Many infants, toddlers, and preschoolers are hospitalized with injuries and illness, but few have been assessed in research studies. Little is known about traumatic stress in injured and ill children who are very young. Although this research is challenging, it is also critically important.” (p. 3)

That may be why I’m having such a hard time finding information about how to help young children cope with medical trauma. I’ll keep working on that.

In the mean time, for further reading, there are a couple of great trauma bibliographical databases to mine. Both contain links to articles available on the Internet:

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