A general practitioner’s guide to common reactions to trauma and loss by children aged 0–5 years

Family doctors regularly see the effects of trauma and loss on children of all ages.

Many parents present at family practices concerned by their child’s behaviour. At other times, a general practitioner might become concerned that a parent underestimates the effects of trauma on their child.

Research regularly shows that the most important aspect of children’s recovery from trauma or loss is being believed and supported by a parent or trusted adult. Children need their parents or trusted adults to help them manage the feelings, thoughts and behaviours that arise as an effect of trauma or loss. Sometimes, general practitioners need to help parents understand common effects of trauma or loss and how to be support the recovery of their children.

Below is a list of typical responses for infants, toddlers and pre-schoolers (0–5 years).

The child may:

• seem listless or limp
• complain of tummy aches or headaches
• become sick more often with colds, headaches, or stomach aches
• appear irritated or unable to settle or relax.

The child may:

• ‘babble’ a lot and be hyper-aroused and unsettled
• get startled by small noises or movements
• have sleep difficulties including difficulty going to sleep alone, wake in the night and have nightmares
• regress in behaviour, for example: young children who have been toilet trained may start to wet their pants or defecate themselves in the day time. This can be very upsetting and confusing for them
• start wetting the bed
• show delayed progress in developmental milestones like feeding themselves or sleeping independently
• struggle to listen and follow instructions
• avoid new things or going new places
• get into fights, be argumentative, and refuse to co-operate or challenge authority.

The child may:

• become distressed and unsettled when a parent, carer or sibling is distressed (young children are highly sensitive to the emotions of others around them)
• become increasingly clingy or fussy
• cry all the time, often with increased intensity
• repeatedly ask the same questions about the disaster, or where their loved one or pet is
• refuse to go to places or do things for themselves when previously able
• be extra watchful and fearful, cry easily and withdraw socially
• exhibit confusion regarding the permanency of death and may believe their loved one or pet will return and may feel abandoned
• avoid or are frightened by reminders of the event
• play act or draw the event, or ‘play disaster’
• blame themselves for the event or making up stories about why it happened.

Royal Australian College of General Practitioners, Managing emergencies in general practice: A guide for preparation, response and recovery. East Melbourne, Vic: RACGP, 2017.

Royal Australian College of General Practitioners, Emergency planning and response in general practice. Fact sheet: Mental health in emergencies and disasters. East Melbourne, Vic: RACGP, 2017.

Royal Australian College of General Practitioners. Self-care and mental health resources for general practitioners. East Melbourne, Vic: RACGP, 2017.

Trauma websites:

Child Trauma Academy: www.childtrauma.org

International Society for Traumatic Stress Studies: www.istss.org

References
Australian Child and Adolescent Trauma, Loss and Grief Network: www.earlytraumagrief.anu.edu.au
Raising Children Network: www.raisingchildren.net.au
Zero to Three website: www.zerotothree.org
Child development and trauma guide: www.wa.gov.au/organisation/department-of-communities/identifying-child-abuse-and-neglect