A general practitioner’s guide to common reactions to trauma and loss by children aged 9–12 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.

Children of this age group often show their distress and emotions though their behaviour and bodily complaints like tummy pains, headaches, poor concentration and ability to follow instructions.

Below is a list of typical responses for children in later childhood (9–12 years).

The child may:

• show regressed behaviour like baby talk or acting younger than their age
• act aggressively or with bravado, or become destructive
• acting out by hurting others or themselves, taking risks, or getting into fights with others

• withdraw from friends or family members
• be startled by small noises or movements
• not want to be at school or see/talk to others
• withdraw into themselves, not speaking to others or seeing their friends
• display changes in normal eating
• show increased tiredness or sleeping in class
• rebel against or show disdain for authority
• have academic difficulties or trouble at school.

The child may:

• become sad and preoccupied with death and loss
• attach themselves to others, seek security and experience guilt
• show a range of grieving emotions; anger, denial, despair
• show a new awareness of death or want to talk about death and destruction more than usual

• display an increased interest in what happens during and after death.
• older children and young teenagers may not express their grief or sadness or may find it difficult to talk about it. They may pretend everything is fine, deny it happened, or say they don’t care

• display mood or personality changes
• communicate new fears or old fears returning
• display a lack of eye contact or a ‘spaced out’ look
• show anxiety or worry about lots of things
• make efforts to avoid reminders of the event
• show changes or delays in speech, memory, or learning
• have a new awareness of death and mortality.

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
Child development and trauma guide: www.dcp.wa.gov.au/ChildProtection/ChildAbuseAndNeglect