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Thursday, 25 February 2021
PTSD Symptoms in Infants/Toddlers
Posttraumatic Stress Disorder (PTSD) affects many of our children. It often goes hand-in-hand with attachment disorders. The American Psychiatric Association's Diagnostic Manual of Mental Disorders (DSM-IV) definition of PTSD is confusing for many parents because the criteria were designed for adults, not for children. When parents read, "the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others," many breathe a sigh of relief, thinking their child couldn't possibly have PTSD because he never experienced any type of trauma. The child was never threatened. He was in good, loving foster care. Someone fed him, clothed him, and kept him safe and warm since the day he was born. Yet, the experience of being separated from the birth mother could have the same effect on a child as dying. (Refer to Emotional Development; A Discussion of Abnormal Function for more information.) Multiple transitions/placements may have the same effect on an infant/toddler as kidnapping.

Some children have PTSD, some have attachment spectrum disorder, and many have both. The symptoms of the two disorders overlap and it may be difficult for anyone but a professional to identify the difference.

One mom writes that her son's symptoms (likely a blend of PTSD, attachment issues, and/or SID) include:
  • Severe stranger anxiety
  • Excessive fear and whining for unknown reasons
  • Never being comfortable being left--there is NOTHING fun enough (Candyland itself couldn't do it), to make him forget about me and want to separate. Period.
  • Extremely alert to changes in routine or the environment
  • Comforted by strict routine and ritual
  • Sleep problems/fear at night
  • Playtime: he concentrates on ONE activity for a very long time, and will repeat movements, like driving a car in back and forth in the same way over and over
  • Hoarding food, inappropriate eating (like stuffing mouth till overfull)
  • Extreme emotional reactions to mildly upsetting events: terrified of dogs- even OURS, hanging on my neck for dear life in physical therapy as if he expects to be hurt terribly--even though our dogs are sweet and therapy has never hurt

She writes, "He seems to kind of expect the worst possible scenario when confronted with a new situation, and his fear is profound. He needs constant reassurance that all is well and we are still here for him." (a. 14mo, FC)

Many professionals believe that a child must have PTSD in order to have an attachment disorder, but doesn't necessarily need to have an attachment disorder to have PTSD. If the child has attachment issues, it may be difficult to see PTSD until the attachment issues have been treated. As the child begins to feel safe, he may be more apt to share his scary feelings with his parents. As a result, PTSD issues may present themselves quite a while after the child arrives home. One adoptive mom reports that her daughter's issues did not begin to surface until she'd been home about 18 months. (a. 7mo, OR)

Many times, PTSD reactions are so delayed, or so unrelated to the original trauma, that it makes it difficult, if not impossible, for families to identify the PTSD triggers.

We went to a friend's barbecue for the 4th of July. Our 35 month old seemed to enjoy himself, only acting slightly nervous around the fireworks. (Just store-bought. We didn't attend a large fireworks display.) That night he went to bed fine and slept great. The next day he didn't have any noticeable problems, save being a little tired from staying up the previous night. But the next day (36 hrs+ after the event), he was a mess. Luckily we had a regularly scheduled visit to the therapist that day. Sure enough, it was all related to being around the fireworks. Yet he really looked like he enjoyed himself that night. Often when we see PTSD symptoms we are unable to figure out the trigger because the reaction can be delayed by hours or days. Before his PTSD diagnosis, I'm certain that I attributed symptoms to tiredness or teething, not realizing that what I was seeing was emotional pain. (a. 5.5mo, FC)

Find additional information on PTSD in children:
An Adorable Little Baby & Trauma; One Child's Story

Adoptees and Post-Traumatic Stress Disorder

Posttraumatic Stress Disorder in Children

Research on PTSD and children:
Parents' PTSD May Boost Stress in Offspring

Severe Trauma Affects Kids' Brain Function, Say Researchers

PTSD Symptoms or "triggers" may include (but are not limited to):

Physical Punishment
Sound of Native Language
Angry Outbursts
Exaggerated Startle Response
Extreme Emotional Reactions
Sleep problems
Recurring Play Themes
Acting Younger Than One’s Age
Unusual fears
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