Building Resilience in Children and Youth Dealing with
Trauma
Even from as young as 18 months, children can be affected by traumatic events and have serious
problems later in childhood and adulthood. But the great news is that, with help from families,
providers, and the community, children and youth can demonstrate resilience when dealing with
trauma.
Traumatic experiences can range from a one-time incident, such as a sudden death of a loved one
or a natural disaster, to ongoing exposure to experiences, such as bullying or family violence.
Identifying that a child has experienced trauma is not always easy because emotional and
behavioral responses to trauma vary depending on a child’s age, personality, the type and
severity of the incident, and availability of adult support.
Studies on stress response in children show that there can be physiological and structural changes
in the brain and neurological systems and can, without intervention, result in enduring problems
such as depression, anxiety, aggression, impulsiveness, delinquency, hyperactivity, and
substance abuse.
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More than 60% of youth age 17 and younger have been exposed to crime, violence and
abuse either directly or indirectly.
Young children exposed to 5 or more significant adversities in the first 3 years of
childhood face a 76 percent likelihood of having one or more delays in their cognitive,
language, or emotional development.
As the number of traumatic events experienced during childhood increases, the risk for
the following health problems in adulthood increases: depression; alcoholism; drug
abuse; suicide attempts; heart and liver diseases; pregnancy problems; high stress;
uncontrollable anger; and family, financial, and job problems.
There is a range of behaviors that could be signs that a child is having difficulty dealing with a
traumatic event, such as, but not limited to:
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Separation anxiety or clinginess towards teachers or caregivers
Changes in appetite
Decreased interest in and/or withdrawal from friends or family and normal activities
Over- or under-reaction to physical contact, sudden movements, and sounds
Angry outbursts and/or aggression
More frequent complaints of headaches, stomachaches, or fatigue
Repeatedly recreating the event through comments, drawings, or activity
Emotional “numbing,” or expressing no feelings at all about the event
Drop in school performance
What can teachers, caregivers, and other adults do to help a child who has experienced trauma?
The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) offers these
suggestions:
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Maintain usual routines
Make sure that the child is not being isolated
Provide a safe place where the child can talk about the incident
Be sensitive to potential environmental cues that may cause a reaction (e.g., an
approaching storm or the anniversary of an event)
Prepare the child in advance of a change in routine or other event that could be unsettling
Monitor what information the child shares with other children to prevent excessive
curiosity from peers
Nurture the child’s positive self-view
Draw on cultural and familiar assets
With the support of caring adults, children can recover from traumatic events, reestablish a sense
of well-being, and obtain treatment and other services if needed. The more you know about
trauma and children, the more you can do to help them. For more resources on early
childhood and trauma, visit http://www.samhsa.gov/children/earlychildhood_trauma.asp.
April 2011: Childhood Trauma's Impact on Health Risks
As the number of traumatic events experienced during childhood increases, the risk for the
following health problems in adulthood increases:
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Depression
Alcoholism
Drug abuse
Suicide attempts
Heart, liver, and pulmonary diseases
Fetal death during pregnancy
High stress
Uncontrollable anger
Family, financial, and job problems
With help from families, providers, and the community, young children can demonstrate
resilience when dealing with trauma.
As the number of adverse events (i.e., physical, emotional, and sexual abuse; neglect; violence;
and natural disasters) experienced in childhood increases, the risk for the following health
problems increases: depression; alcoholism; drug abuse; suicide attempts; heart, liver, and
pulmonary diseases1; fetal death during adolescent pregnancy; high stress; uncontrollable anger;
and family, financial, and job problems.2,3 The effects of these events are long-term, powerful,
cumulative, and may be invisible to health care providers, educators, social service
organizations, and policymakers because the linkage between trauma and problems later in
adulthood is concealed by time, the inability to “see” the process of neurodevelopment, and the
effects of the original traumatic events, which may not become evident until much later in life.4
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Research has shown that caregivers can buffer the impact of trauma and promote better outcomes
for children even under stressful times when the following Strengthening Families Protective
Factors5 are present:
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Parental resilience
Social connections
Knowledge of parenting and child development
Concrete support in times of need
Social and emotional competence of children
Text description of this chart is available on a separate page.
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Text description of this chart is available on a separate page.
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Text description of this chart is available on a separate page.
For more information on the impact of adverse childhood experiences, please visit
http://www.cdc.gov/ace/index.htm .
1. Felitti, V.J., Anda, R.F., Nordenberg, D., Williamson, D.F., Spitz, A.M., Edwards, V.,
Koss, M.P., & Marks, J.S. (1998). Relationship of childhood abuse and household
dysfunction to many of the leading causes of death in adults: The Adverse Childhood
Experiences (ACE) Study, American Journal of Preventive Medicine, 14 (4), 245-258.
Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9635069?dopt=Abstract .
2. Hillis, S.D., Anda, R.F., Dube, S.R., Felitti, V.J., Marchbanks, P.A., & Marks, J.S.
(February 2004). The association between adverse childhood experiences and adolescent
pregnancy, long-term psychosocial outcomes, and fetal death. Pediatrics,113(2), 320–
327. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/14754944?dopt=Abstract .
3. Anda, R.F., Felitti, V.J., Fleisher, V.I., Edwards, V.J., Whitfield, C.L., Dube, S.R., &
Williamson, D.F. (2004). Childhood abuse, household dysfunction and indicators of
impaired worker performance in adulthood. The Permanente Journal, 8(1), 30–38.
4. Perry, B.D. (2009). Examining child maltreatment through a neurodevelopmental lens:
clinical application of the Neurosequential Model of Therapeutics. Journal of Loss and
Trauma, 14, 240-255.
5. Horton, C. (2003). Protective factors literature review. Early care and education programs
and the prevention of child abuse and neglect. Center for the Study of Social Policy.
Retrieved from
http://strengtheningfamilies.net/images/uploads/pdf_uploads/LiteratureReview.pdf
(PDF).
Graphs were created by the Center on the Developing Child at Harvard University from the cited
articles and are used by permission. For more information from the Center about early childhood
development, please visit http://www.developingchild.harvard.edu .
Dube, S.R., Anda, R.F., Felitti, V.J., Edwards, V.J., & Croft J.B. (2002). Adverse childhood
experiences and personal alcohol abuse as an adult, Addictive Behaviors 2002;27(5):713–725.
Retreived from
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list
_uids=12201379 .
Dube, S.R., Felitti, V.J., Dong, M., Chapman, D.P., Giles, W.H., & Anda, R.F. (March 2003).
Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: The
Adverse Childhood Experiences Study. Pediatrics, 111(3), 564-572.
Chapman, D.P., Whitfield, C.L., Felitti, V.J., Dube, S.R., Edwards, V.J., & Anda, R.F. (2004).
Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of
Affective Disorders, 82(2), 217–225. Retrieved from
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list
_uids=15488250 .
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Dong, M., Giles, W.H., Felitti, V.J., Dube, S.R., Williams, J.E., Chapman, D.P., & Anda, R.F.
(2004). Insights into causal pathways for ischemic heart disease: adverse childhood experiences
Study. Circulation, 110(13),1761–1766. Retrieved from
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list
_uids=15381652 .
Use these sample messages to share this early childhood trauma and resilience data point with
your connections on Twitter and Facebook and via email.
Twitter: More trauma in childhood = increased risk for serious #health issues in adulthood.
Which ones? Read: http://1.usa.gov/eXqVRX via @samhsagov #1in5
Facebook: Research shows that more traumatic experiences in childhood increases the risk for
serious health problems in adulthood. Learn more about childhood trauma’s impact on health
risks in adulthood and pass it on to observe National Children’s Mental Health Awareness Day:
http://1.usa.gov/eXqVRX
March 2011: Childhood Trauma's Impact on a Child's
Developing Brain
Studies on the brain show that physical, emotional, or sexual abuse in childhood can:
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cause permanent damage,
reduce the size of parts of the brain,
impact the way a child's brain copes with daily stress, and
can result in enduring behavioral health problems such as depression, anxiety,
aggression, impulsiveness, delinquency, hyperactivity, and substance abuse.
With help from families, providers, and the community, young children can demonstrate
resilience when dealing with trauma.
New brain imaging surveys and other techniques show that physical, emotional, or sexual abuse
in childhood (as well as stress in the form of exposure to violence, warfare, or famine) can cause
permanent damage to the neural structure and function of the developing brain. In addition to the
implications outlined in the data point above, traumatic or stressful experiences can lead to
conditions such as borderline personality disorder, dissociative episodes, hallucinations,
delusions, psychosis, paranoia, anger outbursts, and impaired attention. Whether in the form of
physical, emotional or sexual trauma, or exposure to warfare or famine, stress can set off a ripple
of hormonal changes and key brain alterations that may be irreversible.1
However, research has shown that caregivers can buffer the impact of trauma and promote better
outcomes for children even under stressful times when the following Strengthening Families
Protective Factors2 are present:
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Parental resilience
Social connections
Knowledge of parenting and child development
Concrete support in times of need
Social and emotional competence of children
Trauma Data Source:
1. Teicher, M.H. (2002). Scars that won't heal: The neurobiology of child abuse. Scientific
American. 68-75. (Retrieved from
http://www.icscommunitynetwork.org/scarsthatwon_theal+.pdf [PDF - 295 KB]).
2. Horton, C. (2003). Protective factors literature review. Early care and education programs
and the prevention of child abuse and neglect. Center for the Study of Social Policy.
(Learn more at www.strengtheningfamilies.net )
Use these sample messages to share this early childhood trauma and resilience data point with
your connections on Twitter and Facebook and via email.
Twitter: Physical, emotional or sexual abuse in childhood can impact a child's developing brain.
Find out how: http://1.usa.gov/faK4p1 via @samhsagov #1in5.
Facebook: Studies on the brain show that physical, emotional, or sexual abuse in childhood can
impact a child's developing brain. Learn more about childhood trauma's impact on childhood
development and pass it on to observe National Children's Mental Health Awareness Day:
http://1.usa.gov/faK4p1
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