Each year in the United States approximately five million children experience some form of traumatic experience. More than two million of these are victims of physical or sexual abuse. Millions more are living in the terrorizing atmosphere of domestic violence. Natural disasters, car accidents, life-threatening medical conditions, painful procedures, exposure to community violence—all can have traumatic impact on the child. By the time a child reaches the age of eighteen, the probability that any child will have been touched directly by interpersonal or community violence is approximately one in four. Traumatic experiences can have a devastating impact on the child, altering their physical, emotional, cognitive and social development. In turn, the impact on the child has profound implications for their family, community and, ultimately, us all.

Traumatic events in childhood increase risk for a host of social (e.g., teenage pregnancy, adolescent drug abuse, school failure, victimization, anti-social behavior), neuropsychiatric (e.g., post-traumatic stress disorder, dissociative disorders, conduct disorders) and other medical problems (e.g., heart disease, asthma). The deterioration of public education, urban violence and the alarming social disintegration seen in some of our urban and rural communities can be traced back to the escalating cycles of abuse and neglect of our children.

For most children, thankfully, severe trauma is a new experience. And like all new experiences, the unknown will add to the confusing and frightening circumstances surrounding the traumatic event. The trauma may significantly challenge the child's sense of the world. A flood, tornado, car accident, shooting or abuse by a caregiver—all challenge the child's beliefs about the stability and safety of their world. Very young children may not understand what happened and will be confused or even frightened by the reactions of their siblings or caregivers.
© Bruce D. Perry, MD, PhD and the ChildTrauma Academy. For more information about the work of the ChildTrauma Academy, please visit ChildTrauma.org.

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