Trauma alters brain chemistry and creates both mental and physical symptoms.

Spotting the signs and symptoms of post-traumatic stress disorder in children can be challenging, as their cognitive powers and behaviours are still developing.

So, here are our PTSD tips for teachers and other professionals on what to look out for, and how to uspport them.

1. Understand what PTSD is

There are lots of articles about PTSD on our website which can help you understand more about the condition including it’s causes, symptoms and the treatments available.

Remember, PTSD in children and young adults is not always linked to abusive situations. It can result from a single event (such as a house fire, death or car accident), witnessing people they love in danger, and substantial hospital stays that separate them from caregivers. Find out more about the causes of PTSD in children and young people here.

2. Being alert to PTSD signs

In addition to the symptoms, there are behavioural indicators that a child may have PTSD.

Avoidance and emotional detachment

A common coping mechanism is to distance themselves from their trauma. They may refuse to acknowledge it happened or appear as generally ‘shut down’ and emotionally withdrawn.

Irritability and being easily triggered

Having your body’s ‘alarm system’ switched on constantly can result in being overly sensitive and reacting in extreme ways, out of proportion to an incident.

Hypervigilance can also result in children showing extreme reactions to people, sounds or even smells that remind them of their experience.

They may also have poor sleep due to restlessness and nightmares, adding to their potential to be on edge and easily angered.

Children with PTSD may also struggle to concentrate or become easily distracted, especially when sitting at the front of a room.

Acting out and aggression

One of the hardest things for teachers to assess is the difference between a child being wilfully disobedient or aggressive, and one who is behaving badly due to distress and anxiety they can’t articulate. Oppositional behaviour and aggression could indicate they are trying to regain a degree of control, due to the impact of trauma.

3. Reliving traumas

A child with PTSD may give clear indications of their distress, by seeking to frequently talk about what happened, write about it or draw pictures. Particularly as PTSD in children can cause intrusive memories, thoughts or images that they struggle to ‘switch off’.

Should you stop a child in your class from reliving their trauma? The common wisdom is to distract them and stop them from ‘dwelling on the past’. However, many children are naturally gregarious and desperate to share. If they are not distressing classmates, providing children with an outlet to relive things can be a healthy release.

4. Respond quickly

When a child displays PTSD symptoms, have coping strategies ready to use. For example, a safe, calm and quiet space for them to go to. Or, they may need breathing exercises and mindfulness strategies to defuse escalating emotions.

It clearly helps if you know their triggers – such as loud noises or feeling ‘under attack’. Your response should also include reminders of expected behaviours and constructive suggestions of how they can move forwards positively as well as reminding them they are safe in that moment.

5. Providing a safe environment

Children with PTSD often don’t want to be singled out, but there are things a teacher can do to help them stay calm and engaged.

Anyone who has experienced trauma can relish the predictability and calming nature of a routine, so be ready to explain changes to your students with PTSD, and manage any concerns. Also, they may benefit from being offered more choices to instil a feeling of being in control.

Another PTSD tip for teachers is using positive affirmations and encouragement for a child struggling with self-worth and distrust of adults. Also, consider ways to address ways to stay safe in an age-appropriate way with your whole class.

6. Grounding techniques

These are calming techniques you can use on children with PTSD and other mental health issues. These basically help a child to settle their emotional and mental turmoil by focusing on their five senses. This could be a class activity or you could set the individual child tasks that bring them back to the present. Some great examples of grounding techniques are:

• FIVE THINGS: get the child or young person to list ‘5 things you see, 4 things you hear, 3 things you smell, 2 things you can touch and1 thing you taste

• 5-4-3-2-1 SIGHTS: ‘If noticing each sense is tough for your student right now, try an exercise just with sights. Create categories and have students name what they see. Here’s an example: 5 colours I see, 4 shapes I see, 3 soft things I see, 2 people I see and 1 book I see’

• BE A TREE: ‘There’s nothing more grounded than a tree! Teach your student to feel his or her connection with the ground by imaging him/herself as a tree. This sounds like, “I am firmly planted. I feel my feet rooted to the ground. My back is a strong trunk helping me feel stable in the moment. I feel my toes connecting with the ground. My arms are my branches. I feel them reach out into the world.” Simply noticing their bodies and feeling their connection with the room helps kids feel grounded!’
• OBJECT FOCUS: ‘Keep some unique items on hand with different textures and colours. These could be sensory items, colourful rocks, snow globes or something else. Students can hold an item in their hands and tune in all of their focus to the item. Notice the colours. Notice the textures. How does it feel in my hand? How does it feel when I squeeze it? What colours do I see? Just notice everything there is to notice about the item!’
• STOMP STOMP BLOW: ‘For an active grounding exercise, have students stomp the left foot, stomp the right foot and then exhale deeply. Continue this pattern of stomp, stomp, blow, stomp, stomp, blow, stomp, stomp, blow. Feel the connection of feet with the floor. Blow away anxious thoughts.’

7. Additional calming techniques

Making school a safe place for a child with PTSD can be as simple as a ‘den’ in the corner, comfortable and warm with cushions and blankets.

Calming options could also include listening to music and colouring in or providing the child with a fidget toy, lavender bag to squeeze or much-loved personal item for self-soothing.

8. Speak to defuse not treat

Clearly, you can’t engage in any form of counselling or therapy. However, it can be helpful to draw a line between their lived experience and current situation. For example, by quickly explaining that a loud noise was a door banging or a book being dropped. Or someone who’s crying is upset, not in danger.

9. Listen empathetically

If children know they have an empathetic ear, teachers can be the first people they talk to when they’ve experienced (or are experiencing) trauma.

When a child in your class opens up about their PTSD some details may be particularly distressing or significant. It can be challenging to stay calm but you must avoid judgements or promises you can’t keep. However, you can challenge misconceptions and misunderstandings that threaten the child’s mental health, such as positive affirmations about them, and reassurance that school is a safe place for them to be.

PTSD recovery takes time, and may well require professional help. As soon as you suspect a child has PTSD, it’s important to find a swift way to address your concern. 

This film from Nip in the Bud gives Tips for Teachers who either have a child or children in their class who are experiencing symptoms of Post-Traumatic Stress Disorder (PTSD) or have a known diagnosis of PTSD.