The effects of trauma on children are broad in scope and can last throughout a lifetime. However, little is known about the immediate physical effects that trauma exposure can have on a child. Further, when a traumatic event does occur, local emergency departments are usually the first responders on the scene. As first responders, it is imperative that these departments are able to identify, and appropriately intervene in cases where children are exposed to trauma.
This study seeks to describe the physical health symptoms, use of emergency departments (EDs), and health-related problems in young children (birth through 5 years) exposed to trauma, in order to determine if these children have a greater risk of experiencing health-related problems. Two hundred and eight young children were surveyed at several family-based care facilities throughout the Northeastern US. As families were seeking mental health, developmental assessment, and intervention services for their children, they were invited to participate in the study. Traumatic events were measured using a 24 question survey to be answered by the parent, designed to capture in-depth information regarding the child’s exposure to trauma (e.g. neglect, witness to violence, separation from primary caregiver, or natural disasters).
The data regarding trauma was compared with data collected regarding the health status of the child. This information was collected using a questionnaire in which the parent would respond regarding any reoccurring health problems experienced by the child, current medication related to health problems, or if any of the child’s regular activities had been disrupted due to health problems.
Additionally, this study examined factors such as race/ethnicity, education of the caregiver and household income level to see if they had any impact on the trauma/health relationship. In this study, 94% of the caregiver respondents were the biological parent of the child. Most of the children were non-Hispanic white (56.7%) or Hispanic (22.1%), and 47% of care-givers had a 6-month household income of less than $20,000. Seventeen percent had less than a high school education.
Over 70% of young children had experienced some type of traumatic experience. The most common types being separation from a caregiver, witness to physical violence within the family, witness to threats of violence, and witnessing the arrest or imprisonment of a family member.
The findings of this study showed nearly 75% of young children with behavioral problems had experienced at least one type of trauma in their lifetime. Further, children exposed to high levels of trauma (four or more types) were almost three times as likely to have visited an emergency department for health-related problems.
Importantly, this study builds upon previous research suggesting that screening for psychological trauma exposure in these emergency facilities may help to increase the detection of trauma. Additionally, this study demonstrates a need to screen for other types of trauma as well, such as witnessing a natural disaster or family violence, as these types of events have been shown to cause stress-related disease.
Currently, children seeking services at emergency departments who are experiencing or have experienced trauma are not being identified because the symptoms do not present in the same way cuts and bruises do. Training health care professionals to screen for trauma-related symptoms may help to reduce not only the pain and suffering of the individual child, but the financial burden of society as well, which is estimated to be over $103 billion annually when total costs for all associated services (medical, legal, law enforcement, child welfare, etc.) are considered.
Written by Buddy Toth, Visiting Student in Research.