Last reviewed 21 February 2020

Adversity and trauma can have a long-lasting impact on children’s mental health and their relationships with other people in their lives. Young children may not be able to verbalise their feelings but can still be seriously affected by traumatic events or experiences, and early intervention is key. Elizabeth Walker looks at how nurseries can identify the signs and symptoms of early childhood trauma and support the children in their care.

Types of trauma

Research suggests that traumatic experiences are common and can be especially harmful when they occur in early childhood as they can affect the child’s development and ability to form attachments. Young children are also very dependent on their caregivers making them especially vulnerable to trauma. There are a range of experiences or events that may cause a child to suffer from trauma or post-traumatic stress, including:

  • physical, emotional or sexual abuse to the child or a family member

  • death or serious injury of a parent, sibling or caregiver

  • illness, operations or accidents

  • conflict between parents, separation or divorce

  • access to inappropriate content on the television, in books or online

  • transitions such as suddenly moving schools or house

  • being displaced or moving countries

  • living in poverty

  • neglect

  • natural disasters

  • war or violence

  • acts of terrorism.

Early years providers should form strong relationships with parents, carers and other professionals in order to share experiences and knowledge on individual children’s lives. Very young children, unlike older children or adults, cannot always verbalise their feelings or understand the link between what has happened and how it influences their feelings or behaviour.

How to recognise signs of trauma

The impact of childhood trauma is wide ranging and it can affect behaviour, brain development, cognition, physical and mental health as well as relationships and emotions. A child’s response to a distressing or frightening experience will depend on a range of factors including their age, stage of development and personality, as well as the impact of the trauma on their parents and carers. Each child will react differently and what is traumatic for one child may not be for another.

Since young children’s language is still developing, it is important to look for other clues in their behaviour and the way they play to understand if the trauma has had an effect. Early years practitioners must be able to recognise the different signs and symptoms of trauma and be confident to report any concerns effectively. Possible reactions of young children with exposure to traumatic stress include the following.

Behavioural symptoms

  • Excessive crying or screaming and difficult to console.

  • Becoming more clingy or fearful.

  • Exhibiting regressive behaviours, such as thumb sucking, baby talk, bedwetting or toilet accidents.

  • Separation anxiety.

  • Easily startled.

  • Displaying excessive temper or aggression.

  • Imitating the traumatic event through play or in drawings.

  • Being verbally abusive.

  • Being withdrawn.

  • Lack of self-confidence.

  • Being unable to trust others or make friends.

  • Believing they are to blame for the traumatic event.

Physiological symptoms

  • Sleep problems or nightmares.

  • Poor appetite, low weight or digestive problems.

  • Stomach aches or headaches.

  • Toileting delay or regression.

  • Inability to express emotions.

  • Loss of developmental milestones.

Cognitive symptoms

  • Delay in language and communication development.

  • Memory problems.

  • Difficulty in focusing or a short attention span.

  • Displaying signs of a special educational need or disability.

Due to the developmental risks associated with young children's traumatic experiences, it is essential that vulnerable children are identified as soon as possible after experiencing trauma. If early years practitioners identify any of these signs or symptoms there are many ways they can support the child, as well as involving any other relevant health or care professionals.

How to support children

Evidence has shown that support from parents or carers is key to helping a child or young person cope with what is happening in their lives. Research on resilience in children demonstrates that an essential protective factor is the reliable presence of a positive, caring, and protective parent or caregiver, who can help shield children against adverse experiences. Early intervention is key and early years staff can help to reduce the negative impact of traumatic events by encouraging children to talk about their experiences, and providing reassurance that there are adults in their lives who are working to keep them safe.

Early years staff can offer support by:

  • being calm and reassuring the child that you will keep them safe

  • talking about the child’s feelings using simple language and listening carefully to their concerns

  • being honest

  • reassuring children that their feelings or behaviour is a normal reaction and it is ok to feel upset, angry or sad

  • working closely with the child’s family

  • using drawing, play or stories to help a child to communicate

  • encouraging children to think of ways they can distract themselves from unwanted or negative thoughts

  • maintaining a routine which helps children feel safe and secure

  • managing transitions carefully, such as a change in key person or moving to a new room in the setting (see also Managing transitions in early years provisions)

  • planning the day around the individual needs of the children

  • adapting activities if these could trigger stressful memories

  • considering whether usual sanctions are appropriate

  • referring children to relevant health or care professionals where appropriate.

When to seek further help

Whilst early years providers can do a lot to support the children in their care, there will be many cases where further professional help needs to be sought. Some traumatic experiences may be one-off or short term, but they may also be repeated or enduring.

Some children are more resilient and their symptoms of trauma may diminish with time but for others the symptoms will persist. If there are any ongoing concerns about the symptoms a child is displaying, it will be necessary to seek further advice from a health professional or child and adolescent mental health services. Providers should work closely with parents and other professionals to ensure the child is fully supported during their time at the setting and, if necessary, develop a care plan for their individual needs.

If at any time, a member of staff has any concerns over a child’s safety or welfare, this should be discussed with a manager or the designated safeguarding lead who should notify the local authority children’s social care and, in emergencies, the police. If there are further signs of potential abuse and neglect, this should be reported and referred again. See also What to do if you’re worried a child is being abused.

Best practice and action points

Early years providers should:

  • ensure all staff have a good understanding of the impact of trauma through their induction and training

  • know how to identify signs and symptoms of trauma

  • ensure staff are able to report or communicate any concerns effectively

  • develop an effective key person system

  • develop strong relationships and work in partnership with families

  • work closely with specialists and workers from other agencies

  • create an environment where children feel safe and secure, maintaining routines whenever possible

  • ensure staff have any specialist training required to deliver targeted support for individual children

  • adapt activities for children

  • know how to manage transitions and support children through changes in their lives

  • ensure safeguarding policies and practice are robust

  • have a procedure in place to make referrals to other professionals and agencies.