How do trauma and adverse childhood experiences affect children? – CHOC

Insights from Dr Sheela ModirA licensed clinical psychologist and supervisor of the mental health service line at Rady Children’s Hospital Orange County (Rady Children’s)

key takeaways

• Trauma and adverse childhood experiences (ACEs) affect children differently as they grow up: Symptoms of trauma vary by age, ranging from regression in young children to anxiety, withdrawal, or risky behavior in adolescents, making it essential for caregivers to monitor changes in a child’s specific behavior.
• Support starts with the “5 Es”: Finding out what the child knows, explaining events clearly, expressing that feelings are normal, using emotionally healthy coping, and ensuring stability help children feel safe and supported after trauma.
• Get help if symptoms persist: When emotional or behavioral changes interfere with daily functioning, professional mental health support can provide tools for treatment and help minimize the long-term effects of trauma.

How trauma can shape a child’s health and development

Childhood should be a time of security, growth, and discovery—but for many children, it is marked by trauma, instability, or neglect. Adverse childhood experiences (ACEs), including abuse, household dysfunction, and other forms of toxic stress, can leave lasting marks on a child’s physical, emotional, and cognitive development.

As research continues to reveal the deep and long-term impact of ACEs on health and behavior, it becomes increasingly clear that early intervention and trauma-informed care is essential. Here, Dr. Sheila Modir, pediatrician at Rady Children’s, discusses how caregivers, teachers and health care professionals can recognize the signs of trauma, understand its effects, and provide the support children need to heal and thrive.

What are the differences between stroke and ACE?

Trauma is an emotional response to a tragic event, such as a car accident, natural disaster, or the COVID-19 pandemic. While some emotional reactions are short-lived, others may persist and impair daily functioning, especially in children.

Adverse childhood experiences, a concept stemming from the Centers for Disease Control and Prevention (CDC) and Kaiser studies, refers to 10 specific types of trauma — including various forms of abuse and neglect — that are experienced between the ages of zero and 18. The study revealed that trauma is far more common and widespread across all communities and socioeconomic backgrounds than previously thought, highlighting the importance of recognizing and addressing it.

“You’re hearing a lot more about adverse childhood experiences recently because research articles are highlighting it and a lot of professionals are giving presentations about it and collecting data,” says Dr. Modir.

What are the symptoms of trauma and adverse childhood experiences?

Childhood trauma manifests differently depending on the child’s developmental stage. Young children, such as preschoolers, often lack the verbal skills to express their emotions, so trauma can manifest as excessive crying, tantrums, nightmares, separation anxiety and regressive behaviors like losing potty training or needing help eating.

In school-age children, emotional reactions become more complex, including anxiety, sadness, restlessness, trouble sleeping or concentrating, and physical complaints such as stomach aches or headaches – often prompting a visit to the pediatrician. Teens may experience more intense emotional reactions, such as depression, anxiety, and loneliness, and may deal with risky or defiant behavior.

“Your teen can join in self harmUse substances, restrict eating, or engage in physical aggression at school. They may become isolated and withdrawn or sleep too much, or too little. “They may become more agitated and irritable,” explains Dr. Modir. “As they go through these stages of development, you see trauma impact them in different ways and produce different emotional responses across the developmental lifespan.”

The “5 Es” Approach

To help children deal with the emotional aftermath of trauma, Dr. Modir recommends that parents use the “Five Es” approach:

1. to explore Asking questions gently builds on what the child already knows, to understand his or her perspective, and to foster conversation.
2. explain Address the situation using developmentally appropriate language, correct any misinformation, and reassure the child about their safety.
3. express That all emotions – like sadness, anger, or fear – are normal, as well as limiting media exposure and modeling healthy coping strategies.
4. emotionally ideal By showing children how you manage your stress, such as deep breathing or discussing your feelings openly.
5. ensure stability By maintaining predictable routines and structure, children are provided with a sense of control and security during uncertain times.

When should parents and caregivers seek professional help?

Parents should be alert to their child’s emotional signals, recognize what is typical for them, and pay attention to any changes beyond that baseline. Some signs of distress, such as changes in sleep or appetite, may be normal after an infection or traumatic event, such as the loss of a pet. However, if these signs persist over time and begin to interfere with the child’s ability to function socially, academically, or emotionally, it may be time to seek help from a mental health professional.

“It’s really just being aware of the emotional signals that your child may be presenting and being able to understand and know if the symptoms are starting to impair their daily functioning,” says Dr. Modir.

Keep calm and carry on: advice for parents and carers

Adults play an important role in helping children cope with trauma by modeling healthy emotional responses. Children often observe and imitate the behavior of adults, even if it is not obvious. By remaining calm and controlled, parents help their children co-regulate—understand and internalize those emotional signals.

Discussing coping strategies openly as a family not only strengthens these skills, but also helps build resiliency in children when faced with difficult or traumatic events. Dr. Modir encourages parents and caregivers to never underestimate the value of professional help.

“It’s really important to reach out to a therapist during difficult times, so we reduce that persistent mental health stigma. Know this talking to a professional When you reach a certain point that’s an opportunity, not any kind of ‘failure,'” she assures. “Helping your child process their emotions is an investment in their future.”

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