Recognizing and Referring Children with Posttraumatic Stress Disorder: Guidelines for Pediatric Providers

Education Gaps

Posttraumatic stress disorder (PTSD) affects approximately 4% of US children and teens and can severely impact the quality of social, academic, and personal welfare aspects of a child or adolescent and can persist into adulthood. Yet, 1 study indicated that only 18% of pediatricians surveyed felt that they had adequate knowledge of pediatric PTSD, and most (72%) reported that greater collaboration with mental health providers would improve their assessment of PTSD. (1) Health-care providers who treat pediatric populations should be aware of the magnitude of this problem and be able to screen for and refer children and teens with PTSD for specific treatments. (1)

1. Banh MK, Saxe G, Mangione T, Horton NJ. Physician-reported practice of managing childhood posttraumatic stress in pediatric primary care. Gen Hosp Psychiatry. 2008;30(6):536–545

Objectives

After completing this article, readers should be able to:

1. Identify and refer children affected by trauma for appropriate evaluation and evidence-based treatment.

2. Summarize the evidence for treatment approaches, including psychotherapies.

3. Understand the importance of pediatric providers knowing about what treatments have been supported for treating pediatric posttraumatic stress disorder.

Case Example 1

At a routine health supervision visit, a mother expresses concern that her 3-year-old daughter has “gone back to the terrible twos.” The mother says that her daughter is having intense tantrums that can last hours, is having increased difficulty separating from her, is taking much longer than usual to get to sleep at night, is often coming into her mother’s room in the middle of the night, and has wet her pants on several occasions although she was previously toilet trained. The mother says that these behaviors began shortly after an …