HOLLYWOOD, CALIF. – In treating children exposed to trauma, think about the DEFs once the ABCs are taken care of. That's the message Nancy Kassam-Adams, Ph.D., delivered at the annual meeting of the International Society for Traumatic Stress Studies.
“After Airway, Breathing, and Circulation, think about Distress, Emotional support, and Family,” said Dr. Kassam-Adams of Children's Hospital of Philadelphia.
A large percentage of children experience a serious injury or other trauma at some time during their childhood, and according to at least one study, 16% have posttraumatic stress symptoms months later, she said.
Parents are more likely to turn to their family doctor than to anyone else when seeking psychosocial assistance for children with acute stress, and in the 6 months after a serious injury 80% of families pay a median of three visits to their primary care physicians. These are golden opportunities to intervene and perhaps to prevent serious cases of posttraumatic stress disorder, Dr. Kassam-Adams said.
A child may experience distress from physical pain, anxiety, and grief or loss. One way to help is by assessing all of these factors, listening carefully to how the child understands the situation, correcting any misconceptions, and treating the child's physical ailments in a way that maximizes his or her control over the situation.
Reassurance and realistic hope can also be provided, and bereavement resources can be mobilized when necessary.
In assessing emotional support, ask both parent and child what works to help the child cope with difficult or scary things. Remember that the injured child is part of a family system, and other members of the family may have suffered injury or trauma as well.
Try to determine whether the family is coping well with the trauma and whether they will need outside help.
After the ABCs: DEFs of Traumatic Stress