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Interviewer: How to help your young child after a traumatic event. We'll talk about what you can do next on The Scope.

Announcer: Health tips, medical news, research and more for a happier, healthier life from Ï㽶ÊÓƵ of Utah Health Sciences. This is the Scope.

Interviewer: Dr. Katherine Rosenblum is the director of the infant and early childhood clinic at the Ï㽶ÊÓƵ of Michigan. When scary things happen to young children, we're talking about infants, toddlers preschoolers, what can you do to help them through that? Is this something that a lot of parents don't recognize first of all?

Dr. Rosenblum: I think it's something that people often overlook because we think young kids are really little, maybe it won't affect them so much, maybe they won't remember things that happened, and also because it's hard for them to tell us what they're thinking and feeling if they don't have the words for it yet. But in fact little kids are affected by scary things that happen in the environment or that happen to them. So we often think about how young kids actually do experience trauma or stress and what we want people to be thinking about is how we can help them to manage those feelings. I think how we can help them cope.

Interviewer: How do you define trauma or stress to that age group?

Dr. Rosenblum: Little kids deal with little stresses all the time. For example, starting at a new school, Mom or Dad is going to work and we have to adapt to separations. It's hard but kids can learn to manage that. It's a stress and it helps them learn I can manage little stresses.

Trauma, in contrast, is something that's so big that actually it overwhelms the individual's ability to cope effectively, and especially for little kids. When they're faced with something that is traumatic or really, really distressing, then what they need is a lot of help to be able to figure out how to recover from that and to be able to recover from that. It really requires additional support from outside.

Interviewer: So are we talking about emotional trauma exclusively or physical trauma as well?

Dr. Rosenblum: Actually, it can be a whole range of things. One of the most common traumatic experiences for young kids is accidents. They get injured or hurt. And that can be really scary and overwhelming and parents might see that after an accident they're afraid, they're more fearful, they're more clingy, that sort of thing, dog bites, things that can happen in the environment.

Interviewer: Falling off of a play set maybe even.

Dr. Rosenblum: Absolutely right. If it was really a scary experience, maybe they had a broken arm, or they had to have some sort of a medical procedure, those things can be really distressing. But with support they can really recover from that.

Big traumas are things that are just told really overwhelming to to the child. It might be witnessing someone being seriously hurt or injured, or really scary events that happen in the community. Those are things that we really think of as true traumas. They overwhelm that young child's sense of, "I can I can cope." It really creates a sense of intense fear or threat, danger.

Interviewer: Seems like we're talking about a wide range of things like from separation anxiety because a parent is going to work versus a traumatic accident. Are they all kind of dealt with the same way or do they require different strategies?

Dr. Rosenblum: The one thing that's sort of common across all of those things for young kids and the number one thing that young kids need when they're managing things that are challenging is the support and help of their primary caregivers, what we think of as their attachment figures, their parents. Young kids are totally dependent on their caregivers to help them navigate life's challenges, and whether those challenges are small or big they're turning to their primary caregivers for help with coping.

Interviewer: I'm sensing here as a parent a little bit of a struggle because on one hand, I don't want to over . . . because a little bit of stress and that sort of thing's good so I don't want to maybe overprotect or over . . . I mean how do you decide how much?

Dr. Rosenblum: It's really important to on one level follow your child's cues. So your child is going to be showing you, :I need you in some way," and parents have an intuitive sort of sense often of, "When my child needs me, I'm going to go to them and help them." Doesn't mean that you're going to prevent them from having to face challenges. Normative things like going to school, that's really important and you're helping them learn how to balance. But when young kids are experiencing something that a parent knows is really really stressful, then I think it's actually really important for the parents to sort of say, "Hey I'm here. I'm here with you. You're safe right now. I'm going to take care of you. I'm going to protect you"

Interviewer: And what does that interaction look like? Say a child falls off of a play set. You can tell the over the next couple of days there is a big fear there. My dad was a rancher. He'd say, "You get bucked off the horse you get back on". Is that the approach you take or is there a better approach?

Dr. Rosenblum: Let me sort of step back and share something with you that's sort of interesting. We often have people who sort of say, "Hey, I'm worried about spoiling my child. If my child is crying and I pick them up, is that going to spoil them?" What we actually know from the research is that when kids express feelings like being afraid or sad and they have parents who pretty consistently and reliably go to them and help them with those experiences, they actually end up as they get older being more able to cope with life's punches if you will, the hard things that come in life. They can sort of bounce back get up and do things better on their own as well.

So I think two things. One, we want kids to be able to try to sort of manage small things on their own. If your dad saw you sort of fall down and bump your knee, it might be totally appropriate to take a moment, sort of look and say, "Hey, wait a second, is he really hurt? Is he really distressed or is he going to be able to sort of bounce back from this on his own?" That's totally appropriate. But if he sees that you're really crying, that you're really hurt, and you're looking up, that's a time where we really hope a parent is going to say, "Hey buddy. You know I'm here for you. I've got your back. Come here and let me help you."

Interviewer: With an adult I might validate somebody's feelings a bit. "I totally understand why that was a scary experience." Do you do the same thing with kids?

Dr. Rosenblum: Absolutely. "That was really scary. But you know what? I'm here. I'm going to help you and you're going to be okay." Little kids really like to know that someone's there, someone's got their back, someone's going to scoop them up, give them a hug and then help them be able to sort of do that bounce, get back into normal daily routines and experiences. That's another piece that's really important here. I think the other part of your question was, "I don't want to over react." I don't think it's overreacting to really be asking how is my child managing, am I seeing . . . If something scary, something really big happens, use your child as your guide. Look at your child's behavior. Is your child looking more fearful, having trouble sleeping, a little bit more clingy? If all of those things are true then that's a time to give a little bit more. But if your child seems to be doing okay, all right, be a watchful observer. Use your child to help you determine what your child needs.

Interviewer: Would there be a point where you'd visit a counselor?

Dr. Rosenblum: Absolutely. So if your child is continuing to persist in showing more clinginess, looks very fearful, can't sort of do the normal routines, seems really distressed or you're just really concerned about them, trust your gut, talk to the primary and pediatricians are a great resource. They can help you sort out is this something that we can sort of wait and see and sort of watch and wonder? Or is this something where it might actually be helpful to get some extra help?

Interviewer: Do you have a resource if a parent's listening right now on their like, "This is great. I'd like to learn more"?

Dr. Rosenblum: There's a really wonderful website called the National Child Traumatic Stress Network and they have a website, NCTSN.org, and that provides wonderful resources for parents, for teachers of young kids about how to help kids manage really scary or big things. For smaller sort of things, the more every day sorts of occurrences, there are a number of resources that are available as well. The American Academy of Pediatrics has a website dedicated for parents and there's also a wonderful resource called Zerotothree.org. Again, lots of resources to help parents navigate life's challenges with young kids.

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