There are a lot of questions about when and how to intervene, Forman-Hoffman said. Do you offer help to all children who've been exposed to a trauma, like a school shooting or a tornado? Or do you wait until some kids have developed traumatic stress symptoms and intervene only with them?
One thing that's unclear, Forman-Hoffman noted, is whether any therapies have negative effects. Could some children do worse because they are having to "relive" the trauma? That's a particularly important question when it comes to therapies intended to prevent kids from developing symptoms.
"You do not want to do them harm, of course," Forman-Hoffman said.
"Most children exposed to a non-chronic trauma will do fine," Dowd said. But she and Forman-Hoffman both said it's important to step in when children are having problems weeks to months after the trauma. Often, kids will only start having obvious symptoms at that point.
You can start by talking with your child about the event and how they are feeling. If you think your child is struggling, Dowd said, talk to your pediatrician or other provider.
The review focused on children who'd lived through natural disasters or "man-made" traumas like community violence. So, it does not say anything about therapies for kids suffering chronic traumas like abuse or neglect, Forman-Hoffman noted.
Find out more about childhood traumatic stress from the National Child Traumatic Stress Network.
SOURCES: Valerie Forman-Hoffman, Ph.D., M.P.H, research epidemiologist, RTI International, Research Triangle Park, N.C.; Denise Dowd, M.D., M.P.H., emergency and urgent care, Children's Mercy Hospital and Clinics, Kansas City, Mo.; March 2013 Pediatrics
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