Any book on traumatic stress in South Africa would be incomplete without attention to the traumatisation of children. Exposure to traumatic events is not restricted to adults who operate in the world outside of the family or home and it is common cause that children (ranging from infants to adolescents) are vulnerable to trauma stemming from exposure to a broad spectrum of events. Children in many instances are both direct and indirect victims of trauma and are frequently witnesses to violence enacted between adults in their environment. While children may have a range of coping capacities to deal with extreme stressors, the fact that aspects of their bodies, minds and brains are not fully developed means that they are often particularly vulnerable to the impact of trauma. In addition, they need to invest psychological resources in mastering normative developmental tasks and attempts to manage traumatic events may impede such development and lead to considerable strain. Many studies have shown that the impact of trauma at early stages of development can have a long-lasting impact on personality formation, behaviour and mental health. For example, it is now well established that adult abusers more frequently report having suffered abuse in their own childhoods than non-abusers. A South African-based study found that, along with several other conditions, exposure to traumatic life events and childhood PTSD were associated with the increased likelihood that the individual would not complete high school education. Trauma in childhood may thus have both more immediate as well as long-term effects.

While children present with trauma responses that in many respects parallel those of adults, their response to traumatic incidents is strongly determined by their developmental stage and capacities. Thus anyone assessing or intervening with traumatised children needs to have a good understanding of normal developmental patterns.

Prevalence of Trauma and Posttraumatic Stress in Children

It is difficult to establish what percentage of children are exposed to traumatic events and just how many become disturbed as a consequence of this, given some of the problems in assessing exposure and levels of distress across situations and countries. Trauma exposure, for preschool children, for example, is unlikely to come to the attention of outside authorities unless parents or caregivers report such exposure on behalf of the child.