Can Children Suffer from Post-Traumatic Stress After a Car Accident?

According to a study conducted in Sweden the answer is most certainly yes!

Research conducted at the University of Gothenburg in Sweden determined that approximately 30% of children injured in car accidents end up suffering from Post-Traumatic Stress Disorder.

Long lasting effects
The research by Eva Olofsson went on to determine that up to 20% of children still suffer from the mental and psychosocial effects of PTSD up to a year post accident.

Psychological injuries last longer than physical injuries?

Olofsson determined that about 16% of children injured in traffic suffered from physical injuries one year post accident but 22% of children were still suffering from mental and psychological problems one year post accident. Suggesting that psychological injuries may outlast physical injuries in young people.

“My results suggest that the experience of having an accident has a greater effect than the actual physical injuries. To be injured as an unprotected pedestrian in an accident with a vehicle can be experienced as more stressful, more frightening and more threatening than, for example, a cycling accident with no one else involved.”

Diagnosing PTSD in children

One of the challenges in the Diagnostic and Statistical Manual (DSM) which is used to diagnose psychological and psychiatric illnesses has been the different effects that psychological disorders may have depending on the age group. Earlier editions of the DSM did not adequately account for age when considering diagnostic criteria.

However, the latest edition of the DSM (DSM-5) contains new diagnostic criteria called Post-Traumatic Stress Disorder in Pre-School Children.

Research has shown that because very young children do not have fully developed cognitive and verbal expressive capabilities the diagnostic criteria must be more behaviour centric.

For example, one of the original diagnostic criteria for Post-Traumatic Stress Disorder required the victim to show extreme distress at the moment of injury. However, if children are too young or do not have the communication skills adequate to express their anxiety or distress there is no appropriate way to meet the diagnostic criteria. So this requirement has been eliminated in the DSM-5 when diagnosing PTSD in children.

See this article from the National Center for PTSD for a more in depth explanation of the new diagnostic criteria.

Quantifying psychological injuries in children

In my work as a personal injury lawyer representing children in car accidents, I agree with Ms. Olofsson’s conclusions about the lasting effects of PTSD. Children who have been in a car accident may “appear” to have suffered relatively minor physical injuries. However, the psychological effects of the accident can be significant and long lasting. Anxiety and post-traumatic stress are real and debilitating injuries.

The challenge is in how to quantify or accurately measure the effects of post-traumatic stress in children.

As an advocate for survivors of childhood abuse I am frequently faced with situations where my clients have been diagnosed, as adults, with chronic Post-Traumatic Stress Disorder. In attempting to quantify the harm that they have suffered one looks back over their lifetime to see what effect their PTSD has had on their ability to work, their family relationships, their education and earning capacity. Through the use of psychological experts one can connect the harm that caused the post-traumatic stress to the problems with education income or relationships to provide some measure of the harm that the injured person has suffered.

However, quantifying psychological injuries in children is more difficult. There is no such thing as a crystal ball for damages. When a child is injured and suffers from post-traumatic stress you cannot look back to see what affect it has had on their short life span. Rather, you have to project forward to determine what possible or probable effects PTSD may have in the future. for example, how long will the affects last, to what degree will they impair the child’s ability to continue their education and/or gain employment?

Unfortunately there are few pediatric psychologists who have experience in dealing with the effects of PTSD in very young children.

While having appropriate expert evidence is important in any case it is even more important in claims involving children because psychological injuries are invisible and the diagnosis itself may be difficult for clinicians unfamiliar with the signs and symptoms of PTSD in children.

Photo by Kelly Long