There are more than 1.5 million crashes involving children in the U.S. annually, suggesting that more than 25,000 children each year may require help in coping with reactions to a crash. Researchers urge clinicians to screen children and their parents after any crash experience.
"Until now, research on traumatic stress after crashes had only examined patient populations in hospitals or clinics," said Dr. Flaura Winston, M.D., Ph.D., a pediatrician at The Children's Hospital of Philadelphia and lead author on the study. "In this study, we found that, although it's less common, traumatic stress can occur in children and their parents even if a child wasn't injured in the crash." Dr Winston is also co-Director and a principal investigator on the Partners for Child Passenger Safety study.
The study, published in this month's Archives of Pediatric and Adolescent Medicine, examined 1,091 crashes reported to State Farm that occurred in 15 states and Washington, D.C., involving 1,483 child occupants between the ages of five and 15, as part of Partners for Child Passenger Safety, an ongoing research collaboration between the Children's Hospital and State Farm. While traumatic stress symptoms were seen in children and their parents regardless of injury, if a child received medical care after the crash, both the child and their parents were four times more likely to have serious acute stress symptoms than when no medical attention was required.
Symptoms of acute stress disorder (ASD) can include frequent or upsetting thoughts or memories about the crash; avoidance of reminders of the crash, like refusing to get into a car; jumpiness or constantly feeling in danger; and dissociation or emotional detachment.
"The majority of these children, and their parents, are not diagnosed properly and do not receive the psychological care they need to recover and get back to normal activity," says Dr. Winston.
Parents Suffer Traumatic Stress After Child-involved Crashes
In the study, parents were more likely than children to show signs of emotional distress following an accident. About one in six children with serious injuries (such as a fracture) and about one in four of their parents showed symptoms of acute stress after a crash. When injuries were minor, about one in 20 children and one in six parents were affected.
"For a family, a crash is like their own personal disaster," says Chiara Baxt, Ph.D., a co-author on the study and psychologist on the research team. "We found that the disruption a crash causes in the lives of parents was a predictor that the parents especially could suffer from symptoms of traumatic stress." Having a child recovering from an injury, having a vehicle so damaged it can't be driven, and dealing with financial repercussions of a crash are factors that may increase the likelihood of traumatic stress symptoms for parents.
The researchers recommend that clinicians screen for symptoms of acute stress in all children who have been in a crash, and in their parents, regardless of whether the child suffered injuries. Most children will recover with time and support, but in some cases symptoms will persist and get in the way of daily functioning, a sign that mental health counseling may be needed in order to recover completely.
What Can Parents Do?
Children's Hospital researchers say that the most important thing parents can do is to be aware of their child's emotional reaction to the crash and to their own. Parents can talk openly with children about the experience and answer questions the child might have; encourage younger children to draw pictures and older children to write about what happened and how they are feeling; and keep daily routines as normal as possible.
"Ask for help," says Dr. Winston. "If you are worried about your child or yourself, talk to someone such as your family doctor." If symptoms persist for a few weeks and are interfering with school or play, it is important to speak to a doctor or counselor.
Fact sheets for parents and screening tools for physicians are available at traumalink.chop.edu.
About Partners for Child Passenger Safety
Partners for Child Passenger Safety is a research collaboration between The Children's Hospital of Philadelphia and State Farm. As of February 2005, PCPS has created a database containing information on more than 377,000 crashes involving more than 557,000 children from birth through age 15 years. It is the largest source of data on children in motor vehicle crashes.
About The Children's Hospital of Philadelphia
The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking second in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit www.chop.edu.
About State Farm®
State Farm® insures more cars than any other insurer in North America and is the leading U.S. home insurer. State Farm's 17,000 agents and 76,000 employees serve nearly 73 million auto, fire, life and health policies in the United States and Canada. State Farm also offers financial services products. State Farm Mutual Automobile Insurance Company is the parent of the State Farm family of companies. State Farm is ranked No. 18 on the Fortune 500 list of largest companies. For more information, please visit http://www.