Psychological Trauma in Children After Traffic Accidents

Insurance companies often question claims of injury for children, stating that they are more "resilient" than adults, and that injuries are not serious in whiplash injuries. A new study that investigated the effects of traffic accidents on children, however, shows that psychological symptoms can persist for months after an accident.

Researchers studied 57 children (ages 5-18) who had been in a traffic accident. They and their parents were interviewed within a few days of the accident, and again 12-15 weeks after the accident. Most (65%) of the accidents were car-pedestrian collisions, while 18% of the injuries occurred while the child was in the car.

At the initial evaluation, the study found that 70% of the children showed some signs of post-traumatic stress disorder (PTSD), with 36% showing moderate to severe symptoms. At the follow-up evaluation the number had significantly decreased, but 14% of the children had moderate to severe PTSD symptoms, and 35% had mild symptoms.

"Accidents, although often frightening and distressing for victims, were mostly considered minor, after the initial shock, by parents, friends, and relatives. Subjects were often told they had been fortunate and their condition could have been worse. Little opportunity was left to discuss feelings, such as fears or helplessness, and enforced normality was imposed upon several victims...Parents were commonly unaware of their avoiding behaviour, but acknowledged tension, mood swings and tantrums in their child, leading to frequent arguments."

The children most likely to develop symptoms of PTSD were those who were younger (those who could not understand what had happened to them) and those who were very distressed at the time of the accident. The authors stress that these children should be followed very closely, that the families should be made aware of possible reactions and symptoms, and that referral to a mental health professional may be warranted in certain cases.

Di Gallo A, Barton J, Parry-Jones WL. Road traffic accidents: early psychological consequences in children and adolescents. British Journal of Psychiatry 1997;170:358-362.