Children in car crashes should be monitored for acute stress symptoms, whether injured or not
November 10, 2005
In a national study (USA) of children in motor vehicle crashes, researchers
at The Children's Hospital of Philadelphia report that traumatic stress can
occur without injury. Looking at a wide range of crashes reported to State Farm
Insurance Companies®, researchers found that while most children did well, two
percent of the children and five percent of their parents experienced multiple
traumatic stress symptoms that disrupted their lives.
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 http://www.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 http://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.statefarm.com
® or in Canada http://www.statefarm.ca
Dana Mortensen
Mortensen@email.chop.edu
Children's Hospital of Philadelphia
http://www.chop.edu