symptoms of exposure to violence

The following symptoms are frequently associated with exposure to domestic violence:
 
Sleep Difficulties: Children may have difficulty falling asleep at night and may wake frequently or refuse to sleep in their own beds. They may have nightmares or early morning waking.

Somatic Symptoms: Children may complain of headaches, stomach aches, or other chronic pain or discomfort.

Increased Anxiety about Separation from caregivers: This symptom happens most with young children. It may be observed as children arrive at day care centers or schools in the morning, as children transition from one activity to another during the day, or as children express worry about parents and their safety.

Increased Aggression/Anxiety: Some children become more aggressive. Some misread social cues and the intent of others. They mistake others' actions as purposely aggressive and respond accordingly. For example, a child who has grown up with domestic violence may misattribute the intentions of another child who accidentally trips over his feet. The child sees this as a provocative or hostile action and responds by hitting the other child.

Increased distractibility or activity level: Some children become increasingly active or distractible. This response may be linked to the escalated or chronic stress the child experiences and the accompanying changes in brain chemistry. These children have trouble concentrating on their work in school and they do not complete tasks. Sometimes these children may be incorrectly diagnosed with Attention Deficit/Hyperactivity Disorder.

Increased withdrawal/apathy: Some children become more withdrawn and isolated from peers. They do not play spontaneously. They may appear to be depressed.

Developmental regression (especially in young children.): Following exposure to trauma, younger children may lose recently acquired developmental skills. For example, a child who was toilet-trained may start wetting the bed or a child may regress to thumb-sucking or other self-soothing behaviors.

Repetitive talk or play about the event: This symptom and the one listed below are classic symptoms associated with post-traumatic stress disorder. Children may talk repetitively about a traumatic event or they will play out aspects of the event. This is the childhood equivalent of the symptom of re-experiencing the trauma.

Intrusive thoughts, memories, worries: This is the equivalent of flashbacks. Children may experience sudden memories of the event or they may obsessively worry about its re-occurrence. These symptoms may be observed in very young children, as well as older children.

Please note that these symptoms are not unique to domestic violence. They may be responses to normal stress, such as a recent move, the birth of a sibling, or a death in the family. They may also indicate problems in other areas, including other forms of trauma, such as child abuse or an automobile accident. If you see any of these signs, please contact a child care professional for an assessment of your child's needs.

Not all children who are exposed to domestic violence develop post-traumatic stress disorder, or other clinical disorders. Many may have isolated symptoms. There are variables that affect the extent to which a child may be affected by his/her exposure to violence.

These include:
Age:  Generally, young children are more vulnerable because they have fewer coping tools to make sense of the violence.
Gender: In general, boys show more external signs, while girls withdraw after exposure.
Familiarity: If a child knows a victim or perpetrator, he/she will be more affected by that exposure.
Frequency: Chronic exposure is more harmful than a single event.
Severity:  The more severe the violence, the more the child will be affected.
Proximity: If the child is closer to the violence, he/she will be more affected than if the violence is only heard or seen from a long distance. In general, the more details the child observes about the violent event, the more he/she will be traumatized.

Source: Groves, Betsy McAlister, Roberts, Elizabeth, Weinrab, Maxine, Child Witness to Violence Project, Boston Medical Center, Shelter from The Storm: Clinical Intervention with Children Affected by Domestic Violence, 2000.