Yes, they can! Children can, like anyone else, develop a cluster of fearful, avoidant, and reactive behaviors to stressful stimuli that persist over time and place, even after the danger is gone. PTSD might indeed look slightly different in children than adults: Instead of a man trembling under a desk with the sound of fireworks, picture a child who refuses to go to the bathroom or clean up properly because of abuse that happened there. Children might not verbalize their reasons for avoiding certain situations very clearly, but you might see clues in their play (e.g., re-enacting painful memories) or the sorts of things they avoid (e.g., staying out of pools if someone drowned, or wanting to keep the light on at bedtime after a trauma that took place at nighttime).

Researchers, including some of my psychologist friends, are busy trying to figure this out! The short answer is that we do not know. Several factors can play a role, including the child’s age, temperament, support system, and the severity or duration of the trauma. Some research even suggests that the existence of emotional turmoil before an event is a stronger predictor of a trauma response than the trauma itself. This makes sense if you think about it like a crack in a bridge: It’s easier to damage a structure that was already weakened. A strong, supportive environment can make a big difference in helping a child process trauma in a healthy way.

No, it’s not always necessary to relive painful memories in detail to heal. In trauma therapy, the goal is not to make a child re-experience the pain, but to help them feel safe, process their feelings, and gain control over the memories that continue to cause distress. Therapy often focuses on helping kids understand and reframe their experiences, so they can move forward without being overwhelmed by the past.

It’s completely understandable to feel stuck when your child doesn’t want to talk about what’s happened. Often, kids who’ve experienced trauma may not have the words or the emotional readiness to open up, and that’s okay. Pushing them too hard can sometimes make things feel worse. In therapy, the focus is on creating a safe space where children can process their feelings at their own pace. There are many ways to approach trauma that don’t require talking directly about it right away. Therapy can help you and your child take things one step at a time, at a pace that feels right.

The conventional wisdom that “time heals all wounds” might actually hold water with childhood PTSD, but not for everyone. A recent study of children exposed to trauma suggests that rates of PTSD are cut in half at 3-month, 6-month, and 12-month intervals, meaning that time may play a part. But that also means that a chunk of these children still met criteria for PTSD after a year, and were suffering throughout this period. I have also worked with veterans who have suffered from PTSD for years, all while waiting patiently for the pain to go away. This is especially sad because it can be treated successfully in just a few months (see below).