Children at Risk After Traumatic Loss and Injury

Article is an exerpt from Phoenix Society's"The Journey Back" © 2006 Megan Bronson RN MSN CS Balance Point, Inc. Belmont, MI 49306

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Traumatic burn injury is often accompanied by multiple losses. These losses can be related to the burn injury itself such as loss of pre burn appearance, loss of body parts, or the loss of function of a body part. Losses related to the traumatic event itself may include the death of significant persons in the child’s life, death of pets, and loss of material possessions. When the following behaviors persist months after the traumatic injury, they are considered red flags and indicate the need for professional assessment and intervention.

  • Anxiety which limits the child’s ability to function, such as school phobia, fear of further loss, fear that he or she might die
  • Persistent difficulty talking about losses related to their burn injury such as changed appearance or a person who may have died in the traumatic event
  • Hyperactivity, aggression, destructive outbursts, consistently irritable and angry, risk taking behavior
  • Marked social and/or emotional withdrawal
  • School difficulties, (this could present as failing grades, difficulty concentrating and following directions, or over-achievement and perfectionism)
  • Persistent self blame and guilt
  • Compulsive caretaking of others or compulsive self reliance
  • Somatic complaints such as headaches or stomach aches, sleeping and eating disturbances
  • Substance abuse or other self destructive behaviors; expressing a desire to die
  • Prolonged inability to cry or to express grief for someone who may have died in the traumatic incident that caused the child’s injuries

Risk Predictors when the trauma includes death of a loved one:

  1. High level of family stress and change
  2. Inadequate support network
  3. Attachment to surviving caregiver is threatened in some way, (i.e. illness, substance abuse, depression, ineffective coping)
  4. Little or no preparation for or involvement in the funeral
  5. Sudden or violent death with no chance to say good-bye
  6. Addictive family system
  7. The level of functioning of the surviving parent is the most powerful predictor of a child’s adjustment after the death of a parent. (Worden, 1996)
  8. Poverty
Reference: © 2006 Megan Bronson RN MSN CS Balance Point, Inc. Belmont, MI 49306. 
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