By Patrick J. McGrath, OC, PhD, FRSC
Question:
I think I have figured out what is happening to my two-year-old son. He is a sensitive child and has had meltdowns at daycare when the power went out and when a community policeman who is volunteering at our daycare, came to the daycare. He could not be consoled. The daycare didn't tell me till the third time the policeman visited.
I think he is having a stress reaction to an accident, or maybe post-traumatic stress disorder. Last winter we were in a traffic crash. He was not injured. It was at night and our van flipped over in a whiteout and landed in the ditch. Our son had been asleep in his car seat. He was pulled out of the wreckage. There were police and flashing lights all over. He really doesn't remember much but he gets scared when there is a siren or a flashing light. He doesn't seem to understand when I talk to him about it. He just says he is afraid.
What can we do to help him?
Dr. Pat responds:
Your theory is likely right. Your son suddenly was thrown into a confusing and terrifying situation. Many children suffer from post traumatic stress disorder (PTSD) or other stress injuries after car crashes.
Your son's early age is both a bonus and a problem. It is a bonus because young children seem to be more resilient and able to bounce back than most of us. It is a disadvantage because his memories are laid down in images without words attached to them. He cannot talk about them because these memories are not connected to language.
Your goal is to help your son make sense of his experience. You can help him use the language he has now developed to understand what happened. He has to learn how to think about what happened. Give him the language to calm himself down.
Try to prevent times where he melts down as this may increase his fear. At the same time, he must learn to face what he is afraid of. Avoidance will make his fear worse.
You could use small toys to recreate what happened and give him new ways to think about it:
- A crash occurs.
- The little boy in the accident is scared.
- The policemen come with flashing lights and sirens.
- The policemen save the little boy.
- The boy is happy.
- The boy thanks the policeman.
- All is well.
Try to figure out other situations that might cause distress for your son. You can recreate these situations. For example, the little boy hears a siren when he is in the car. He says to himself that the policemen are going to help someone.
A second strategy would be to coach your son through difficult situations. If you can be with him when the policeman visits his daycare, you can coach him and let him gradually approach the policeman. Perhaps the policeman might even visit you at home. If he is not in uniform but brings his uniform to show your son, this may be a good slow start. Gradual exposure combined with your coaching your son to say coping statements could really help.
You will likely have to repeat these training sessions many times for them to work. A psychologist could help if progress is not happening.
Patrick J. McGrath OC, PhD, FRSC is a clinical psychologist and a researcher. He is Professor of Psychology, Pediatrics, and Psychiatry at Dalhousie University and Vice President - Research at IWK Health Centre in Halifax. He is also the CEO of the Strongest Families Institute, which provides mental health care to families across Canada.
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