Recovery from a burn injury can be difficult; however, there are many ways to support children during this process. Children can respond to trauma in various ways, depending on their age, personality and developmental stage, making it difficult for parents to determine when their child might need help. It is normal to see some dramatic changes in behavior initially following a trauma and during the acute hospitalization. You can help to build your child’s resiliency after the injury. Resiliency is the ability to overcome challenges and bounce back stronger. You should always consult your child’s medical team at your local burn center for help with these issues.
- Withdrawal.Your child may be quiet and may not be interested in talking with others.
- Regression.Your child may act younger than his or her age. For example, a preschool child who was toilet-trained may go back to using diapers. An older child may be less independent or suddenly rely on you more after an injury.
- Loss of independence.Your child may be needy and less sure of him or herself.
- Fear.Your child may be afraid of being alone.
- Separation anxiety. Your child may get upset about being away from parents or loved ones.
- Sleeping problems.Your child may not be able to sleep or stay asleep.
- Nightmares.Your child may have nightmares.
- Irritability or aggression.Your child may be angry or moody or lash out.
- Appetite changes. Your child may not want to eat or may want to eat too much.
These behavioral changes may be reoccurring, even after treatment, especially as new stressors arise.
During the first month after the injury, your child may have nightmares or flashbacks. He or she may not want to talk about the injury and may feel “on edge” or pretend to be somewhere else. You might also notice that they avoid certain reminders about the accident. These are signs of acute (or severe) stress. These are normal reactions after trauma. If these feelings and stress continue past the first month, your child could have Post-Traumatic Stress Disorder. Some of the symptoms are part of normal recovery. But if the stress and nightmares are severe and continue, you should ask your health care provider for more help.
It is not helpful to pressure your child into talking about the injury. If he or she wants to talk about it or ask questions, take the time and talk to them. If your child does not bring it up, that is okay. Your child may be scared to talk about it. Telling or hearing the story over and over can make your child re-live the pain. Respect how your child responds and watch for signs of anxiety or discomfort. Although some children may not be able to communicate their needs verbally, you can still watch their behavior for clues of what they need. Reach out to a mental health professional who is trained in trauma care if your child:
- Has a change in behavior that lasts two months or more after coming home from the hospital. There is a typical period of adjustment after a large burn injury, but if after a couple of months their behavior has not returned to what it was before the injury, consider getting help.
- Has behaviors that get in the way of returning to normal routines. For example, your child may be physically ready to return to school, but he or she might be scared and not want to leave home.
You may feel sad or guilty about your child’s injury. These feelings are understandable and common. But it can affect your emotional healing and get in the way of helping your child. For example, if you feel guilty, you may be more permissive or lenient about your child’s behavior. You may let him or her get away with talking to you disrespectfully. You may allow him or her to make demands. Or you may give them a lot more gifts than you typically would.
Although sadness or guilt is a normal feeling, if you let it affect your parenting style, you may change your parenting in a way that deprives your children of learning critical life skills. Stressful life events, such as a burn injury, will happen. You can choose to either use those events to build resiliency in your child, or teach them to be a victim or vulnerable child. For example, after an injury, you may want to overprotect your child. You may want to save your child from sad feelings or hard challenges. Instead, your child should have those feelings. Say, “I love you enough to know that you will get through this.” If you always rescue your child from discomfort and frustration, he or she may not be able to handle those emotions or challenges. Believe in your child’s strength, and he or she will believe in themselves. You can use this experience to teach your child how to bounce back from problems.
- Help your child get back into a typical routine. Have the same rules and expectations after the injury as you did before the injury. Parents often want to spoil kids or not enforce typical rules about behavior. This can cause children to worry. For example, they might start thinking, “I must be really hurt if my mom is letting me get away with this.” Although they may not be able to do all of the same chores due to the injury, find appropriate chores that they can do to contribute to the family.
- At first, spend some extra time with your child doing fun and relaxing activities, but get back into a normal routine as quickly as possible.
- Be a good role model. Children watch their parents for cues on how they should respond. Take good care of yourself. Eat healthy. Get enough sleep. Exercise. Get back into your normal routine. Your child can build off of this.
- It is okay for children to see their parents cry or get angry. But intense emotions can be scary for children. So try to express your emotions away from your child.
- Encourage your child’s independence and inner strength.
The Substance Abuse and Mental Health Services Administration (SAMHSA) http://www.samhsa.gov
The National Child Traumatic Stress Network http://www.nctsnet.org/resources/audiences/parents-caregivers
Help Your Child Recover—Build Your Child’s Resilience After a Burn Injury was developed by Shelley Wiechman, Ph.D., A.B.P.P., and Lynne Friedlander, M.Ed., in collaboration with the Model Systems Knowledge Translation Center.
The health information content in this fact sheet is based on research evidence and/or professional consensus and has been reviewed and approved by an editorial team of experts from the Burn Injury Model Systems.
This information is not meant to replace the advice of a medical professional. You should consult your health care provider about specific medical concerns or treatment. The contents of this fact sheet were developed under a grant (number H133A110004) from the U.S. Department of Education, National Institute on Disability and Rehabilitation Research. However, those contents do not necessarily represent the policy of the U.S. Department of Education, and you should not assume endorsement by the Federal Government.
Copyright © 2015
Model Systems Knowledge Translation Center (MSKTC). May be reproduced and distributed freely with appropriate attribution. Prior permission must be obtained for inclusion in fee-based materials.