Acting out, irritability, and complaints of excessive tiredness may be the first signs of un-diagnosed traumatic stress reactions or even PTSD stemming from a chronic illness or injury. These behavioral and emotional reactions, such as depression and anxiety, will not effect every child. However, when a child does experience traumatic stress reactions, any progress in treatments or therapies can be slowed or stalled completely. Because of their unique role and frequency of visits, physical therapists may be the first healthcare provider to see the warning signs in their patients. Conversations during PT sessions may bring un-diagnosed traumatic stress symptoms to the forefront. Or a previously upbeat patient may become withdrawn and progress in therapy may stall. Recognizing the signs and symptoms of traumatic stress, physical therapists can alert the rest of the medical team and help the child receive the necessary mental health care.