Skip to main content
Home
Pediatric Medical Traumatic Stress
  • Home
  • Trauma-informed pediatric care

    What is Pediatric Medical Traumatic Stress?

    • The basics
    • Prevalence & course
    • Traumatic stress symptoms
    • Risk factors
    • Understanding the family's experience
    • Key research findings

    How to Provide Trauma-Informed Care

    • The basics
    • D-E-F framework
    • Levels of risk and trauma-informed care
    • Timeline for trauma-informed care
    • Referral to mental health care
    • Addressing health disparities
    • Developmental considerations
    • Cultural considerations

    Self Care & Secondary Trauma

    • The basics
    • Self care tips
    • Organizational support
  • Find information for..
    • The healthcare team
    • Physicians-PAs-NPs
    • Nurses
    • Pre-hospital providers
    • Medical interpreters
    • Mental health professionals
    • Child welfare professionals
    • Child Life Professionals
  • Professional Education
    • Take a Free Online Course
    • Other education resources
  • Find Tools and Resources

    Patient Education

    Patient Education

    • For parents & caregivers
    • For children & teens

    Screening & Assessment

    Screening & Assessment

    • The basics
    • Find screening & assessment tools
    • Screening after pediatric injury
    • Psychosocial Assessment Tool (PAT)
    • Acute Stress Checklist (ASC-Kids)
    • Family Illness Beliefs Inventory (FIBI)

    Intervention

    Intervention

    • The basics
    • Surviving Cancer Competently (SCCIP)
    • Cellie Coping Kit

    Trauma-Informed Care

    Trauma-Informed Care

    • The basics
    • TIC Provider Survey
    • Observation Checklist - Pediatric Resuscitation

    COVID-19

    COVID-19

    • COVID-19
    • Resources for healthcare staff
    • COVID-19 Exposure and Family Impact Scales (CEFIS)
    • Helping my child cope

    Resources

    Resources

    • More resources
  • For Patients and Families
    • Coping with injury or illness
    • Sleep
    • Pain
    • Behavior
    • Worries & fears
    • Quiet or withdrawn
    • School
    • Siblings
    • Parents
    • Need more help?
    • Family voices

Quiet or Seems Withdrawn

Are you worried because your child:

mom_and_child
  • Doesn’t want to talk about his/her injury or illness?
  • Tries to push injury or illness out of his/ her mind?
  • Not interested in usual activities, friends or family?

Many children who don’t talk much about their feelings or reactions are finding other ways to cope, and are doing well. Others just aren’t ready to talk yet. And some (especially teens) may be talking with friends even if they’re not talking much about it with parents.

If your child seems very “down” or withdrawn, and this does not get better within a few weeks after the diagnosis or injury, talk with your child’s doctor about getting additional help.

How can you help your child who isn’t talking about it or seems withdrawn?

Be patient with your child
  • Strong feelings are common but temporary reactions to the injury, illness, and hospital experience.
  • Younger children’s early reactions- including crying, whining, clinging or acting out- are common and expected in small amounts.
  • Teens may feel confused, angry, or scared. Remind them these feelings are okay.
  • If your child or teen’s behavior gets to be too much, it’s okay to set rules and limits like you would normally.
  • Work with the medical team while in in the hospital to plan a daily routine so that things are more predictable and familiar.
Younger children are often more upset at being left alone
  • When you are not with your child at the hospital, have a family member or familiar adult stay with your child.
  • Always tell your child when you are leaving, why, and when you’ll be back.
Help your child connect with family and friends
  • Everyone needs some time alone, but be sure that your child also spends some time with friends and family.
  • Encourage your child to to keep in touch with friends by phone, email, text, or social media on a regular basis.
  • Talk ahead of time about how to explain the injury, illness, or treatment complications/side effects and answer questions.
  • While at the hospital, ask your child’s nurse to introduce your child to others on the floor with similar experiences.
  • Being in the hospital can increase feelings of loneliness, especially in teens.
  • If you notice that your child seems less interested in being with people he/she usually enjoy, bring this up with your child and help them sort out their feelings by asking questions and listening.
Let your child know you’re available to listen when he or she is ready
  • If your child does not want to talk about things now, “keep the door open” for talking at your child’s time and pace.
  • Encourage connections with friends and with adults you both trust.
  • In the hospital, use phone, email, and other ways to stay in touch.
Encourage your family to share feelings
  • Remember everyone in the family can be affected – often in different ways.
  • Talking about what things have been like for each person is often helpful.
  • Talks can happen in different ways at different times (dinnertime, bedtime) and in different places (in the car, at home, in the hospital).
Help your children name their feelings, such as being sad, scared, lonely, or angry
  • Sharing your own feelings can show children that it’s okay to do the same.
  • When children or other family members talk, accept their feelings and be a good listener, even if what they have to say is hard to hear.
  • You know your child and how she or he likes to share thoughts and feelings.
  • Younger children might show them through play, drawing, or telling a story.
  • Older children or teens might want to write about their experiences and feelings, or express them by writing poetry, a song, or drawing).
Help them get back to their normal routine as quickly as possible
  • Notice if your child seems withdrawn or is losing interest in things they used to enjoy.
  • To help with emotional recovery, it’s important for your child to get back to his/her normal routine as much as possible (taking their physical condition in to account).
  • Encourage them to do their usual activities, even if they don’t really feel like it at first (this is usually the best way to start feeling a little better).
  • Make a plan for the week’s activities.
  • Start with small steps and build on these.
Listen to one mom talk about the benefits of talk therapy:

Helpful Resources:

  • At the Hospital: Helping My Child Cope
  • En el hospital: Cómo ayudar a mi hijo a sobrellevar la situación
  • Hospital Hero- A Child’s Workbook
  • ¡Héroe Del Hospital! Una historia sobre tu hospitalización
  • Does my child need talk to someone?
  • Do I need to talk to someone?
field_image
Quick links
  • About Us
  • Ethics & Compliance
  • Privacy Policy
  • Terms of Use
Quick Contact
  • cpts@chop.edu
  • 3401 Civic Center Blvd.
    Philadelphia, PA 19104

Subscribe to Health Care Toolbox

CHOP Nemours Logo NCTSN Logo Award 2012

© 2021 Children's Hospital of Philadelphia. All Rights Reserved.