November 17, 2005
Kids in Car Crashes May Suffer Traumatic Stress
By Charnicia E. Huggins
NEW YORK -- Children involved in motor vehicle crashes may show signs of acute stress disorder, even if they experienced only minor cuts and scratches, new research shows.
"Traffic crashes cause more than injuries for many children and their parents," study author Dr. Flaura K. Winston, an associate professor of pediatrics at the University of Pennsylvania, told Reuters Health.
"While most are resilient, traumatic stress can occur in both children and their parents after crashes," added Winston, the founder and co-director of TraumaLink, a pediatric trauma research center based at the Children's Hospital of Philadelphia and the University of Pennsylvania.
Each year, more than 1.5 million children in the United States are exposed to motor vehicle crashes and about 300,000 of them are injured.
Within the first month after a motor vehicle crash, roughly 25 percent of children hospitalized with injuries, and their parents, are known to experience acute stress disorder (ASD) symptoms, such as re-experiencing the trauma through intrusive thoughts or images, and sleep difficulties.
Research on traumatic stress after motor vehicle crashes has primarily been conducted among those receiving care in medical treatment settings, but they represent only a small proportion of affected individuals. Previous investigations have revealed that most children exposed to motor vehicle crashes are not injured, and, in many cases, those who are injured do not always seek medical treatment.
To more fully determine the prevalence of ASD symptoms in children and their parents after motor vehicle crashes, Winston and her colleagues conducted telephone surveys of parent drivers and their 5- to 15-year-old children, based on a crash surveillance system and insurance claims. Their study sample of 1,091 crashes involving 1,483 children is representative of 24,376 children in 18,422 crashes.
Overall, 1.6 percent of the children experienced ASD symptoms, as did nearly 5 percent of the parents, Winston and her team report in this month's Archives of Pediatrics and Adolescent Medicine.
Children most likely to exhibit such symptoms were those who were injured during the crash and those who received medical care, the report indicates.
For example, children who experienced concussions, fractures or other consequential injuries were nearly seven times more likely to experience ASD symptoms than those who were not injured. Children with cuts and scratches and other mild injuries were about three times more likely to experience ASD symptoms.
For parents, ASD symptoms were most common among those whose child was injured, those whose child received medical care and those involved in more severe crashes, whose vehicle could not be driven afterwards.
"Because of the high exposure of children to traffic crashes, health care professionals should consider screening children and their parents for traumatic stress symptoms when exposure has occurred," Winston and her team conclude.
The study is part of the on-going Partners for Child Passenger Safety research, for which Winston serves as principal investigator. The research involves a collaborative effort between The Children's Hospital of Philadelphia and State Farm Insurance Companies.
More information about child passenger safety, injury and violence prevention is available at TraumaLink online at www.chop.edu/traumalink/.
SOURCE: Archives of Pediatrics and Adolescent Medicine, November 2005.