In 1994, over 45,000 children under 16 in Britain were injured in road accidents, of whom about 7200 were seriously injured and 300 died. The medical services which treat such accidents rarely consider the emotional needs of the children involved. The authors' clinical experiences clearly indicate that some children suffer severe post-traumatic stress after an accident. This chapter presents their study of the psychological consequences of accidents to their child survivors, and discusses possible risk factors associated with more severe emotional reactions. Until recently, many researchers relied on reports by parents and teachers, instead of questioning children directly, so that individual psychopathology was overlooked and levels of distress were greatly underestimated. In older children, sleep disturbance is very common. The associated factors, in accidents involving children, include individual and family factors, and the emotional impact on children. The case studies of two of the injured children are described in moderate detail. There is at present a lack of systematic prospective research on the psychological effects of accidents on children. The risk and protective factors which might influence post-traumatic responses in such children need examination. These children need more psychological support.
Abstract