"The study investigated the range of acute stress symptoms in children and their parents to enable pediatricians to better identify and address the psychological impact of injury," said Dr. Nancy Kassam-Adams, a study coauthor. "Evidence about the prevalence of these symptoms in injured children can help physicians distinguish between normal reactions to trauma and reactions that require further care and follow-up."

The study population was made up of 97 children who were admitted consecutively to an American university children's hospital for accident-related injuries. The children had been injured in a traffic crash in which the child was a passenger, a pedestrian, or a bicyclist.

"A key component to assessing acute stress is that pediatricians understand how both parents and children respond to a child's injury," stated Dr. Flaura Winston, the other study coauthor. "It is normal for parents to be very distressed in the aftermath of a child's injury, yet parents' own acute stress symptoms may influence a child's response to the traumatic event."

Acute stress disorder is a group of symptoms and reactions that may occur within the first month after a traumatic experience. Symptoms include re-experiencing the trauma, avoiding reminders of the trauma, hyperarousal, and dissociation.

Post-traumatic stress disorder exists when symptoms persist for at least one month and begin to impair the individual's everyday function. For adults, symptoms of acute stress disorder soon after a traumatic event are a warning sign for development of post-traumatic stress disorder.

Prior research indicates that even children with minor injuries from a traffic crash are at risk for developing post-traumatic stress disorder, according to information cited by the authors. However, there has been little research available for pediatricians about occurrence of acute stress symptoms and later development of post-traumatic stress disorder in injured children.

In the current study, researchers found that acute stress symptoms were common within the first month after injury. Among injured children and their parents, more than 80 percent experienced at least one significant acute stress symptom. About 25 percent of children and parents experienced broad acute distress, reporting symptoms of dissociation, re-experiencing, avoidance, and hyperarousal. Roughly 40 percent of families were affected by these more pervasive acute stress symptoms, with the injured child, a parent, or both reporting broad distress. Symptoms did not always concurrently occur in both parent and child.

"We need to identify effective ways for health care providers to support distressed parents, so that parents in turn can most effectively help their child to cope with a traumatic injury," stated Dr. Kassam-Adams.

The research outlined in the Pediatrics article has immediate implications for clinical practice, particularly regarding parent education and supportive care for families. The researchers offer recommendations for pediatricians and other primary care providers treating a child who is injured in a traffic crash, including the advice to refer a child or adult to a mental-health professional for additional assessment and care if acute stress symptoms persist for more than one month or impair everyday function.