What Trauma Looks Like

Too often the normal response of trauma in children and adolescents is viewed as negative behavior, for example physical aggression or substance abuse. When it is viewed and treated as such, the traumatic experience itself remains unaddressed and the child’s development is impacted. In fact, Post-Traumatic Stress Disorder is often misdiagnosed in children because symptoms present as behavioral issues (1). According to Yoder, an individual can present trauma through “acting in” behaviors in which the person turns the trauma in on oneself, or “acting out” behaviors, in which the person turns the trauma outward towards others (2).

"A lot of these kids get labeled as being bad, difficult, defiant. This is a very natural response to their circumstances. What the child is doing is a survival strategy for them, but it creates behaviors that are very difficult in the classroom, and when they  are in a crisis mode, they can't learn." Linda Chamberlain, First Impressions - Exposure to Violence and a Child's Developing Brain (3)


It is important to recognize this cycle of “acting in” and “acting out” in a non-linear process and is a natural response to experiencing trauma. Yoder provides the following examples of these behaviors (2).

Acting in

  • Substance abuse
  • Overeating or not eating
  • Self-mutilation
  • Depression
  • Anxiety
  • Physical ailments (somatic complaints)
  • Suicidal ideation

Acting out

  • Physical or verbal aggression
  • Gang activity
  • Criminal activity
  • Running away
  • High risk sexual behavior
  • Repetitive conflict

A short video by Dr. Peter Levine, PhD reviews the physical signs and behaviors of children experiencing trauma. He discusses what the behaviors actually mean and how addressing the behaviors can help a child heal from their trauma (3).

Click here to see how Head Start-Trauma Smart, designed by the Crittenton Children’s Center, shows their trauma informed response to the acting in and acting out behaviors (4).


  1. Rennison, C., & Taylor, L.A. (2013). Recognition and treatment of posttraumatic stress disorder.  Journal of the American Academy of Physician Assistants, 26(3), 64-66.
  2. Yoder, C. (2005). The little book of healing trauma: When violence strikes and community security is threatened. Intercourse, PA: Good Books.
  3. First Impressions - - Exposure to Violence and a Child's Developing Brainhttps://www.youtube.com/watch?time_continue=432&v=GuWkqF-WfOM
  4. Kids in the House (2013). Signs of Trauma in Kids – Peter A. Levine, PhD. Retrieved from http://youtu.be/pWSOEhJMCfk
  5. Robert Wood Johnson Foundation (2014). Head Start- Trauma Smart. Retrieved from http://youtu.be/bXzKVpiSzH8