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The International Federation of Red Cross and Red Crescent Societies (2002) and Ehrenreich (2001) emphasize that children's reactions to traumatic events differ slightly among various age groups. Here is an overview of reactions considered typical for each age group.

• Pre-school children (ages 1-5)
• Older children (ages 6-11)
• Adolescence (ages 12-18)
• Adult (18+)

Pre-school children (ages 1-5)

Among pre-school children (ages 1-5), anxiety symptoms may appear in generalized form as fears about separation, fears of strangers, fears of "monsters" or animals, or sleep disturbances. The child may also avoid specific situations or environments, which may or may not have obvious links to the disaster. The child may appear pre-occupied with words or symbols that may or may not be associated with the disaster in obvious ways or may engage in compulsively repetitive play which represents part of the disaster experience. The child may show a limited expression of emotion or a constricted pattern of play may appear. He or she may withdraw socially or may lose previously acquired developmental skills (e.g., toilet training). (Ehrenreich, 2001)

Older children (ages 6-11)

Older children (ages 6-11 or so) may engage in repetitious play in which the child reenacts parts of the disaster or in repeated retelling of the story of the disaster. The child may express (openly or subtly) concerns about safety and preoccupation with danger. Sleep disturbances, irritability, or aggressive behavior and angry outbursts may appear. The child may pay close attention to his or her parents' worries or seem to worry excessively about family members and friends. School avoidance (possibly in the form of somatic symptoms) may appear. The child may show separation anxiety with primary caretakers, "magical" explanations to fill in gaps in understanding, and other behaviors usually characteristic of much younger children. Other changes in behavior, mood, and personality, obvious anxiety and fearfulness, withdrawal, loss of interest in activities, and "spacey" or distractible behavior may appear. (Ehrenreich, 2001)

Adolescence (ages 11-18)

As children approach adolescence, their responses become increasingly like adult responses. Greater levels of aggressive behaviors, defiance of parents, delinquency, substance abuse, and risk-taking behaviors may be evident. School performance may decline. Wishes for revenge may be expressed. Adolescents are especially unlikely to seek out counseling. (Ehrenreich, 2001)

Adult (18+)

For an adult, although the effects of disaster may be profound and lasting, they take place in an already formed personality. For children, the effects are magnified by the fact that the child's personality is still developing. The child has to construct his or her identity within a framework of the psychological damage done by the disaster. When the symptoms produced by disaster are not treated, or when the disaster is ongoing, either because of the destruction wrought (e.g., by an earthquake) or because the source of trauma is itself chronic (e.g., war or relocation to a refugee camp), the consequences are even more grave. The child grows up with fear and anxiety, with the experience of destruction or cruelty or violence, with separations from home and family. Childhood itself, with its normal play, love, and affection, is lost. Longer-term responses of children who have been chronically traumatized may include a defensive desensitization. They seem cold, insensitive, lacking in emotion in daily life. Violence may come to be seen as the norm, legitimate. A sense of a meaningful future is lost. (Ehrenreich, 2001)

Symptoms Shown by School-Aged Children

• Depression.
• Withdrawal.
• Generalized fear, including nightmares, highly specific phobias of stimuli associated with the disaster defiance.
• Aggressiveness, "acting out".
• Resentfulness, suspiciousness, irritability.
• Disorganized, "agitated" behavior.
• Somatic complaints: headaches, gastrointestinal disturbances, general aches and pains. These may be revealed by a pattern of repeated school absences.
• Difficulties with concentration.
• Intrusive memories and thoughts and Sensations, which may be especially likely to appear when the child is bored or at rest or when falling asleep.
• Repetitive dreams.
• Loss of a sense of control and of responsibility.
• Loss of a sense of a future.
• Loss of a sense of individuality and identity.
• Loss of a sense of reasonable expectations with respect to interpersonal interactions.
• Loss of a realistic sense of when he or she is vulnerable or in danger.
• Feelings of shame.
• Ritual re-enactments of aspects of the disaster in play or drawing or story telling. In part, this can be understood as an attempt at mastery. Drawings may have images of trauma and bizarre expressions of unconscious imagery, with many elaborations and repetitions.
• Kinesthetic (bodily) re-enactments of aspects of the disaster; repetitive gestures or responses to stress reenacting those of the disaster.
• Omen formation: the child comes to believe that certain "signs' preceding the disaster were warnings and that he or she should be alert for future signs of disaster.
• Regression: bed wetting, soiling, clinging, heightened separation anxiety.
• Post Traumatic Stress Disorder syndromes much like those of adults, although possibly with less amnesia, avoidance, and numbing evident.