How PTSD in Foster Children Impacts Long-Term Outcomes

What is Post Traumatic Stress Disorder (PTSD) and its impact on Foster Children?

At seven in the morning, a five-year-old girl woke to the sound of a gunshot.  She heard her mother's voice on the phone, and then there was another gunshot.  She found her family had died when she ran to her grandmother's bedroom.

Since no other family cared for her, she'll now enter the foster system. Her new foster family will provide care for a little girl with PTSD and any other mental illness that may be diagnosed.

On February, 2026, the report stated 5,806 children were in Virginia's foster care.  Of these children,  2,547 are under the age of ten.  This is only one of many stories describing how children become "foster children."

What is Post-Traumatic Stress Disorder (PTSD) in Young Children 

PTSD in children under the age of seven is different from that in adults.  Their developmental stage affects their initial and long-term response and treatment for PTSD.

Experts report that preschool children diagnosed with PTSD demonstrate impaired functioning. This is evident in many aspects of their lives.

They often also develop other mental problems due to this traumatic experience.  These can include Separation Anxiety Disorder and Oppositional Defiant Disorder.  We will examine other forms of complex trauma in this article.

These impairments and symptoms remain stable in the long term.  The very young child doesn't just "get over" PTSD.  Complex post-traumatic stress disorders take time to heal, especially following repeated trauma that many kids in social services care have been through, from verbal abuse to physical abuse and being removed from their biological family.  Still, we all try very hard to care for the child's welfare while they start to heal.

Causes of Early Childhood PTSD

First, it's key to understand that the child's perception of the traumatic event impacts PTSD risk. So, how is childhood trauma defined?  The answer is on an individual basis.

Studies report that about 15 to 43 percent of girls and 14 to 43 percent of boys experience at least one trauma.  Approximately three to 15 percent of girls and one to six percent of boys develop PTSD.

The term Developmental Trauma disorder is often used for pre-verbal children. As with Complex PTSD, it results from prolonged and / or repeated traumatic events. One example is child abuse perpetrated by a familiar person.

Under Standing Child Abuse in Virginia

Many of the cases child services investigates involve child abuse. This can encompass several forms of maltreatment, including:

• Emotional abuse 10%, such as isolation, rejection, or excessive criticism
• Neglect 65% by not providing care, clothing, or food
• Physical abuse 18%
• Sexual abuse 10%

Some believe that two-thirds of child abuse cases never get reported. In 2023, 5 children died every day in the USA; the estimated national number of children dying from abuse and neglect was 1,773 in 2024, in 2024 this number is now 4.8 a slight drop.

Domestic Violence

Experts also report that about 10 percent of children are exposed to domestic violence annually. This may involve physical, sexual, or emotional abuse. Some even witness a murder.

Deaths or Traumatic Events

The PTSD trigger may be a single experience in the family or community. For example, the natural disaster of Hurricane Katrina impacted those caught in the storm. One study focused on 70 children aged three to six from New Orleans.

Studies found that 62.5 percent of those who stayed during Katrina developed PTSD. Among the children who evacuated, the rate was 43.5 percent.

Other causative events can include:

• Severe injury or death of someone close to them
• Violent events such as fires, car crashes, or school shootings
• A friend's suicide
• Witnessing violence in their community

Remember that the child's PTSD risk depends on how they perceive the experience. Other factors include their parent's reaction, the severity, and proximity to the trauma.

Understanding Trauma Foster Care Trauma

Unfortunately, just entering foster care creates trauma for the child. Suddenly, they're living with strange people in a new place. Even though the goal is to give them a safe environment, they suffer additional losses.

They feel disconnected and unsafe without the comfort of their family's routines. Every decision took place out of their control, creating insecurity for children in foster care.

They often didn't even get to see or say goodbye to their parents or siblings. There's no closure, creating stress because they've lost all normally expected outcomes.

Often, the children learn to believe, "I can't trust adults to take care of me." They withdraw and "put up" protective barriers. These children suffer the tragic loss of innocence and feel worthless.

Foster children may never see justice or a resolution to their problems. This creates an unfathomable loss in their lives.

Symptoms of PTSD in Young Children 

Infants respond to their parent's or caregivers' emotions. If the baby senses anxiety, anger, or other distress, it may react in several ways. Examples include fussiness, being hard to soothe, disrupted sleeping and eating patterns, or withdrawal.

Children respond to parental nurturing and emotions between the ages of two and five. Children with PTSD may feel unsafe and have persistent scary memories and thoughts. Examples of PTSD behaviors seen in this age group include:

• Repetitive talking about or "playing" the event
• Irritable outbursts and tantrums
• Excessive tearfulness and crying
• Increased fears of being alone, the dark, monsters, etc.
• Heightened sensitivity to noises and sounds
• Changes in sleeping, eating, and toileting
• Increased separation anxiety and clinginess
• Behavior reversion to thumb-sucking, baby talk, or bed-wetting

Children may think that the disaster will get fixed and their life will return to normal. They may withdraw and feel detached and separated from others. Avoidance is often internalized, so it's hard to see at this age.

Treating PTSD in Children

There are several effective treatments that mental health professionals use for helping infants and very young children. It's vital to assess each unique situation and formulate a care plan to meet their needs. The following describes different approaches used.

• Cognitive Behavioral Therapy (CBT)
• Eye Movement Desensitization and Reprocessing (EMDR)
• Long-term relation-based therapy
• Play therapy

Working with the family is key since PTSD impacts everyone close to the child. In some cases, the causative event leads to the child's removal from the home. This means it's vital to include the foster families in the treatment plan.

How to Provide Trauma Foster Care

So, how do foster parents help their foster children with PTSD? Everyone around them needs to have a calm demeanor and soothing voice when caring for an infant. Consistently meet the baby's needs to work on developing trust and a healthy attachment.

Spend a lot of time holding and making comforting physical contact. Smile and look into their eyes.

Be Patient

With older children, often they've already moved around several times. Invite them to talk about their feelings and experiences. Please don't press the issue, though, as children need to process the information on their timetable.

Be prepared to answer questions they may ask over and over. Encourage family discussions about feelings such as sadness, fear, or anger.

At first, let the child get used to your home. As their comfort increases, give them responsibility so that they feel like part of the family. Be careful not to overstress them.

Be patient and find ways to offer comfort, support, and safety. Invite them to hug or cuddle with you. Remember, this might be a repetition of their trauma if they were abused.

Focus on Effective Communication

Make sure to use language that the child understands. You can also try different methods of communication. Examples include sign language, drawing pictures, or role-playing with toys.

Be Flexible

This is common within the first month. Yet, some children feel numb for a while. Watch for signs and symptoms of PTSD.

People with PTSD need support for their mental health problems, not only PTSD. Understand the risk factors to understand how you can help.

When this wears off, their behavior can deteriorate. You may need to establish new boundaries. Always seek help if you feel overwhelmed, as this will only worsen the situation.

Create Routines 

Establish set routines since young children find this comforting. They know what to expect next in a previously out-of-control world.

Create a daily schedule for mealtimes, storytime, and bedtimes. Practice traditions such as singing a song or prayers before meals and before they go to sleep.

Special Nighttime Considerations

For children who've suffered traumatic events, nighttime can increase their anxiety. After your child is in bed, tell them a story or talk with them. Give them a comfort item and, if age-appropriate, let them come to you if they're scared.

Are You Interested in Exploring Foster Care Services?

Do you feel called to care for children with PTSD in the foster care system? FosterVA is the licensed child placement agencies (Extra Special Parents) initiative. They aim to raise Virginia's awareness of the need for "great foster families."

When great foster parents care for children, they give the gift of resiliency. Their children thrive and survive with a brighter future.

Our team works with parents interested in fostering and/or adopting children of all ages. We'll provide the support needed to make your and your child's dreams come true.