Young Children (5 and younger)

Young children bear a disproportionate share of violence and abuse in the home. 

Exposure to domestic violence (abuse between adult partners in the home) affects 

many young children. When very young children are exposed to violence, their 

expectations for a predictable world are shattered and they may lose the basic trust 

that a caregiver will emotionally and physically protect them. 

Children in this age range may respond in a variety of ways. They may: 

■ Be irritable or fussy or have difficulty calming down

■ Become easily startled

■ Resort to behaviors common to being younger (for example, thumb sucking, 

bed wetting, or fear of the dark)

■ Have frequent tantrums

■ Cling to caregivers

■ Experience changes in level of activity

■ Repeat events over and over in play or conversation

■ Become passive and lose interest in playing

■ Become over-compliant

Trauma-Informed Care for Children Exposed to Violence

Tips for Child Welfare Staff

What happens when children who are involved in the child welfare system are exposed to 

violence?

Children who are in the child welfare system have been affected by abuse, neglect, and/or domestic violence. Many 

of these children have experienced physical attacks, violations, and injuries. Once in the system, they face other 

stressors caused by the very system that was designed to protect them and remedy the situations that brought them 

into the system in the first place. For example, when children are separated from their families, their relationships 

with caregivers are ruptured, they are uprooted from familiar surroundings, and their daily routines are destroyed. In 

the child welfare system, families often face uncertainty and instability that can continue for years.

Violent events can cause ongoing and overwhelming feelings of hopelessness and fear. They may be compounded 

by other stressors, among them school and community violence, poverty, and homelessness. These issues have a 

cascading effect and leave children vulnerable to further victimization and increase the likelihood of school failure, 

substance abuse, and involvement in criminal activities. Later in their lives, these children may drop out of school or 

end up in programs for runaways, delinquents, or substance abusers.

Early and effective intervention can help children involved in the child welfare system begin a healing process and 

ultimately thrive. Child welfare workers can be more responsive to the needs of children exposed to violence and their 

families once they understand the impact of that exposure and become more knowledgeable about the symptoms to 

watch for. An effective response gives children the opportunity to regain a sense of safety and ultimately recover from 

the effects of exposure to violence. 

What are some of the warning signs of exposure to violence?

Children’s reactions to exposure to violence can be immediate or appear much later. Reactions differ in severity 

and cover a range of behaviors depending on the frequency, intensity, and closeness of the traumatic events. Many 

reactions vary according to a child’s age. 
Safe Start: Working Together to Help Children Exposed to Violence

2 Children Exposed to Violence: Tips for Child Welfare Staff

Elementary School-Age Children (6–12 years)

Elementary and middle school children exposed to violence may show problems at 

school and at home. They may:

■ Have difficulty paying attention 

■ Become quiet, upset, and withdrawn

■ Be tearful and sad and talk about scary feelings and ideas

■ Fight with peers or adults

■ Show changes in school performance

■ Want to be left alone

■ Eat more or less than usual

■ Get into trouble at home or school

Teenagers (13–18 years)

During these years, the most rapidly developing brain areas are those crucial for 

success in forming interpersonal relationships and solving problems. Exposure to 

violence impedes this development and can lead to difficulties in behavior, cognition, 

and identity formation. Teenagers exposed to violence may:

■ Talk about the event all the time or deny that it happened

■ Refuse to follow rules or talk back with greater frequency

■ Complain of being tired all the time

■ Engage in risky behaviors

■ Sleep more or less than usual

■ Increase aggressive behaviors

■ Want to be alone, not even wanting to spend time with friends

■ Experience frequent nightmares

■ Use drugs or alcohol, run away from home, or get into trouble with the law

What can child welfare staff do?

Child welfare staff can play a critical role in reducing the impact of exposure to violence on children. The first step 

is to recognize that a lifetime of exposure to violence is pervasive in families entering the system. Rates of exposure 

to different types of violence—including family, school, and community violence—vary across different groups. 

Families from different ethnic and linguistic groups may express the impact in different ways. However, it is critical to 

be sensitive to the ways in which exposure affects current behavior, treatment, and outcomes for each family. Child 

welfare staff may: 

Screen for exposure to violence symptoms and mental health needs of children and their families on an ongoing basis

Routine screening for safety and risk in cases of exposure—especially to domestic violence—and the possible impact 

on children is recommended at every phase of the child protection process. In addition, it is critical for child welfare 

staff to screen for the ongoing mental health service needs of children and their families. 

Refer for individualized comprehensive mental health assessment

Many children in the child welfare system exhibit behavior problems that warrant mental health care. An assessment 

of a family’s history of exposure to violence and its impacts provides a solid basis for the development of a service 

plan. This plan should assist the family in resolving the issues that led to their involvement in the child welfare system 

and, at the same time, support each child’s development and well-being.
Safe Start: Working Together to Help Children Exposed to Violence

3 Children Exposed to Violence: Tips for Child Welfare Staff

Plan for individualized interventions that take 

into consideration traumatic experiences for 

both caregivers and children, which may be 

affecting the current family situation

Children’s responses to violence differ based on age, 

gender, and life history. Treatment plans must be 

adjusted to ensure individualization, age appropriateness, 

and family history. In every case, however, it is critical 

that the treatment plan help the child and caregivers 

reestablish a normal routine, safety, and predictability. 

In addition, it is important to realize that families and 

other caregivers may have been exposed to violence 

themselves and may display signs of reaction to trauma. 

In such cases, it is critical to develop specific plans and 

structures that help caregivers address their own needs 

so that they can become a powerful anchor to the child’s 

treatment.

Facilitate access to evidence-based 

interventions

Child welfare workers understand the needs that families 

have, and they advocate for specialized services for 

those children with severe and persistent trauma-related 

symptoms. However, these specialized interventions are 

not a substitute for other needed services.

The report Evidence-Based Practices for Children 

Exposed to Violence: A Selection from Federal 

Databases1 describes several interventions that have 

shown success in decreasing negative symptoms in 

children who have been exposed to violence. In addition, 

this report provides information on several common 

characteristics of effective treatments for children. 

Help for child welfare staff exposed to violence

Child welfare workers may have been exposed to violence 

directly or indirectly. Exposure to violence may come from 

their own families and communities or from the families 

they serve. To be able to effectively respond to children’s 

and families’ needs, child welfare workers should 

develop their own plan for resolving personal issues and 

addressing job stressors.

Additional Resources

Cohen, E., McAlister Groves, B., & Kracke, K. (2009). Understanding Children’s Exposure to Violence. Moving from Evidence to 

Action: The Safe Start Series on Children Exposed to Violence, Issue Brief #1. North Bethesda, MD: Safe Start Center, Office 

of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. 

http://www.safestartcenter.org/pdf/IssueBrief1_UNDERSTANDING.pdf

Family Violence Prevention Fund. (2009). Connect: Supporting Children Exposed to Domestic Violence, In-Service Training for 

Resource Families. San Francisco: Family Violence Prevention Fund. http://www.endabuse.org/content/features/detail/1314/ 

National Child Traumatic Stress Network. (2010). Caring for Children Who Have Experienced Trauma: A Workshop for Resource 

Parents. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. 

Department of Health and Human Services. http://www.nctsnet.org/products/caring-for-children-who-have-experienced-trauma

National Child Traumatic Stress Network. (2008). Child Welfare Trauma Training Toolkit. Rockville, MD: Center for Mental 

Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human 

Services. http://www.nctsnet.org/products/child-welfare-trauma-training-toolkit-2008

___________________________________

1The report is available at http://www.safestartcenter.org/pdf/Evidence-Based-Practices-Matrix_2011.pdf.

For more information and resources, please contact the Safe Start Center, 

a National Resource Center for Children’s Exposure to Violence:

http://www.safestartcenter.org 

1-800-865-0965

info@safestartcenter.org