Safe Start: Working Together to Help Children Exposed to Violence

Infants (birth to 12 months)

Building a sense of security in an environment in which infants can trust 

parents, family members, and others to lovingly take care of their needs is the 

most important developmental task of infancy. When infants are exposed to 

violence, the world begins to feel like a scary place. The attachment process is 

affected because the environment is not trustworthy and dependable. 

Some of the warning signs of exposure to violence for infants include:

■ Changes in sleeping and eating patterns

■ Clinginess

■ Difficulty separating from adults (especially parents)

■ Inconsolable crying

■ Fear of new things

■ Being easily startled

■ Sadness

Trauma-Informed Care for Children Exposed to Violence

Tips for Early Childhood Providers

What happens when children are exposed to violence?

Children are very resilient—but they are not unbreakable. No matter what their age, children are deeply hurt when 

they are physically, sexually, or emotionally abused or when they see or hear violence in their homes and communities. 

When children see and hear too much that is frightening, their world feels unsafe and insecure. 

Each child and situation is different, but exposure to violence can overwhelm children at any age and lead to problems 

in their daily lives. Some children may have an emotional or physical reaction. Others may find it harder to recover 

from a frightening experience. Exposure to violence—especially when it is ongoing and intense—can harm children’s 

natural, healthy development unless they receive support to help them cope and heal.

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. People from different cultures may have their own ways of showing their 

reactions. How a child responds also varies according to age. 

Toddlers (13–16 months)

Growing feelings of independence and beginning to use words or gestures to 

communicate are the key developmental tasks during these months. When 

children are exposed to violence the development of language, curiosity, and 

exploratory skills are interrupted.

Some of the warning signs of exposure to violence in toddlers include:

■ Difficulty paying attention

■ Isolation

■ Fearfulness

■ Aggressiveness

■ Anxious reactions to loud noises

■ Stomachaches and other physical complaints
Safe Start: Working Together to Help Children Exposed to Violence

2 Children Exposed to Violence: Tips for Early Childhood Providers

What can early childhood care and education providers do?

There are many ways in which early childhood caregivers 

can help young children who have been exposed to 

violence begin the healing process:

■ Help children feel safe by having consistent 

routines and establishing clear and developmentally 

appropriate expectations for their behavior

■ Learn to understand children by observing their 

daily routines and behavior and identifying any 

changes

■ Help children identify, label, and express feelings

■ Help children feel they have control over their lives 

by providing opportunities to take pride in their 

accomplishments and accept themselves as unique 

individuals

■ Encourage and model nonviolent ways to interact 

and play

■ Limit children’s exposure to violent media

■ Learn to deal with difficult behaviors such as fear 

about separation, breaking the rules, nightmares, 

and regression 

When is professional help recommended?

Certain behaviors may indicate the need to recommend 

a consultation with a pediatrician, family doctor, or a 

mental health professional. Here are some behaviors to 

watch for:

Infants. Babies grow so rapidly during their first year 

that “normal” development varies greatly from child to 

child. However, it may be necessary to seek professional 

help if the baby shows no curiosity, extreme passivity, 

lack of response to adults, and constant difficulties 

sleeping or eating.

Toddlers. Danger signs for toddlers include extended 

periods of sadness, loss of interest in daily activities, 

loss of sleep or appetite, and exaggerated fear of being 

alone. Abrupt changes in behavior, such as hyperactivity, 

may be another sign of a need for professional guidance.

Preschoolers. Early care providers may consider 

seeking professional help when preschoolers withdraw 

from adults, peers, and friends; show reactions of panic; 

appear depressed or unhappy much of the time; act 

much younger for an extended period; or constantly 

misbehave in school in ways that are not typical for the 

child. 

Preschoolers (11⁄2–5 years)

Critical developmental tasks during these years include separating fantasy from 

reality, realizing how thoughts and feelings are related to consequences, and 

playing cooperatively with peers.

Exposure to violence during this period may distort children’s thinking about 

themselves and the world around them. Some of the warning signs of exposure 

to violence include:

■ Atypical aggressive behaviors

■ An increasing desire to withdraw from those around them

■ Repeating the events in play or stories

■ Loss of appetite

■ Loss of previously developed skills

■ Difficulty concentrating
Safe Start: Working Together to Help Children Exposed to Violence

3 Children Exposed to Violence: Tips for Early Childhood Providers

Mandated Reporting

Many children experiencing crises or violence are also at risk for child abuse and neglect. 

All States have child welfare systems that receive and respond to reports of child abuse and 

neglect, offer services to families, provide foster homes for children who must be removed from 

their parents’ care, and work to find permanent placements for children who cannot safely 

return home.

Domestic violence does not equal child abuse and neglect, and therefore not all cases of 

domestic violence must be reported to child protective services. When responding to families 

affected by domestic violence, it is very important to consider simultaneously the safety of the 

child and the safety of the adult victim.

State by State information on reporting requirements can be found at http://www.childwelfare.

gov/systemwide/laws_policies/state.

Additional Resources

Cohen, E., & Kaufmann, R. (2005). Early Childhood Mental Health Consultation. Rockville, MD: Center for Mental Health 

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

http://store.samhsa.gov/shin/content/SVP05-0151/SVP05-0151.pdf

Cohen, E., & Knitzer, J. (2004). Young Children Living with Domestic Violence: The Role of Early Childhood Programs. In S. 

Schechter & J. Knitzer (Eds.), Early Childhood, Domestic Violence, and Poverty Paper Series, #2. Iowa City, IA: University of 

Iowa School of Social Work. http://www.nccev.org/pdfs/series_paper2.pdf 

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

Seitzinger, K. (2011). Tutorial 6: Recognizing and Addressing Trauma in Infants, Young Children, and Their Families. 

Strengthening Early Childhood Mental Health Consultation in Head Start and Early Head Start. Washington, DC: Center for 

Early Childhood Mental Health Consultation, Georgetown University Child and Human Development Center. 

http://www.ecmhc.org/tutorials/trauma/index.html

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