Changing the course of children’s lives 

 by changing the course of their care
Established by Congress in 2000, the National 

Child Traumatic Stress Network (NCTSN) brings a 

singular and comprehensive focus to childhood 

trauma. NCTSN’s collaboration of frontline 

providers, researchers, and families is committed 

to raising the standard of care while increasing 

access to services. Combining knowledge of 

child development, expertise in the full range of 

child traumatic experiences, and dedication to 

evidence-based practices, the NCTSN changes 

the course of children’s lives by changing the 

course of their care. 

 

This project was funded by the Substance Abuse 

and Mental Health Services Administration 

(SAMHSA), US Department of Health and Human 

Services (HHS). The views, policies, and opinions 

expressed are those of the authors and do not 

necessarily reflect those of SAMHSA or HHS.

Writing/editing: Deborah A. Lott

Design: Sue Oh Design

Sandy King/Stone/Getty Images
Traumatic events are common in the lives of 

America’s children. 

Every year millions of children and adolescents in the United States experience 

traumatic events. Some of these events are single occurrences. Others, such 

as abuse, neglect, and witnessing domestic violence, may be ever-present 

features of a child’s life. A recent, nationally representative survey of 1400 

American youths found that more than two thirds had experienced at least 

one significant traumatic event by the age of 16. More than one third reported 

exposure to multiple kinds of trauma.

Child traumatic stress is one of our most 

underrecognized public health problems.

Childhood traumas vary from physical and sexual abuse to community and 

domestic violence, life-threatening illness, natural disasters, and the sudden 

loss of parents, siblings, and other loved ones. Though children are resilient, 

they can also be profoundly affected by these experiences. With help, they can 

recover and thrive. Without it, trauma’s effects can derail their childhoods and 

reverberate into adult life. Yet child traumatic stress remains one of our most 

underrecognized public health problems. 

A 16-year-old witnesses the 

shooting of her best friend 

in a random act of community 

violence. 

A 12-year-old believes that he 

will be killed as he is beaten 

once again by his alcoholic 

stepfather. 

Two terrified toddlers huddle 

together with their parents 

as a hurricane takes the roof 

off their house. 
Many children suffer 

from traumatic stress.

In the aftermath of traumatic events, 

many children suffer from traumatic 

stress. They do not just forget and 

move on. Instead, they may become 

nervous, fearful, and easily startled. 

Images and feelings from the trauma 

repeat in their minds uncontrollably. 

They may have trouble sleeping or 

recurrent nightmares. Unable to 

concentrate or focus, they may begin 

to perform poorly in school. They feel 

distanced from their friends and lose 

interest in favorite activities. To avoid 

distressing physical and emotional 

reactions to reminders of the trauma, 

they withdraw even further from 

relationships and activities. As they 

struggle to make sense out of 

what has happened, they may feel 

responsible and blame themselves. Anya Brewley Schultheiss/Flickr/Getty Images
Childhood traumatic stress can derail a child’s 

healthy development.

In the long run, childhood trauma may have far-reaching impacts, and can derail 

the course of healthy development. Traumatic stress can adversely affect a 

child’s memory, attention, behavior, and emotional and social life. A growing 

body of research shows that traumatic stress can change the biology of the 

brain and nervous system. It can deplete a child’s capacity to bear ordinary life 

stresses. It can even alter the structure of the developing brain. 

Trauma, and the problems that often follow in its wake, can damage a child’s 

trust in a safe world. Children who’ve experienced significant trauma often cannot imagine or plan for a positive future. An adolescent with a history of trauma 

may be unable to accurately gauge danger and so may be overly fearful, or not 

fearful enough, and indulge in high-risk behaviors. 

“The training I received from the NCTSN helped me understand what was driving 

my foster child’s behavior. For the first time, I understood it was not about me. 

Despite the challenges, I was able to keep this child in my home, and now we are in 

the process of adopting.”

resource parent

Ignoring childhood trauma 

carries a large societal cost.

Poverty, crime, low academic achievement, addiction, mental illness, and 

chronic disease all have roots in 

untreated childhood traumatic stress. 

Every year, billions of dollars are 

spent in the United States to address 

the serious consequences of ignoring 

this public health problem. Aldo Murillo/Vetta/Getty Images
The effects of childhood trauma 

reach into adulthood.

Ongoing, large-scale studies have traced the 

legacy of untreated childhood trauma into 

adulthood. People with histories of childhood 

trauma, particularly severe or repeated trauma, 

are at higher risk of developing psychiatric 

disorders such as depression. They are more 

likely to abuse alcohol and other substances. 

Their bodies may respond abnormally to stress. 

Even the risk of chronic physical conditions, 

such as heart and lung disease, may be 

significantly increased. 

“My therapist understood me and took in everything I was saying, and that helped me a lot. 

As I got older and went through different events 

in my life, I developed a strength I would not have 

had if I hadn’t received trauma services.” 

youth who received treatment 

from an nctsn center

Sage Corson/Flickr/Getty Images Jetta Productions/Lifesize/Getty Images
Child traumatic stress is one of the most treatable 

mental health problems of childhood.

Despite its potentially serious consequences, childhood traumatic stress 

is one of the most treatable mental health problems of childhood. With rapid 

intervention, a child’s life can be put back on track. Children who receive timely 

and appropriate treatment may not only recover, but gain the tools and capacity 

to cope more successfully with future stress. When helped to put what has 

happened to them into perspective, children are able to plan for their futures. 

Often they develop greater empathy for the suffering of others and a desire to 

help their communities and larger society. 

The National Child Traumatic Stress Network 

(NCTSN) brings a singular and comprehensive focus 

to child trauma.

Comprised of grantee centers across the country and a coordinating center 

based at UCLA and Duke University, the NCTSN has raised the visibility of 

this public health problem and sparked new approaches to addressing child 

traumatic stress. This strong collaborative network brings together leading 

experts in the field, frontline providers, and families to increase the pace of 

advances in care and move scientific gains quickly into practice. 

Mimi Haddon/Stone/Getty Images
Transforming Trauma Treatment

Since the launch of the NCTSN

n Hundreds of thousands of children have received effective, culturally sensitive, 

evidence-based assessment and treatment for child traumatic stress.

n Nearly a million providers have been trained in best practices.

n Family members and consumers have offered valuable input to ensure 

that treatment addresses the real needs of families and is responsive to 

their concerns.

n Data from more than 14,000 children treated by the NCTSN have provided 

an unprecedented portrait of child trauma in America; this information is 

used to improve care and shape national child policies. 

n Innovative and engaging new learning models, such as the NCTSN Learning 

Collaborative, ensure that changes in practice take hold and are sustained 

in service agencies across the country. 

n The NCTSN Core Curriculum on Childhood Trauma has identified the most 

important principles of trauma treatment across theoretical models 

and disciplines. It has become a model in the field for innovative trauma 

education. 

“The NCTSN has had a powerful influence on individual clinicians like me, particularly 

in small and rural communities. We can play an important role in influencing our entire 

community to adopt more trauma-informed approaches.” 

nctsn provider

Milan Zeremski/The Agency Collection/Getty Images
Bringing A Trauma 

Perspective to the Systems 

that Serve Children

To reduce the effects of trauma on the 

lives of children, it is important to not 

only transform trauma assessment 

and treatment, but to bring a trauma 

perspective to every system and 

institution that serves children. The 

NCTSN is a catalyst for transformative 

systems change. It works directly with 

those systems – healthcare, juvenile 

justice, law enforcement, child welfare, 

education, foster care – that have the 

greatest impact on children’s lives. 

The NCTSN has created practical 

and effective tools to ensure that 

everyone who works closely with 

children recognizes the role of trauma 

and takes appropriate actions to help 

children recover. 

Alistair Berg/Digital Vision/Getty Images
Here are a few examples of NCTSN products and 

initiatives for systems change:

n The Child Welfare Trauma Training Toolkit. A comprehensive 

curriculum for child welfare workers.

n Cops, Kids, and Domestic Violence. A DVD to train police officers 

in how to reduce the traumatic impact for children of a domestic 

violence call.

n Caring for Children Who Have Experienced Trauma: A Workshop for 

Resource Parents. A comprehensive curriculum, taught by a mental 

health professional and a foster parent mentor, to teach resource 

parents how to help the traumatized children in their care.

n Psychological First Aid. A print and online evidence-informed 

approach to enable first responders and volunteer workers to meet 

the immediate needs and concerns of disaster survivors. 

n Child Trauma Toolkit for Educators. A guide that provides school 

administrators, teachers, staff, and parents with basic information 

about working with traumatized children in the school setting.

n Ten Things Every Juvenile Court Judge Should Know about Trauma 

and Delinquency. A technical assistance bulletin highlighting crucial 

facts judges should know so they can best meet the needs of 

traumatized children involved with the court system. 

For more information about the 

NCTSN, a listing of local centers, 

and suggestions on what you can do 

to help, visit www.NCTSN.org. 

You can also send questions via 

e-mail to info@NCTSN.org.
Educating Families and 

Communities

The support of family, community, and 

society is crucial to reducing trauma’s 

impact on children. Families and communities already know this intuitively but 

need targeted information and proven 

tools. Through our Web site (NCTSN.org), 

public education efforts, and online 

Learning Center (http://learn.nctsn.org), 

the NCTSN has become the foremost 

source of reliable and comprehensive 

information on child traumatic stress for 

families, communities, and the public.

“When the NCTSN started, no one in our 

area knew about child traumatic stress. 

Now judges are ordering trauma-focused 

assessment and treatment from the bench. 

Participation in the Network has really 

transformed our community.” 

nctsn member
www.nctsn.org