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Psychiatric Injury in Children after road traffic accidents


All road users know what a dangerous place the road is and children are particularly vulnerable. According to the Transport Statistics of Great Britain 2008, in 2007 a horrifying 56,000+ children and teenagers were killed or injured in road traffic accidents. Some of these children will have sustained psychological as well as physical injury. There are a number of possible psychological reactions, among them normal stress response and then recovery, depression, anxiety and also post traumatic stress disorder.

Although there is a widespread ignorance of post traumatic stress disorder (PTSD) in children, it is, in fact, quite common. The child who has sustained PTSD may not necessarily have been directly involved in the incident but may have witnessed the involvement of a parent or loved one. Thus there may be a psychological injury even though the child has not been physically hurt. Whilst they by no means provide a conclusive diagnosis, the appearance of regressive behaviours, such as a return to bed wetting or recurring nightmares, or aggressive behaviour, or a child becoming more withdrawn can all be indications that the child is suffering with PTSD. Among my clients I have come across a fear of motorised transport, a refusal to travel alone, a fear of crossing roads, a refusal to sleep alone, anxiety and mood swings. All these behaviours are upsetting for the child and the parent, and can be difficult to manage.

I often hear from parents that they consciously avoid discussing the accident which led to their child’s injury in front of the child for fear of aggravating matters and upsetting the child. Unsurprisingly, therefore, the psychiatric consequences of an accident can be overlooked, or perhaps not recognised at all. Even in cases where the parent is aware that there has been a psychiatric consequence, through the prevalence of nightmares about the accident in question, or an obvious aversion to car travel, for example, it might seem wrong to inflict further investigation and treatment on a child, particularly one who may have had to spend considerable time in hospital recovering from physical injuries. Parents may believe that they are protecting their child by not exploring the psychological symptoms and reassure themselves that whatever it is will improve with time alone. Unfortunately this rarely proves to be the case in practice. Psychiatrists say that the sooner a condition receives attention the better the chances of a quick and entire recovery.

Parents need not fear that they will be excluded from the treatment process. The involvement of the parent(s) in the treatment will be key. The treating psychologist will want to see how the parent interacts with the child and will help the parent to understand and control the child’s behaviour. The good news is that children on the whole respond very well to psychological treatment. They tend to need less treatment because they have less mental “baggage” than do adults. Usually fewer than 10 sessions will be needed.

When a claim for personal injury is brought on behalf of a child any settlement agreed between the parties has to be approved by a Judge at an Infant Settlement Hearing. The court will always invite the litigation friend (usually a parent) to comment on the child’s current condition. If there is any suggestion that a child has not recovered from injuries because appropriate treatment has been wanting, or that the compensation is inadequate because the extent of the injuries has not been properly investigated then the settlement will not be approved. A good personal injury solicitor will ensure that all necessary and appropriate medical evidence has been obtained and in cases of child psychological injury this will mean that the child has been seen by a child psychiatrist and probably had some kind of formal treatment with a specially trained clinical psychologist.

One of the benefits of bringing a personal injury claim for a child is that access can be obtained to treatment which might not be so readily available on the NHS where resources are limited. Another benefit is that the ultimate goal of your solicitor will be the same as yours: either to have seen your child recover or to have set your child well on the road to recovery.


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