What Does It Mean to Grow Up With Gun Violence?

The mass shooting in Uvalde killed 19 elementary students and two teachers, leaving the community in grief and despair. This also prompted many in the United States to reevaluate and discuss the devastating impact of gun violence.

Early exposure to gun violence could create immediate and traumatic disturbances in a child’s life and go on to disrupt their health and development in the future.

“Everyone has a short-term reaction and change in health and behavior in the immediate aftermath,” Lisa Jaycox, PhD, MA, a senior behavioral scientist and director of RAND-Initiated Research at the RAND Corporation, told Verywell. “Some people gradually recover and others don’t.”

After experiencing a traumatic event, distress responses such as separation anxiety, sleep disturbance, and irritability are common in children. But these experiences often go away in a few months, according to the American Psychological Association (APA).

People who experience long-term distress that interferes with their lives may be diagnosed with post-traumatic stress disorder (PTSD). The rate of PTSD among mass shooting survivors can be higher than 50%.

Children between the ages of 5 and 12 may not have PTSD flashbacks like adults do, but they are more likely to misremember events. Younger children may even play pretend shooting games after witnessing a school shooting.

But most children with traumatic exposure are not identified or do not receive proper treatment, especially those from racial minority groups or living in poverty.

Physical Consequences of Trauma

In a TED talk about the physical impact of repeated traumatic experiences in childhood, Nadine Burke Harris, MD, MPH, FAAP, surgeon general of California and cofounder of the Center for Youth Wellness, described the body’s alarm response to seeing a bear.

“Your heart starts to pound, your pupils dilate, your airways open up, and you are ready to either fight that bear or run from the bear—and that is wonderful if you’re in a forest and there’s a bear,” Burke Harris said.

In non-urgent situations, an active fight-or-flight response can do more harm than good. It may cause children to feel scared, angry, irritable, or withdrawn, according to the Substance Abuse and Mental Health Services Administration (SAMSA).

“Children are especially sensitive to this repeated stress activation because their brains and bodies are just developing,” Burke Harris said.

Some other health consequences of trauma include learning problems, diabetes, and heart disease, according to SAMSA. Additionally, trauma is a risk factor for nearly all behavioral health and substance disorders.

Burke Harris focuses her research on adverse childhood experiences (ACEs), which are traumatic events that can affect a child’s long-term health. Experiences related to gun violence are not captured in ACE screening currently, although some researchers suggested they should be.

What Should Care Look Like for Child Trauma?

Healing from trauma can require people to talk about what they went through and, at times, relive it. People with PTSD may also rely on cognitive behavioral therapy (CBT) to process their trauma.

Seeking help early could aid some survivors in their recovery, Jaycox said, but this isn’t always accessible due to expensive and limited treatment options.

Jaycox notices this problem firsthand in her work providing early intervention care for school children who have been exposed to trauma. When she and her team identify a student who is in need of one-on-one therapy, they are often unable to find a quick option and have to keep the student in a group setting.

“It’s really hard to find people the right kinds of services,” Jaycox said.

And a small town may not have a variety of mental health care assets. “Nobody has enough—not even the big cities,” she said.

Living in a tight-knit community like Uvalde may also pose challenges for people’s recovery, because much of the community has been affected by the same trauma and there are few outlets for escape. However, community support can also help people process and work through experience, and neighbors may be able to lean on each other to heal, Jaycox said.

“In a scenario like this, a small town where so many people are affected, everyone’s reeling from the trauma, and people aren’t going to be able to do a lot of planning right away,” Jaycox said. “But as things settle down ... there’s a lot of opportunities to rebuild community, both within the school and in the broader community.”