Behavioral assessment and treatment of PTSD in prepubertal children: Attention to developmental factors and innovative strategies in the case study of a family

This paper describes the assessment and treatment of a family of 4 prepubescent children following the experience of a traumatic attack of the 6-year-old girl by a dog. The two eldest children received diagnoses of posttraumatic stress disorder(PTSD), and in addition, the 6-year-old victim developed a simple phobia of medical procedures. The younger children also developed posttraumatic reactions specific to their developmental level. Because the traumatic experience was witnessed by all of the children in the same family, their comprehensive data provide a cross-sectional illustration of the developmental expression of posttraumatic reactions in very young children. Established behavioral treatment approaches for PTSD were adapted to be developmentally appropriate and involved individual hierarchical, imaginal, and in-vivo exposure, coupled with joint sessions utilizing the older sibling as a behavioral model for his sister's simple phobia. This family case study illustrates the use of behavioral assessment and treatment methods in a clinic setting.