During infancy and up to about age 2 years, trauma is reacted to by high anxiety, manifested by crying, biting, or other agitated behaviors. The need for human contact is a driving force at this stage. Preschool-age children are more aware of their victimization and may express themselves through reenactment and play about the event. They often exhibit anxious attachment behaviors toward caretakers and may become dramatically less independent, show sleep disturbances, and exhibit regression and withdrawal. From ages 6 to 10, victimization may result in radical behavioral changes, including deterioration of school performance, somatic symptoms, and expression of anxiety through play. In pre-adolescence, effects may include regression, survival guilt, expression of extreme anger, suppression of thoughts and feelings about the event, and psychosomatic illnesses. They also may attribute symbolic meanings to events surrounding the victimization. Reactions to trauma in adolescents most resembles adult post-traumatic stress reactions. They often feel anger, shame, and betrayal, and may act out their feelings through rebellious behaviors. Eating and sleeping disorders are common, and substance abuse, suicidal thoughts, and depression are potential problems. Intervention should be age appropriate, and emphasize a reaffirmation of attachments and relationships and a hopeful future. Parents should be encouraged to tolerate regressive behavior and aggression. The issue of death may have to be dealt with, and additional considerations must be addressed if the victim becomes involved in the criminal justice system.