Counsellors are waiting for Christchurch children to return to school after their holidays to see those not coping with the latest spate of earthquakes.
Continuing quakes over the past 16 months have resulted in many families seeking help for children who can't sleep, won't leave their parents' side or are showing other behaviour problems.
Counsellors say many of the most traumatised children improved as the quakes died down, but there is concern the latest series of quakes might have set that progress back.
Canterbury District Health Board child and adolescent mental health social worker Heather Clay said severe cases had not been seen since December 23 - when quakes were as large as magnitude 6 - but the end of the holiday period might change that.
"I suspect the reality of going back to home, school, work - that kind of thing - in the next few weeks is more likely to bring (the quake effects) on.