3.6 Trauma Informed of Childhood Trauma

Child Development And Trauma Reactions

The following points give an essential perspective for using the information about childhood trauma and its impact on development across specific age groups:

• Children, even at birth, are not ‘blank slates’ – they are born with a certain neurological make- up and temperament. As children get older, these individual differences become greater as they are affected by their experiences and environment. This is particularly the case where the child is born either drug dependent or with fetal alcohol syndrome.
• Even young babies differ in temperament e.g., activity level, amount and intensity of crying, ability to adapt to changes, general mood, etc.
• From birth on, children play an active role in their own development and impact on others around them.
• Culture, family, home and community play an important role in children’s development, as they impact on a child’s experiences and opportunities. Cultural groups are likely to have particular values, priorities and practices in child rearing that will influence children’s development and learning of particular skills and behaviours. The development of children from some cultural backgrounds will vary from traditional developmental norms, which usually reflect an Anglo-Western perspective.
• As children get older, it becomes increasingly difficult to list specific developmental milestones, as the achievement of many of these depends very much on the opportunities that the child has to practice them, and also, on the experiences available to the child. A child will not be able to ride a bicycle unless they have access to a bicycle.
• Development does not occur in a straight line or evenly. Development progresses in a sequential manner, although it is essential to note that while the path of development is somewhat predictable, there is variation in what is considered normal development. That is to say no two children develop in exactly the same way.
• The pace of development is more rapid in the early years than at any other time in life.
• Every area of development impacts on other areas. Developmental delays in one area will impact on the child’s ability to consolidate skills and progress through to the next developmental stage.

Most experts now agree that both nature and nurture interact to influence almost every significant aspect of a child’s development.

• General health affects development and behaviour. Minor illnesses will have short to medium term effects, while chronic health conditions can have long-term effects. Nutritional deficiencies will also have negative impacts on developmental progression. Specific characteristics and behaviours are indicative only. Many specific developmental characteristics should be seen as ‘flags’ of a child’s behaviour, which may need to be looked at more closely, if a child is not meeting them. Teachers and education staff should refer to relevant specialist assessment guides in undertaking further assessments of child and family.

There has been an explosion of knowledge in regard to the detrimental impact of neglect and child abuse trauma on the developing child, and particularly on the neurological development of infants. It is critical to have a good working knowledge of this growing evidence base so that we can be more helpful to families and child focused.

The following basic points are useful to keep in mind and to discuss with parents and young people:

• Children need stable, sensitive, loving, stimulating relationships and environments in order to reach their potential. They are particularly vulnerable to witnessing and experiencing violence, abuse and neglectful circumstances. Abuse and neglect at the hands of those who are meant to care is particularly distressing and harmful for infants, children and adolescents.
• Given that the infant’s primary drive is towards attachment to a parent or caregiver, not safety, they will accommodate to the parenting style they experience. They have no choice given their age and vulnerability, and in more chronic and extreme circumstances, they will show a complex trauma response. They can eventually make meaning of their circumstances by believing that the abuse is their fault and that they are inherently bad.
• Infants, children and adults will adapt to frightening and overwhelming circumstances by the body’s survival response, where the autonomic nervous system will become activated and switch on to the freeze/fight/flight response. Immediately the body is flooded with a biochemical response which includes adrenalin and cortisol, and the child feels agitated and hypervigilant. Infants may show a ‘frozen watchfulness’ and children and young people can dissociate and appear to be ‘zoned out’.
• Prolonged exposure to these circumstances can lead to ‘toxic stress’ for a child which changes the child’s brain development, sensitizes the child to further stress, leads to heightened activity levels and affects future learning and concentration. Most importantly, it impairs the child’s ability to trust and relate to others. When children are traumatized, they find it very hard to regulate behaviour and soothe or calm themselves. They often attract the description of being ‘hyperactive’.

Babies are particularly attuned to their primary carer and will sense their fear and traumatic stress. This is particularly the case where family violence is present. They will become unsettled and therefore more demanding of an already overwhelmed parent. The first task of any service is to support the non-offending parent and to engage the family in safety.

• Traumatic memories are stored differently in the brain compared to everyday memories. They are encoded in vivid images and sensations and lack a verbal narrative and context. As they are unprocessed and more primitive, they are likely to flood the child or adult when triggers like smells, sights, sounds or internal or external reminders present at a later stage.
• These flashbacks can be affective, i.e., intense feelings, that are often unspeakable; or cognitive, vivid memories or parts of memories, which seem to be actually occurring. Alcohol and drug abuse are the classic and usually most destructive attempts to numb out the pain and avoid these distressing and intrusive experiences.
• Children are particularly vulnerable to flashbacks at quiet times or at bedtimes and will often avoid both, by acting out at school and bedtimes. They can experience severe sleep disruption and intrusive nightmares which add to their ‘dysregulated’ behaviour, and limits their capacity at school the next day. Adolescents will often stay up all night to avoid the nightmares and sleep in the safety of the daylight.

Now that we know about the impact of the risk factors and of childhood trauma we can begin thinking functionally about the needs of these students and begin by considering the factors depicted in the triangle, heart and speech bubble shapes in the figure below.

Figure 3.6.2 Understand the function by Govind Krishnamoorthy and Kay Ayre licensed under CC BY-SA.

According to figure 3.6.2, the triangle represents the pyramid of needs (see Snowman et al., 2009 for Maslow’s hierarchy of needs) starting with physiological needs, such as adequate food, hydration, clothing and physical health care. Examples of how this can be supported in the school environment include rest times, snack times built into learning time, water bottles on desks and available at all times throughout the day, and breakfast clubs.The heart represents the feelings of grief linked to the losses in the child’s life that may impact their academic and social functioning at school. These losses may include the death of loved ones, separation from family and friends, and traumatic grief linked to experiences of abuse. Understanding these losses and their impact on the student can inform our expectations of the student’s functioning, the management of the classroom and school environment to minimise triggers and the support for the student to build trusting relationships that can help them with these complex and painful feelings.The speech bubble shape represents the student’s behaviour as communicating unmet needs and unprocessed feelings. The deprivation and abuse experienced by these children often leaves them with deficits in their skills to seek out appropriate support. Due to this, the child’s misbehaviour may come across as deliberately defiant and oppositional, when in fact, it may the result of their inability to appropriately communicate the challenges that they are facing. It is then, the job of the educators to understand the context of the child – both in and out of the school environment – to interpret the function and meaning of the misbehaviours and disengagement.

Childhood Adversity and Maltreatment

Child maltreatment refers to any non-accidental behaviour by parents, caregivers, other adults or older adolescents that are outside the norms of conduct and entail a substantial risk of causing physical or emotional harm to a child or young person. Such behaviours may be intentional or unintentional and can include acts of omission (i.e., neglect) and commission (i.e., abuse) (Bromfield, 2005; Christoffel et al., 1992). Child maltreatment is commonly divided into five main subtypes:

• physical abuse
• emotional maltreatment
• neglect
• sexual abuse and
• exposure to family violence

Figure 3.6.3 Childhood maltreatment sub-types