Parenting a Child Who Has Experienced Trauma
Following on from my trauma training earlier in the week, I reflected on how difficult it can be for the parents and carers of children who have experienced trauma to know how to best meet their needs. Here is some helpful information about childhood trauma and how to help your child.
What Is Trauma?
Trauma is an emotional response to an intense event that threatens or causes harm. The harm can be physical or emotional, real or perceived, and it can threaten the child or someone close to him or her. Trauma can be the result of a single event, or it can result from exposure to multiple events over time.
Potentially traumatic events may include:
Abuse (physical, sexual, or emotional)
Neglect
Effects of poverty (such as homelessness or not having enough to eat)
Being separated from loved ones
Bullying
Witnessing harm to a loved one or pet (e.g., domestic or community violence)
Natural disasters or accidents
Unpredictable parental behaviour due to addiction or mental illness
For many children, being in the child welfare system becomes another traumatic event. This is true of the child’s first separation from his or her home and family, as well as any additional placements.
The Impact of Untreated Trauma
Children are resilient. Some stress in their lives (e.g., leaving caregivers for a day at school, riding a bike for the first time, feeling nervous before a game or performance) helps their brains to grow and new skills to develop. However, by definition, trauma occurs when a stressful experience (such as being abused, neglected, or bullied) overwhelms the child’s natural ability to cope. These events cause a “fight, flight, or freeze” response, resulting in changes in the body—such as faster heart rate and higher blood pressure—as well as changes in how the brain perceives and responds to the world. In many cases, a child’s body and brain recover quickly from a potentially traumatic experience with no lasting harm. However, for other children, trauma interferes with normal development and can have long-lasting effects.
Trauma may affect children’s…
In the following ways
Bodies
Inability to control physical responses to stress
Chronic illness, even into adulthood (heart disease, obesity)
Brains (thinking)
Difficulty thinking, learning, and concentrating
Impaired memory
Difficulty switching from one thought or activity to another
Emotions (feelings)
Low self-esteem
Feeling unsafe
Inability to regulate emotions
Difficulty forming attachments to caregivers
Trouble with friendships
Trust issues
Depression, anxiety
Behaviour
Lack of impulse control
Fighting, aggression, running away
Substance abuse
Suicide
Factors that determine the impact of traumatic events include the following:
Age. Younger children are more vulnerable. Even infants and toddlers who are too young to talk about what happened retain lasting “sense memories” of traumatic events that can affect their well-being into adulthood.
Frequency. Experiencing the same type of traumatic event multiple times, or multiple types of traumatic events, is more harmful than a single event.
Relationships. Children with positive relationships with healthy caregivers are more likely to recover.
Coping skills. Intelligence, physical health, and self-esteem help children cope.
Perception. How much danger the child thinks he or she is in, or the amount of fear the child feels at the time, is a significant factor.
Sensitivity. Every child is different—some are naturally more sensitive than others. The effects of trauma vary depending on the child and type of traumatic events experienced.
Understanding Your Child’s Behaviour
When children have experienced trauma, particularly multiple traumatic events over an extended period of time, their bodies, brains, and nervous systems adapt in an effort to protect them. This might result in behaviours such as increased aggression, distrusting or disobeying adults, or even dissociation (feeling disconnected from reality). When children are in danger, these behaviours may be important for their survival. However, once children are moved to a safer environment, their brains and bodies may not recognize that the danger has passed. These protective behaviours, or habits, have grown strong from frequent use (just as a muscle that is used regularly grows bigger and stronger). It takes time and retraining to help those “survival muscles” learn that they are not needed in their new situation (your home), and that they can relax. It might be helpful to remember that your child’s troublesome behaviour may be a learned response to stress—it may even be what kept your child alive in a very unsafe situation. It will take time and patience for your child’s body and brain to learn to respond in ways that are more appropriate for his or her current, safe environment.
Trauma Triggers
When your child is behaving in a way that is unexpected and seems irrational or extreme, he or she may be experiencing a trauma trigger. A trigger is some aspect of a traumatic event that occurs in a completely different situation but reminds the child of the original event. Examples may be sounds, smells, feelings, places, postures, tones of voice, or even emotions. Youth who have experienced traumatic events may re-enact past patterns when they feel unsafe or encounter a trigger. Depending on whether the child has a “fight,” “flight,” or “freeze” response, the child may appear to be throwing a tantrum, wilfully not listening, or defying you. However, responses to triggers are best thought of as reflexes—they are not deliberate or planned. When children’s bodies and brains are overwhelmed by a traumatic memory, they are not able to consider the consequences of their behaviour or its effect on others.
Signs of Trauma in Children of Different Ages
Young Children (Ages 0–5)
School-Age Children (Ages 6–12)
Teens (Ages 13–18)
Irritability, “fussiness”
Startling easily or being difficult to calm
Frequent tantrums
Clinginess, reluctance to explore the world
Activity levels that are much higher or lower than peers
Repeating traumatic events over and over in dramatic play or conversation
Delays in reaching physical, language, or other milestones
Difficulty paying
Talking about the trauma constantly, or denying that it happened
Refusal to follow rules, or talking back frequently
Being tired all the time, sleeping much more (or less) than peers, nightmares
Risky behaviours
Fighting
Not wanting to spend time with friends
Using drugs or alcohol, running away from home, or getting into trouble with the law
Difficulty paying attention
Being quiet or withdrawn
Frequent tears or sadness
Talking often about scary feelings and ideas
Difficulty transitioning from one activity to the next
Fighting with peers or adults
Changes in school performance
Wanting to be left alone
Eating much more or less than peers
Getting into trouble at home or school
Frequent headaches or stomachaches with no apparent cause
Behaviours common to younger children (thumb sucking, bed wetting, fear of the dark)
Talking about the trauma constantly, or denying that it happened
Refusal to follow rules, or talking back frequently
Being tired all the time, sleeping much more (or less) than peers, nightmares
Risky behaviours
Fighting
Not wanting to spend time with friends
Using drugs or alcohol, running away from home, or getting into trouble with the law
For many children who have experienced trauma, their development lags behind their age in calendar years. It may be normal for your child to exhibit behaviours that are more common in younger children.
These signs alone do not necessarily indicate that your child has experienced trauma. However, if symptoms are more severe or longer lasting than is typical for children the same age, or if they interfere with your child’s ability to succeed at home or in school, it is important to seek help.
Trauma and Mental Health
Trauma symptoms that are more severe or disruptive to a child’s ability to function at home or at school may overlap with specific mental health diagnoses. This may be one reason why nearly 80 percent of children aging out of foster care have received a mental health diagnosis. For example:
Children who have difficulty concentrating may be diagnosed with ADHD (attention deficit hyperactivity disorder).
Children who appear anxious or easily overwhelmed by emotions may be diagnosed with anxiety or depression.
Children who have trouble with the unexpected may respond by trying to control every situation or by showing extreme reactions to change. In some cases, these behaviours may be labeled ODD (oppositional defiant disorder) or intermittent explosive disorder (IED).
Dissociation in response to a trauma trigger may be viewed as defiance of authority, or it may be diagnosed as depression, ADHD (inattentive type), or even a developmental delay. It may be necessary to treat these diagnoses with traditional mental health approaches (including the use of medications, where indicated) in the short term. However, treating the underlying cause by addressing the child’s experience of trauma will be more effective in the long run.
Helping Your Child
Although childhood trauma can have serious, lasting effects, there is hope. With the help of supportive, caring adults, children can and do recover. Consider the following tips:
Identify trauma triggers. Something you are doing or saying, or something harmless in your home, may be triggering your child without either of you realizing it. It is important to watch for patterns of behaviour and reactions that do not seem to “fit” the situation. What distracts your child, makes him or her anxious, or results in a tantrum or outburst? Help your child avoid situations that trigger traumatic memories, at least until more healing has occurred.
Be emotionally and physically available. Some traumatized children act in ways that keep adults at a distance (whether they mean to or not). Provide attention, comfort, and encouragement in ways your child will accept. Younger children may want extra hugs or cuddling; for older youth, this might just mean spending time together as a family. Follow their lead and be patient if children seem needy.
Respond, don’t react. Your reactions may trigger a child or youth who is already feeling overwhelmed. (Some children are even uncomfortable being looked at directly for too long.) When your child is upset, do what you can to keep calm: Lower your voice, acknowledge your child’s feelings, and be reassuring and honest.
Avoid physical punishment. This may make an abused child’s stress or feeling of panic even worse. Parents need to set reasonable and consistent limits and expectations and use praise for desirable behaviours.
Don’t take behaviour personally. Allow the child to feel his or her feelings without judgment. Help him or her find words and other acceptable ways of expressing feelings, and offer praise when these are used.
Listen. Don’t avoid difficult topics or uncomfortable conversations. (But don’t force children to talk before they are ready.) Let children know that it’s normal to have many feelings after a traumatic experience. Take their reactions seriously, correct any misinformation about the traumatic event, and reassure them that what happened was not their fault.
Help your child learn to relax. Encourage your child to practice slow breathing, listen to calming music, or say positive things (“I am safe now.”).
Be consistent and predictable. Develop a regular routine for meals, play time, and bedtime. Prepare your child in advance for changes or new experiences.
Be patient. Everyone heals differently from trauma, and trust does not develop overnight. Respecting each child’s own course of recovery is important.
Allow some control. Reasonable, age-appropriate choices encourage a child or youth’s sense of having control of his or her own life.
Encourage self-esteem. Positive experiences can help children recover from trauma and increase resilience. Examples include mastering a new skill; feeling a sense of belonging to a community, group, or cause; setting and achieving goals; and being of service to others.
Credit - Child Welfare Information Gateway. Resources on Trauma for Caregivers and Families [Webpage]: https://www. childwelfare.gov/topics/responding/trauma/caregivers.