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Childhood trauma is a growing public health crisis for children today. Research shows that traumatic childhood experiences are increasingly common. It also shows that these negative experiences have a profound impact on the function and development of children. Children exposed to parental substance abuse and domestic violence rarely have secure childhood experiences. The symptomatology tends to be complex and multi-dimensional.
A natural response
Children learn to regulate their behavior by anticipating their caregivers’ responses to them. A caregiver’s response encourages that child to develop an attachment to the caregiver and the environment. Attachments can be both secure and insecure, resulting in a child’s ability to form and engage in relationships for the rest of his or her life. Children’s attachments also impact their ability to regulate their own emotions and senses, as well as adapt to their environment.
Children who experience developmental trauma are often stuck in the “primitive brain,” which is responsible for automatic body functions (breathing, heart rate, and temperature control) and protects us by switching us to survival mode. Survival mode requires an immediate response (fight, flight or freeze) to all possible harmful stimuli. Children who are stuck in their primitive brain due to Adverse Childhood Experiences (ACE) will respond with one of the survival responses and will require co-regulation. These children will require co-regulation much longer than their typically developing counterparts.
Also, children who experience developmental trauma cultivate coping strategies that aid in ensuring safety. However once the child is removed from the unsafe environment, those coping strategies become unhealthy. They inhibit healthy growth and the development of daily life skills that are important for managing impulses, problem solving, and learning and developing higher level thinking and planning skills. These skills take place in higher levels of the brain that are often “offline” and inaccessible due to the quick response of the primitive brain. This limits the ability for information to pass into the higher levels responsible for attachment, relationships, learning, thinking and language. Often these children are misdiagnosed and misunderstood by professionals, friends and family. These misdiagnoses and misunderstandings tend to reinforce the already disorganized patterns of attachment and regulation.
Trauma at an early age
Many professionals and individuals who aren’t educated in the effects of early childhood trauma believe if the child experiences the trauma as an infant or toddler, then the child doesn’t remember the trauma and therefore won’t be affected by it. However that is not the case.
Because language hasn’t developed at that young of an age, memories of the trauma aren’t stored in language, so the child cannot necessarily describe or recall the event in words. Instead it is stored “physically” in sensations and sensory memories.
Infant brains function mainly in the brainstem, the primitive brain, therefore their experience of trauma is held in primitive responses (heart rate, temperature, respiration rate). The child’s sensory system develops with limited ability to effectively filter sensory input due to its over or under response for survival. As a result, the child grows up re-living the trauma through natural body functions, without the ability to put words to the trauma. The child also has difficulty telling the difference between danger or natural body responses to safe experiences that cause activation of the automatic brainstem (aka primitive brain).
Trauma in infancy causes disturbances to the sensory system, which often brings the children challenges in making sense of the world through their senses, including knowing how much pressure their body is exerting, differentiating differed textures, and understanding where their or her head and body are in space (balance and coordination). It also makes it difficult for the child to manage his or her own emotions and regulate responses. Often there may be an increase in anxiety and depression, with the child expressing this through behavioral issues and anger outbursts.
Treatment is available
Beaumont’s Trauma Regulation Treatment team uses a multidisciplinary approach within a medical model for children who have experienced abuse, neglect, peri- and post-natal substance exposure, invasive medical treatments, and/or exposure to community trauma. Our goal is to provide education and support to aid parents and caregivers in understanding the impacts of trauma on their children. Our team is composed of an occupational therapist, a behavioral health therapist, and a physical therapist who work closely to address underlying issues caused from trauma exposure. This interdisciplinary approach supports a combination of bottom-up (occupational and physical therapy) and top-down (behavioral health) treatment to calm the response of the child’s primitive brain and encourage increased access to the relationship and executive functioning parts of the brain. This lets the child develop use of all parts of the brain for neurological growth and development while addressing attachment, regulation, sensory motor challenges, and natural processing of trauma experiences. Our treatment approach values the efforts and inclusion of the caregiver into the treatment team to provide education and resources, empowering the caregiver’s efforts to better support their children through daily growth and development.
The information above is derived from pioneers in the areas of trauma and child trauma: Bessel van der Kolk M.D. and the National Child Traumatic Stress Network, Bruce Perry M.D. Ph.D and the Child Trauma Academy, and Vincent Felitti M.D. and his work with the Adverse Childhood Experience (ACE) study.
For more information on childhood trauma and treatment options refer to:
– Sara Gariepy, MS OTRL, CATP and Kristin Rosales, MSW, CATP are with the Beaumont Center for Children’s Rehabilitation team in Macomb.