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Trauma’s impact on children

a potential legacy of pain

Marjorie Withers, LCPC

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Workshop dedicated To children and families who have

shared their stories: Who have reached for their core of

resilience and coped with feelings and memories:

And To those that have been their heroes whether it was an auntie, a teacher, a therapist, a fireman or another child.

NO ONE IS EXEMPT FROM THE AFTERMATH OF TRAUMA

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Definition of Trauma Horrific event beyond the scope of normal human

experience. ( American Psychiatric Assoc., 1980) Includes events that are perceived as life

threatening. Engenders: Fear, hopelessness, horror,

helplessness. Witnessing violence, and or being a victim of

violence. Being diagnosed with a life threatening disease. Natural disasters, accidents, House fires loss caused

by violence. War, gang war.

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Kinds of Trauma Complex trauma (repeated abuse) Early childhood trauma (before age 6) Domestic Violence Death of a parent or family Community /school violence Natural Disasters Wars Medical Trauma Abuse, physical, sexual, neglect

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Effects of Trauma on Children Effects cognition Effects affect/feelings Effects behavior Effects neurophysiology Effects physiology Responses are coping adaptations

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Impact on Physiology

Traumatic event

Prolonged Alarm Reaction

Altered Neural System

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Prevalence of Trauma in Children in United States Over 5 million children a year experience

trauma. Estimated 2 million from sexual or physical

abuse. Unknown number more terrorized by

Domestic Violence in their home Natural disasters, car accidents, life

threatening illnesses, community violence. By age 18, one out of four will have been

effected by family or community violence.

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Recent studies indicate increase in the numbers of children effected by trauma 84% of second year college students

have experienced at least one major trauma.

Poverty and substance abuse and social turmoil increase exposure rates of trauma.

Multi layers of trauma Concept of Historical Trauma Impacts on future generations

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Trauma knows no age limits In- Utero effects of trauma (increase

cortisol levels). Anxious babies Infant and toddlers exposed to violence

towards a parent have changes in behavior.

Exposure to violence impacts child as much as violence to a child.

Pre-verbal children show signs and symptoms of trauma similar to those of older children.

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Break Think of children you have known and

what trauma may have effected them. What would you do for them if you knew

they were trauma effected?**********************************

BRETHING BREAK:

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Impact of Trauma and its ramifications Trauma can change behavior in

multitudes of ways that may be confused with other diagnoses.

Frequently misdiagnosed as: ADHD Oppositional Defiant Disorder Learning Disability ADD

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Partial list of potential related symptoms: Disruptive Behaviors Fighting Anger “Don’t Care” attitude Criminal behaviors Non compliance with

teachers, medical providers.

Poor frustration tolerance

Substance Abuse Revert to behaviors of

earlier stages/ages

Depression Anxiety Loss of interest Poor Concentration Distracted Hyper vigilance Startle response Absences Suicidal

thoughts/behaviors Hopeless & Helpless

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Post Traumatic Stress Symptoms Numbness Avoidance Hyper arousal Intrusive thoughts Flashback Hyperventilation Anxiety Crying Inability to focus

Fear Helpless/hopeless Memory disruptions Negative feelings Loss of safety Feeling out of control Time (slowed down or

sped up) Physical symptoms

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Differential Response to trauma Dissociation Detached Numb Compliant Decrease Heart Rate Suspension of time De-realization “crazy like behavior” Fainting/light headed

Hyperarousal Hypervigilance Anxious Reactive Alarm response Increase Heart Rate Freeze: Fear Flight: Panic Flight: Terror(Bruce Perry, PhD)

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Role of attachment on the impact of trauma. Foundation of childhood trust and

resilience. Attached child has more skills for seeking

safety and comfort. Attachment can be effected by trauma and

need repair such as when a toddler or young child looses their mother or attached figure.

Child feels betrayed by parent inability to keep them safe.

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Small Groups: What are the major traumas you see in

the children you work with?

What the most common symptoms you see?

What interventions or supports seem to help the child?

Share with large group:

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Lunch Acute Post Traumatic Period Trauma and memory at cellular level Repeated replaying Hypervigilant Increased startle response May have increased breathing rate Fear, Panic, flashbacks, intrusive thoughts*******************************

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Self Protection in children Avoidance Dissociation as protection Longer symptoms go on the more chance

of having PTSD

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Annie Annie was 5 when her mother was killed in

a car accident. Annie was in the car and kept calling her

mother. It took the rescue people 3 hours to get

Annie out.

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Annie’s responses Would not let go of her father Screamed at night for her mother and

would be unable to go to sleep again. Annie would not interact with others when

she returned to school. She would get scared and start running

around the class.

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Intervention Calming skills Reassurance Safe place One adult talking with her Access to things that she enjoyed…

coloring Inclusion of Annie’s best friend when she

wanted to rejoin an activity

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Therapy with father Help family deal with the loss of mother

separate from the accident Information about the accident as Annie

needs or wants it. Place where she can remember it in

playroom Teaching father and significant others

calming skills that work for Annie. Breathing Routine development and plan for nights.

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Role of a caring significant other Children report difference a caring adult

makes: “My aunt was always there after my mom

died” She made me feel safe and special

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Children taking the blame Fear that they should have or could have Protected Saved Avoided Prevented Kept trauma from occurring (wish for

control)Need for correction of untrue thoughts or

assumption

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Child needs Stress management skills Coherent narrative of what happened Changing misassumptions that the

experience caused…it happened because I was bad…changed to bad things can happen even to good kids.

Involvement of parents or safe loving involved adult

Normalcy restoration

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Summary You can make a difference Children are resilient when given tools Mastery of soothing skills Mastery of stress management skills Time, love, reassurance, dependable environment

that encourages safety planning. Trauma reactions are not pathological. Healing from wound to scar I am a survivor…..I am Loved, loveable and I can

soothe myself.