Understanding
Childhood Trauma

Understanding Childhood Trauma

By Maya Hollingshead, November 2024

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Most children who are in foster care or other institutions have experienced abuse, neglect, or deprivation. These events may increase the likelihood of trauma, which is defined as a series of circumstances experienced by a person that are physically or psychologically harmful as well as life threatening, that have lasting effects on the person’s physical, social, mental, emotional, or spiritual well-being (Brodzinsky et al., 2022). Lasting effects of trauma may include developmental delays, psychiatric disorders, and life threatening health conditions (American Academy of Pediatrics (AAP), 2016). Individuals who are adopted are more commonly found in mental health settings and may experience greater difficulty adjusting than children who are not adopted (Brodzinsky et al., 2022). It is safe to assume that every child who has been adopted or fostered has experienced trauma (AAP, 2016). To best help an adopted child, parents must understand why trauma causes adverse effects, how to recognize signs of trauma, and when to seek outside help.

Why Trauma Causes Adverse Effects

To understand why trauma can greatly affect a child, it is important to understand the basics of child development. At birth, the brain is not yet fully developed. Much of development is guided by environmental cues and critical periods (AAP, 2016). Interactions with people are necessary as they guide typical development. Neglect and abuse interrupt typical child development processes (Brodzinsky et al., 2022).

Children who experience prolonged adversity often have increases in the stress response. While stress can be beneficial, prolonged stress can disrupt brain development, organ systems, and increase the risk of physical and mental disorders (Nelson et al., 2020). The duration of the adversity, number of adversities, type of adversity, and the child’s developmental status at the time of the adversity can affect the severity of the biological effects on the child (Nelson et al., 2020).

Recognizing Signs of Trauma

Depending on the age of the adopted child, signs of trauma may vary.

Infants/Toddlers (AAP, 2016)

Not hitting developmental milestones
Frequent tantrums
Aggressive towards other children
Attachment issues
Easily frustrated

Preschool Children (SAMHSA, 2024)

Fear of separation from caregivers
Frequently crying/screaming
Little appetite, weight loss
Nightmares
Enuresis, encopresis, regression of toileting skills

Elementary School Children (SAMHSA, 2024; AAP, 2016)

Anxiety or fearfulness
Frequent feelings of guilt or shame
Difficulty concentrating, learning problems like ADHD
Difficulty sleeping
Loss of details that may seem like lying (confabulation)
Getting into trouble at school or with peers
Organizational difficulties
Enuresis, encopresis, regression of toileting skills

Middle and High School Children (SAMHSA, 2024; AAP, 2016)

Feelings of depression or loneliness
Eating disorders or self-harm behaviors
Abuse of alcohol or drugs
Difficulty keeping up in school
Confabulation
Impulsiveness
Becoming sexually active

How To Help

It is possible that some functions will be resolved on their own, while others may require intervention. Factors such as neuroplasticity of the brain, a positive family environment, stability in the child’s life, sensitive parenting approaches, and a healthy attachment to parents can all help a child with trauma gain more executive functions and adjust to their new life (Brodzinsky et al., 2022).

Behavioral Scripts

It may be helpful for parents to practice and use behavioral scripts when working with their child to understand trauma responses (AAP, 2016). Behavioral scripts are learned behaviors and norms that guide how we act in certain situations. Examples of how to use behavioral scripts include:

Your teenager responds to your request to take out the trash by rolling his eyes and muttering under his breath. You would say, “Let’s try that again.” This statement initiates a redo. Again, you ask your teen to take out the trash and they say “Okay” (The Restore Network).
Your 8 year old demands that you take her to the store and buy something. You say, “Are you asking or telling?”. This statement initiates a redo. This time, she says “Hey mom, do we have time to run to the store today to buy something?” (The Restore Network).

For more resources on behavioral scripts and how to use them, visit this link.

Incorporate Routine

Children greatly benefit from having a consistent, predictable routine. Including simple daily routines such as bedtime or mealtime routines can reduce sleep problems in children, significantly impact eating behaviors, and positively influence physical health (Selman & Dilworth‐Bart, 2024).

Use Sensitive Parenting Approaches

Sensitive parenting refers to family interactions in which parents are aware of their children’s emotional and physical needs and respond appropriately and consistently. Sensitive parents are “in tune” with their children (National Physicians Center). Part of this kind of parenting includes understanding individual development and temperament, responding quickly to their children, and providing encouragement and support during distress (National Physicians Center). Sensitive parenting is associated with improvements in parental well-being and a reduction in child behavior problems (MacBeth et al., 2015). For more parenting resources click here.

Seek Outside Help

At times it is necessary to seek out professional help from qualified therapists. Depending on the age of the child and their specific struggles, therapies such as cognitive behavioral therapy, trauma focused therapy, or parent child therapy may be helpful (AAP, 2016). For more resources on understanding childhood trauma, visit the links below. To learn more about creating a healthy attachment with your adopted child, read our article here.

References

American Academy of Pediatrics. (2016). Helping Foster and Adoptive Families Cope With

Trauma. https://downloads.aap.org/AAP/PDF/hfca_foster_trauma_guide.pdf

Brodzinsky, D., Gunnar, M., & Palacios, J. (2022). Adoption and trauma: Risks, recovery, and

the lived experience of adoption. Child abuse & neglect, 130(Pt 2), 105309. https://doi.org/10.1016/j.chiabu.2021.105309

MacBeth, A., Law, J., McGowan, I., Norrie, J., Thompson, L., & Wilson, P. (2015). Mellow

parenting: Systematic review and meta‐analysis of an intervention to promote sensitive parenting.

Developmental Medicine & Child Neurology, 57(12), 1119–1128. https://10.1111/dmcn.12864

National Physician’s Center. (n.d.). Sensitive or Responsive Parenting.

https://www.physicianscenter.org/parents/parenting-resources/articles/sensitive-or-responsive-parenting/

Nelson, C. A., Scott, R. D., Bhutta, Z. A., Harris, N. B., Danese, A., & Samara, M. (2020).

Adversity in childhood is linked to mental and physical health throughout life. BMJ (Clinical research ed.), 371, m3048. https://doi.org/10.1136/bmj.m3048

Restore Network. (n.d.). Say it with scripts. The Restore Network.

https://therestorenetwork.org/wp-content/uploads/2024/08/Say-It-with-Scripts.pdf

Selman, S. B., & Dilworth‐Bart, J. E. (2024). Routines and child development: A systematic

review. Journal of Family Theory & Review, 16(2), 272–328. https://10.1111/jftr.12549

Substance Abuse and Mental Health Services Administration. (2024, May 24). Recognizing and

Treating Child Traumatic Stress. https://www.samhsa.gov/child-trauma/recognizing-and-treating-child-traumatic-stress