The effects of trauma on young children
Download
1 / 61

the effects of trauma on young children - PowerPoint PPT Presentation


  • 209 Views
  • Updated On :

The Effects of Trauma on Young Children. Stacey Ryan, LCSW Angela M. Tomlin, Ph.D. IAITMH 2006. Types of Trauma. Witnessing violence (domestic and other) Natural disaster Terrorism Accidents Abuse/Neglect Loss of caregiver. Do Young Children Experience Trauma?.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'the effects of trauma on young children' - ostinmannual


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
The effects of trauma on young children l.jpg

The Effects of Trauma on Young Children

Stacey Ryan, LCSW

Angela M. Tomlin, Ph.D.

IAITMH

2006


Types of trauma l.jpg
Types of Trauma

  • Witnessing violence (domestic and other)

  • Natural disaster

  • Terrorism

  • Accidents

  • Abuse/Neglect

  • Loss of caregiver


Do young children experience trauma l.jpg
Do Young Children Experience Trauma?

  • Children under 12 months account for 44% of deaths from child abuse and neglect

  • Persistent crying is an important risk factor in abuse of very young children, related to shaken infant syndrome


Young children and sexual abuse l.jpg
Young children and sexual abuse

  • Infants and toddlers may account for as many as 10% of substantiated sexual abuse

  • Appearance of sexualized behavior is more likely than physical findings

  • The younger the child when abused, the more likely sexualized behavior appears


Young children and domestic violence l.jpg
Young children and domestic violence

  • Child sees attachment figure injured

  • Attachment figure cannot protect self; child is unsure if she can protect him

  • Attachment figure may in turn injure the child


Assessing severity of trauma l.jpg
Assessing severity of trauma

  • Closeness of people involved to the child

  • What the child saw

  • Child’s developmental level

  • Reactions of important adults


How young children understand traumatic events and experiences l.jpg
How Young Children Understand Traumatic Events and Experiences

  • Cognitive and emotional capacity determines how child experiences trauma

  • Level of understanding can also affect memory

  • 2-3 year olds do not understand the finality of death

  • Young children may believe they caused a traumatic event


Clinical patterns in abused neglected infants l.jpg
Clinical Patterns in Abused/Neglected Infants Experiences

Gaensbauer & Mrazek (1981) observed 4 clinical patterns:

  • Developmentally and Affectively retarded group

  • Depressed Group (sad and sensitive to change)

  • Ambivalent Group (rapid shifts in emotion)

  • Angry Group (emotional intensity and low frustration tolerance)


Effects of trauma l.jpg
Effects of Trauma Experiences

  • Can appear immediately or after days, weeks

  • May remind young child of previous traumas, making reaction more severe


Effects of trauma10 l.jpg
Effects of Trauma Experiences

  • Physical & Self-Regulation Effects

  • Traumatic Reminders

  • Development

  • Play

  • Behavior

  • Relationship


Physical and self regulation effects l.jpg
Physical and Self-Regulation Effects Experiences

  • Self-regulation is important task of infancy

  • In babies and young children, problems with self-regulation look like:

    Sleep problems

    Eating problems

    Exaggerated startle

    Hypervigilance


Physical and self regulation effects12 l.jpg
Physical and Self-Regulation Effects Experiences

  • Exposure to traumatic events seems to change the way the infant reacts to future stressors

  • Animal and human studies shows changes in hormones and brain chemicals after trauma

  • These brain changes can be long lasting, leading the child to feel numb or anxious


Traumatic reminders l.jpg
Traumatic reminders Experiences

  • Can be difficult to identify in nonverbal child

  • Sensory (siren, smell)

  • Dreams

  • Re-experiencing the event

  • Irrational fear of benign objects


Developmental effects of trauma l.jpg
Developmental Effects of Trauma Experiences

  • Developmental delays are expected—developmental assessment is advised

  • Problems may occur in development of attachments and other social emotional skills

  • Regression is possible


Effects on play skills l.jpg
Effects on Play Skills Experiences

  • Repetitive actions

  • Driven quality

  • Constricted quality

  • Preoccupation with separation, loss, and reunion


Effects on behavior infants and toddlers l.jpg
Effects on Behavior—infants and toddlers Experiences

  • Increased irritability/inability to soothe

  • Sleep disturbance

  • Emotional distress; sadness

  • Fears of being alone; clinging; refusal to separate

  • Motor agitation

  • Temper tantrums


Effects on behavior toddlers and preschoolers l.jpg
Effects on Behavior—toddlers and preschoolers Experiences

  • Being too clingy with adults

  • Not able to be comforted when upset

  • Problems with exploration: either reckless or too inhibited

  • Aggression toward caregivers, peers, animals

  • Angry noncompliance


Effects on relationship l.jpg
Effects on Relationship Experiences

  • Difficulty forming positive relationships

  • Poor sense of self

  • Lowered self esteem

  • Expectation of being treated poorly

  • Loss of secure base

  • Loss of sense of trust


Long term effects of trauma l.jpg
Long Term Effects of Trauma Experiences

  • Persistent grief reactions (Bowlby)

    Protest: efforts to find the parent through crying, calling, and searching

    Despair: lethargy, sadness, emotional withdrawal, loss of interest in activities

    Detachment: apparent indifference to reminders; selective forgetting*


Long term effects of trauma20 l.jpg
Long Term Effects of Trauma Experiences

  • Increased risk for academic problems

  • Substance use and abuse

  • Early pregnancy

  • Criminal involvement

  • Psychiatric symptoms and disorders

  • Experiencing abuse as a child is linked to abusing one’s own child


Abused children as parents l.jpg
Abused children as parents Experiences

  • Harsh discipline

  • Failure to respond to child’s needs

  • Inconsistent limit setting

  • Inability to express affection

  • Inability to enjoy interactions with child

  • Minimize or deny child’s painful experiences


Young children and neglect l.jpg
Young children and neglect Experiences

  • Failure to provide for child’s physical and emotional needs

  • Leaving child alone for long periods

  • Leaving child for long periods with varied and unreliable caregivers

  • Effects of neglect can be as devastating as physical or sexual abuse


Effects of neglect l.jpg
Effects of neglect Experiences

  • Lack of play and other developmental skills

  • May hoard food

  • Unfamiliar with things we take for granted

  • Expects to take care of self or siblings

  • Challenges adult authority

  • Lacks trust in adults

  • Avoids adults when upset; hard to soothe


Expected difficult reactions to placement in foster care l.jpg
Expected difficult reactions to placement in foster care Experiences

  • Previous relationship failures lead the child to behave in ways that alienate foster parents

  • Caregivers misread behaviors and respond in ways that increase problems

  • Child responds to loss of attachment figure with behavioral, emotional, and physiological dysregulation


Expected difficult behaviors of children in care l.jpg
Expected difficult behaviors of children in care Experiences

  • Acting like they do not need caregivers, even under threatening conditions

  • Acting angry when adult makes efforts to soothe

  • Turning away when hurt

  • Behaving aggressively toward caregivers

  • Behaving aggressively toward peers

  • Problem behavior after visits


Why do we see behavior problems after visits with family l.jpg
Why do we see behavior problems after visits with family? Experiences

  • Visits with parents are traumatic reminders of events that led to the separation or of the separation itself

  • Both the child and parent may feel anxious and angry

  • Supervised visits increasing parents feelings of incompetence

  • Child feels safer expressing angry feelings toward foster parent/family


How foster care helps l.jpg
How Foster Care Helps Experiences

  • One of the most important things a foster parent can do is to help young children have positive relationships

  • Doing this will help with development and behavior

  • To do it right, you have to pay attention to attachment


Arousal relaxation cycle l.jpg
Arousal-Relaxation Cycle Experiences

Child experiences a need

Child feels upset

Child feels content

Adult satisfies need


Are there children with no attachments l.jpg
Are there children with no attachments? Experiences

  • There are children with no attachments

  • It is more likely that a child have an attachment problem rather than no attachment at all

  • The child will develop an attachment with the adult that is available


Why do children form attachments to abusive parents l.jpg
Why do children form attachments to abusive parents? Experiences

  • Children’s need for survival and safety results in attachment to any available adult, even those who abuse or threaten them

  • Children prefer the familiar, even when what is familiar is frightening


Insecure attachments l.jpg
Insecure Attachments Experiences

  • Avoidant patterns (turning away from the caregiver when distressed) develop when caregivers reject baby’s request for nurturance.

  • Resistant patterns (fussy, resistant behavior) develops when caregivers inconsistently respond to the baby


Insecure attachments32 l.jpg
Insecure Attachments Experiences

  • Infants show disorganized pattern when adults demonstrate frightening or frightened behavior with them

  • Infant is afraid of the person they look to for reassurance and nurturance

  • Infant behavior is unorganized and bizarre

  • These patterns are common when children are abused or they witness domestic violence


Long term effects of disorganized attachments l.jpg
Long term Effects of Disorganized Attachments Experiences

  • Aggression with peers

  • Dissociative behaviors


Role of foster parent in attachment l.jpg
Role of Foster Parent in Attachment Experiences

  • Help the child develop a healthy attachment

  • Help child extend attachment to you and improved behaviors to birth family, new fosterfamily, or adoptive family


How foster parents can help l.jpg
How Foster Parents Can Help Experiences

  • Work with the parents

  • Avoid judgments about the biological parents

  • Provide transitional objects to child

  • Provide family pictures

  • Have a plan for the first visit


How foster parents can help36 l.jpg
How Foster Parents Can Help Experiences

Responding to parent anger

  • Listen

  • Be non-reactive

  • Acknowledge how difficult it is to be away from child


How foster parents can help37 l.jpg
How Foster Parents Can Help Experiences

  • Recognize that the child needs you, even when they do not show it

  • Understand rejecting behaviors as old coping methods

  • Listen

  • Put words to behaviors

  • Attend to your own reactions

  • Encourage touch, but do not force it


How foster parents can help at home l.jpg
How Foster Parents Can Help at Home Experiences

  • Safety

  • Routine that shows an adult is “in control”

  • Soothing sensory activities

  • Stop activities that result in re-enactment (including television)

  • Advocate to reduce moves to provide continuity


Question and answer l.jpg
Question and Answer Experiences


Factors in determining types of interventions osofsky fenichel 1994 l.jpg
Factors in Determining Types of Interventions, (Osofsky & Fenichel, 1994)

  • Safety and Stability of Current Living Situation

  • Child’s Developmental Capacities to Make Use of Certain Types of Interventions

  • Quality of Pre-Traumatic and Current Care-Giving Environment

  • Type of Violent Event or Situation

  • Acuteness vs. Chronicity of Trauma

  • Actual and Psychological Proximity of the Violent Events

  • Post Traumatic Symptoms in Child and Caregiver

  • Strengths and Protective Factors in Infant


Goals for intervention lieberman van horn 2005 l.jpg
Goals for Intervention (Lieberman & Van Horn, 2005) Fenichel, 1994)

  • Return to Normal Development

  • Increase Capacity to Respond to Trauma.

  • Maintain Regular Levels of Arousal

  • Re establish Trust in Bodily Sensations

  • Restore Reciprocity in Close Relationships

  • Normalize Reactions to Trauma

  • Encourage a Differentiation Between Reliving and Remembering

  • Place the Traumatic Experience in Perspective


Common intervention needs osofsky fenichel 1994 l.jpg
Common Intervention Needs (Osofsky & Fenichel, 1994) Fenichel, 1994)

  • Improving the caregivers ability to attend to and provide for the child’s needs

  • Further develop caregiver’s ability to interpret child’s feelings, reactions and support child

  • Address cognitive distortions child may have regarding trauma

  • Assist the child in re experiencing trauma in affectively tolerable doses

  • Assist the child and caregiver in coping with any losses


Results of interventions assist child in understanding l.jpg
Results of Interventions Assist Child in Understanding… Fenichel, 1994)

  • Stressful body experiences can be alleviated with help of others and coping strategies

  • Adults can support and protect child

  • Child is not to blame

  • Can talk about emotions rather than only acting them out

  • Life can contain elements of mastery, fun and hope


Methods for intervening l.jpg
Methods for Intervening Fenichel, 1994)

  • Using Play, Physical Contact and Language to Promote Developmental Progress

  • Offering Unstructured Reflective Developmental Guidance

  • Modeling Appropriate Protective Behavior

  • Interpreting Feelings and Actions

  • Providing Emotional Support/Empathetic Communication

  • Offering Crisis Intervention and Concrete Assistance


Areas of clinical concern include l.jpg
Areas of Clinical Concern include… Fenichel, 1994)

  • Play

  • Sensorimotor Disorganization

  • Fearful Behavior

  • Self Endangering Behavior

  • Aggression Toward Parent

  • Aggression Toward Peers

  • Parental Use of Physical Discipline

  • Parental Use of Threats, Criticisms of Child

  • Relationship with Perpetrator


Slide46 l.jpg
Play Fenichel, 1994)

  • Encouragement of Play with Dyad

  • Help the Parent Understand and Support Use of Play

  • Allow the Parent to Be Main Supporter to Child


Sensorimotor disorganization l.jpg
Sensorimotor Disorganization Fenichel, 1994)

  • Help the Parent Understand How these behaviors Affect Them (triggers feelings of rejection, anger and frustration in parent)

  • Develop New Meanings for Parent


Child fears l.jpg
Child Fears Fenichel, 1994)

  • Support Parent Understanding of Fears

  • Bring Attention to Cues Child Gives Regarding Fears

  • Develop with Parents Strategies for Containing Fears


Aggression toward parent l.jpg
Aggression Toward Parent Fenichel, 1994)

  • Give Parents Meaning for This Behavior

  • Assist Parents In Containing Feelings Regarding this Behavior

  • Develop Strategies for Controlling Anger/Aggression


Aggression toward peers l.jpg
Aggression Toward Peers Fenichel, 1994)

  • Build Understanding of Reasons for Behavior

  • Clinician Gives Resources for Deescalating Behavior

  • Empower Parents to Take Action and Assist Child


Parental use of physical punishment l.jpg
Parental Use of Physical Punishment Fenichel, 1994)

  • Explore with Parent Feelings and Concerns

  • Contain Own Emotions and Reactions

  • Educate on Reasons Physical Punishment May Worsen Symptoms


Parental criticism l.jpg
Parental Criticism Fenichel, 1994)

  • Focus on Effects of Relationship

  • Acknowledge Parent Issues/Feelings

  • Build Awareness of Child Experience


Relationship with perpetrator l.jpg
Relationship with Perpetrator Fenichel, 1994)

  • Educate on Child Needs/Experiences

  • Support/Listen to Parent Concerns/Feelings

  • Mutually Develop Strategies


What evaluation research tells us landy menna 2006 l.jpg
What Evaluation Research Tells Us (Landy & Menna, 2006) Fenichel, 1994)

  • Home Visiting is Critical Component

  • Need to Distinguish Between Early Intervention and Prevention

  • Starting Early is Critical

  • Intensity and Duration Counts

  • Ongoing Assessment is Critical

  • Services Most Effective for Moderate Levels of Risk

  • Need for Well Trained Service Providers

  • Use a Variety of Approaches


Treatment videos l.jpg
Treatment Videos Fenichel, 1994)

  • Discussion

  • Questions/Comments


Experience case based discussion l.jpg
Experience Case Based Discussion Fenichel, 1994)

  • Structured way of thinking and talking about situations with families

  • Method for promoting Reflective Supervision and Further Learning

  • 3 Phases:

    • Understanding the Experience

    • Exploring and Sharing the Collective Knowledge and Experience of the Group

    • Summarizing Discussion and Identifying Next Steps


Another way to help l.jpg
Another Way to Help Fenichel, 1994)

  • Speak for the babies..


Want to learn more l.jpg
Want to learn more? Fenichel, 1994)

  • Indiana Association for Infant and Toddler Mental Health (iaitmh.org)

  • 317/638-3501 EXT 221

  • Zero to Three (zerotothree.org)

  • The Center for Social and Emotional Foundations for Early Learning (csefel.uiuc.edu)


Contact us l.jpg
Contact us…. Fenichel, 1994)


The effects of trauma on young children61 l.jpg

The Effects of Trauma on Young Children Fenichel, 1994)

Stacey Ryan, LCSW

Angela M. Tomlin, Ph.D.

IAITMH

2006


ad