Childhood Trauma
What are Traumatic events?
There are many types of Traumatic events and they may be single events or repeated events.
In Childhood, traumatic events occur when a child or young person experiences or witnesses death or a near death experience, serious injury or sexual violence.
The event may be a natural or accidental disaster, war, terrorism, physical assault or any type of child abuse and neglect. The sudden death of a loved one, sexual violence and assault (including trafficking), refugee trauma and family member disappearance, military family-related loss (such as when a family member is deployed, or where a parent dies or is injured), can all be traumatic events.
Personal or family substance use, violence within families and communities and serious accidental injuries including Road Traffic Accidents, drowning, burns or falls may also be considered as traumatic events.
It is also possible to experience traumatic events by listening to the traumatic experiences of others (sometimes called secondary trauma, vicarious trauma or compassion fatigue).
Traumatic events that tend to have the greatest negative consequences are those related to interpersonal (person to person) or intentional trauma. This includes childhood abuse and neglect.
Traumatic events/experiences that are prolonged and repeated and which occur in early childhood are sometimes described as complex or developmental trauma. Complex trauma or developmental trauma are terms used to describe the type of traumatic events and are not diagnoses.
These types of events usually occur within the child’s current relationships and at a time when the young brain is developing. Examples may be emotional, physical or sexual abuse, neglect, loss or abandonment. Other examples are those that may arise from chronic, repeated and severe exposure to community violence, racial trauma, refugee or war trauma. This includes any set of circumstances which are prolonged, from person to person and where an infant or child does not have his or her emotional needs met.
Traumatic experiences in pregnancy and in the first 4 years of a child’s life can affect brain development and have a significant impact on later emotional, mental and physical wellbeing and the effects can persist into adult life. Follow this link for more information about normal brain development and the impact of trauma on the developing brain.
Exposure to prolonged and repeated traumatic events can impact on relationships and the development of personal identity
When an infant or child’s environment growing up is one of fear and neglect, this has major consequences for their future ability to form trusting relationships with appropriate and safe adults. The development of personal identity ( a sense of who we are, what kind of person we are and where we come from) is also affected. Traumatised children, young people and adults may not have a positive view about themselves and this may then adversely affect how we think, affect our behaviours and the choices we make in life.
Exposure to Trauma is common
1/3 of children and young people in England and Wales have been exposed to a traumatic experience by the age of 18 years and 1/4 of those develop Post traumatic Stress Disorder or PTSD by the age of 18 years.
Traumatic Stress responses
Traumatic experiences can create strong emotions and strong physical reactions in children and young people. This might include feelings of overwhelming helplessness, terror and fear as well unpleasant physical symptoms of extreme anxiety and panic.
Viewed through a ‘trauma lens’ these thoughts, feelings and behaviours are understandable reactions to traumatic events that are a child’s attempts to survive and to try and make sense of often frightening and confusing events.
Reactions to traumatic events can differ and range from relatively mild to severe traumatic stress responses – many recover with the help and support of family, friends and community. Infants, toddlers, children and young people can all develop traumatic stress responses and the responses can vary depending on the child’s age and developmental level. Traumatic stress can fundamentally impact a child’s daily life and ability to function. Traumatic stress responses can vary and are different in very young infants, children and young people (see link). The following can be responses to witnessing or experiencing traumatic events or experiences:-
Reactions to traumatic events can vary ranging from relatively minor and mild, to severe and impairing and can impact on mental health, behaviour, social and educational functioning and physical health and wellbeing.
Mental Health
There are 2 mental health diagnoses that are associated with exposure to traumatic events called Posttraumatic stress disorder (PTSD) and Complex Post traumatic stress disorder (CPTSD) – see link. There can be other co-existing mental health difficulties including anxiety, depression and prolonged grief. There can be an increased risk of self harm and suicide.
Behaviour
There can be other co-existing behaviour problems such as defiant or oppositional behaviours and conduct disorder.
Social and educational functioning
Social functioning may be affected. 1 in 2 young people with PTSD under the age of 18 experience social isolation and loneliness. 1 in 4 young people with PTSD are not in employment, education or training.
Physical health
Many young traumatised children complain of physical symptoms such as headaches and stomach aches with some studies reporting an increase in the risk of developing eating disorders, chronic pain and musculoskeletal problems.
Trauma can have a long lasting impact
Some young people who have experienced traumatic experiences are at increased risk of experiencing mental health problems later in life , physical health problems, relationship difficulties and are more likely to experience further abusive experiences.
Recovery from trauma is common and possible
Not everyone who has witnessed or experienced a traumatic event(s) will develop traumatic stress symptoms. Many recover with the help and support of family, friends and community and the importance of predictable, safe and nurturing relationships cannot be overstated.
Each and every contact with an infant, child or young person, no matter how brief, is a precious opportunity to impact positively on a child’s recovery and promote healing. There are multiple, daily opportunities to impact positively on a child or young person’s emotional wellbeing and to help build resilience and promote healing.
When and how to seek help
It is important to know when to seek support and how to seek additional targeted or specialist support to aid with healing and recovery (see link).