Everyone experiences scary or difficult events in their lives. For some children, these events can be so frightening or dangerous that they can have a lasting impact on their well-being. Trauma refers to the physical, cognitive, and emotional responses to an event (or events) that is physically or emotionally overwhelming or life-threatening. Children’s responses to a traumatic event can have negative effects if left untreated.
Trauma can be the result of a single incident, like the unexpected death of a loved one, a serious accident, or experiencing a natural disaster. It can also be chronic or ongoing, such as repeated instances of neglect, bullying, and exposure to family or community violence. Communities can also experience trauma through discrimination and racism that can affect future generations. While trauma from a single event can be impactful, research tells us that children who experience a higher number of Adverse Childhood Experiences, or ACEs, are more likely to have negative consequences that continue into adulthood. Early exposure to many ACEs can lead to excessive stress that can impact brain development. This may affect attention and learning and make it challenging to form positive relationships with others. Regarding education, the impact of trauma has been associated with higher rates of suspension and expulsion, higher dropout rates, increased referrals for special education, and lower academic performance. The long-term effects of trauma on physical and mental health include increased risk of conditions like diabetes, cardiovascular diseases, depression, and suicide (Centers for Disease Control and Prevention, 2019).
Signs of childhood trauma vary based on age and developmental level. For example, children who are preschool-aged or younger may display a regression of skills they previously acquired (e.g., toileting, talking), poor eating habits, and sleep disturbances such as nightmares or fears around falling asleep. Elementary children can present with sleep challenges, difficulties concentrating in school, and retelling the event often, while teens may express feelings of shame and guilt about the event or engage in risky behaviors like drinking or using harmful substances.
If a child has experienced a traumatic event, families should find ways to support safety and predictability, including returning to previous routines like mealtimes and bedtimes. Creating opportunities for expressing feelings in a safe, supportive environment as a family can also be beneficial. Caregivers are encouraged to answer children’s questions about the event honestly while also using words and phrases that match the child’s level of understanding. Depending upon the event, children may have concerns about their own safety or the safety of loved ones, and creating an explicit plan for safety can help alleviate their worries. Engaging in joyful activities together, like reading a book or watching a movie and discussing character emotions or playing games and drawing, can provide children space to express themselves in multiple ways. Although it may be difficult, caregivers should continue to set appropriate limits and boundaries, as this promotes consistency and predictability in the child’s life.
Caregivers will want to pay attention to significant changes in their child’s behavior and seek out additional support from a mental health professional if these changes are extreme or persist for several weeks. Current evidence-based treatments, such as Trauma-Focused Cognitive Behavior Therapy (TF-CBT), will include components to help both children and their caregivers receive the tools they need to cope with the event. Treatment can help children and families identify unhelpful thoughts, learn skills to help cope with thoughts and feelings about the trauma, provide parenting strategies, create a plan for dealing with trauma reminders, and develop a trauma narrative to increase the child’s exposure to the trauma in a safe and controlled setting. Children will develop the tools they need to prepare themselves for a future after trauma.
Schools can meet the needs of students who have experienced childhood trauma. They can adopt policies and procedures that emphasize a positive school climate that will promote safety and trust within the school community. In fact, practices used to enhance school climate and trauma-informed practices are aligned. Trauma-informed care incorporates principles of safety, peer support, trust and transparency, collaboration, empowerment and choice, and cultural, historical, and gender issues (SAMHSA, 2014). School climate is a broad term that also encompasses prioritizing students’ physical and emotional safety as well as nurturing positive and supportive relationships. Empowering students by offering choices will provide a sense of control and agency. Incorporating daily rituals such as morning meetings or individual check-ins can facilitate positive adult-student interactions. Finally, setting clear, predictable expectations will build trust amongst students and staff. Staff members can be trained to recognize signs of trauma in their students and partner with families to select appropriate accommodations to aid in students’ learning. Teachers may notice students withdrawing from others, emotional outbursts that are more intense and/or more frequent, crying more easily, poor academic performance, or sleeping in class. Schools can consider accommodations to support the child, including reducing assignment length, giving extended time, and allowing the child to regularly connect with a school-based mental health professional if they are experiencing emotional difficulties (NASP School Safety and Crisis Response Committee, 2015).
Additionally, incorporating social and emotional curricula can teach both students and teachers to identify ways to express emotions effectively, choose helpful coping strategies to manage difficult emotions, and ask for help from others when they are struggling. When working with children who have experienced trauma, adults should prioritize taking care of themselves to avoid compassion fatigue, which can occur when we are constantly taking care of others. Eating three meals a day, drinking plenty of water, and having a consistent sleep schedule are a few common self-care strategies. Other opportunities can include incorporating enjoyable exercise into daily routine, like dance or yoga, and practicing a simple mindfulness activity, like a body scan, which can help keep them alert to any changes that might indicate they are experiencing compassion fatigue. Staff can develop a “tap-out” system to take a break and trade places with other staff members when they recognize their emotions are heightened so they can ensure that the students’ needs are still being met. Importantly, adults should have patience and compassion not only for the students they serve but for themselves as well.
Childhood trauma can have lasting negative impacts, but support from families, schools, and communities can help children heal.
Jeniffer Cruz, PhD, NCSP, is a licensed psychologist in New Jersey and a Nationally Certified School Psychologist. She works at Behavior Therapy Associates in Somerset, New Jersey. She can be reached at jcruz@BehaviorTherapyAssociates.com and at www.BehaviorTherapyAssociates.com.
References
Centers for Disease Control and Prevention (2019). Adverse Childhood Experiences (ACEs) Prevention Resource for Action: A Compilation of the Best Available Evidence. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
NASP School Safety and Crisis Response Committee. (2015). Supporting Students Experiencing Childhood Trauma – Tips for Parents and Educators. Bethesda, MD: National Association of School Psychologists.
Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
