Children and trauma.
Jason Brien.
Children and adolescents that have been exposed to trauma, either directly or indirectly, experience, process, display and suffer from trauma much differently than adults. Children and adolescent’s brains can undergo significant neurological changes when exposed to chronic stress hormones. The constant influx of stress hormones in the developing brain ultimately serves to weaken neural pathways leading to learning difficulties, limited reasoning abilities, cognitive deficits and reduced ability to cope and manage with stress and adversity come adulthood.
Trauma exposure in childhood and adolescents also negatively affects their immune system. Research has consistently demonstrated links between trauma exposure, increases in stress hormones and weakened immune responses leading to conditions such as autoimmune disease, asthma, anxiety, depression, viral infections and allergies. The thymus, which is a specialised lymphoid organ in the immune system, and facilitates the maturation of T-cells, has been linked to deterioration of the spleen and lymph nodes in children and adolescents exposed to prolonged trauma.
Stress hormones such as cortisol and adrenaline, which is released in response to perceived danger and activates blood flow to major body parts and organs, can become elevated in response to trauma. Elevated stress hormone production in children and adolescents can lead to high blood pressure (which subsequently weakens the heart and circulatory system), Type 2 diabetes, depression, osteoporosis, depression and abdominal obesity. Significant changes in hormone levels in young brains which are still developing can lead to neurological dysfunctions which will impact upon the child/adolescent later in life.
When children and adolescents have been exposed to trauma, their brains, bodies, immune systems and nervous systems change in order to help them survive. These changes can result in changes in thoughts, feelings and behaviours. Children and adolescents may become more aggressive, disconnected (from feelings and reality) and distrustful. They may find that the world is more scarier and more unpredictable than it previously was. The way in which parents, caregivers, siblings, friends and teachers respond to these new changes, feelings and behaviours will either reinforce the distrust or lead to children feeling safe and secure. The symptoms of trauma will be expressed differently depending on age and cognitive maturation. For example;
Children aged 0-5 years:
- Increased fussiness and irritability,
- over active startle response,
- playing with toys or peers in ways that re-enact the trauma,
- insecure and ambivalent attachment styles,
- developmental delays
Children aged 6-12 years
- Atypical quietness or shyness,
- crying or sadness,
- difficulty concentrating,
- changes in school performance,
- Unusual fixation on scary feelings and ideas or interest in violence, blood and gore (may be displayed through play, painting/drawing or media interests),
- loss of interest in previously enjoyable activities,
- changes in peer/sibling relationships (increased fighting or bullying),
- headaches, stomach aches and/or other body complaints without apparent cause,
- regressed behaviours such as thumb sucking, rocking, bed wetting or scared of dark.
Adolescents aged 13-18 years;
- Unusual fixation on scary feelings and ideas or interest in violence, blood and gore (may be displayed through play, painting/drawing or media interests),
- social withdrawal,
- loss of interest in previously enjoyable activities,
- increased disobedience and rule breaking,
- increased frustration, irritability and/or aggression
- decreased school performance,
- sudden changes in social groups leading to negative peer influence,
- alcohol, drug and substance misuse,
- running away and criminal activity.
For the most part, children and adolescents are extremely resilient. Although their developing brains and bodies make them more vulnerable to the effects of trauma, the same brain plasticity makes them much more able to reverse neurological changes if they seek trauma treatment before adulthood. It is important that parents, caregivers, teachers and friends recognise that a child or adolescent has been exposed to trauma and is suffering as a result. Parents and caregivers etc can help their loved ones by following these tips;
- Provide a safe, trusting and loving environment to allow the child/adolescent the security to open up and express their thoughts, feelings etc. This means being emotionally open and available whilst remaining non-judgmental,
- help the child/adolescent identify trauma triggers,
- avoid physical punishment. Physical punishment will increase distrust and decrease feelings of safety,
- teach your child relaxation techniques,
- encourage self-esteem,
- set predictable and consistent routines,
- discourage your child from obsessively relieving the traumatic event.
Resources
Child Welfare Information Gateway. Available online at https://www.childwelfare.gov/pubs/factsheets/child-trauma
Cohen, J. A. (2003). Treating acute posttraumatic reactions in children and adolescents. Biological Psychiatry, 53(9), 827-833.
DePrince, A. P., Weinzierl, K. M., & Combs, M. D. (2009). Executive function performance and trauma exposure in a community sample of children. Child abuse & neglect, 33(6), 353-361.
Grasso, D. J., Ford, J. D., & Briggs-Gowan, M. J. (2013). Early life trauma exposure and stress sensitivity in young children. Journal of pediatric psychology, 38(1), 94-103.
Hall JE (2016). Guyton and Hall textbook of medical physiology (13th ed.). Philadelphia: Elsevier. pp. 466–7. ISBN 978-1-4557-7016-8.
McCloskey, L. A., & Walker, M. (2000). Posttraumatic stress in children exposed to family violence and single-event trauma. Journal of the American Academy of Child & Adolescent Psychiatry, 39(1), 108-115.