pres trauma in childhood

Trauma In ChildhoodTrauma In Childhood

Trauma in ChildhoodTrauma in Childhood

PTSD in childhood is under diagnosed.PTSD in childhood is under diagnosed.

Children with PTSD often have three or more Children with PTSD often have three or more diagnosis in attempts to find an accurate diagnosis in attempts to find an accurate diagnosis. diagnosis.

PTSD in childhood effects brain development.PTSD in childhood effects brain development.

PTSD in childhood effects neurocognitive PTSD in childhood effects neurocognitive development.. development..

Common Diagnostic Common Diagnostic Confusion…Confusion…

Common diagnosis given instead of childhood Common diagnosis given instead of childhood PTSD.PTSD. Oppositional defiant disorder.Oppositional defiant disorder.

Attention deficit hyperactivity disorder. Attention deficit hyperactivity disorder.

Generalized anxiety disorder.Generalized anxiety disorder.

Events Known to Lead to Events Known to Lead to Symptoms of PTSD Symptoms of PTSD

(Trauma)(Trauma)Violence Violence

WarWar

Terrorist attacksTerrorist attacks

Physical assault/ViolencePhysical assault/Violence

Sexual assaultSexual assault

Seeing another person Seeing another person hurt.hurt.

Community violence Community violence

Domestic ViolenceDomestic Violence

Accidental Accidental

Car AccidentsCar Accidents

FallsFalls

Natural disastersNatural disasters

SurgeriesSurgeries

Animal attacksAnimal attacks

Near Drowning Near Drowning

PoisoningPoisoning

CancerCancer

Life threatening illness Life threatening illness

PTSD in Early ChildhoodPTSD in Early Childhood

More intense symptoms of traumaMore intense symptoms of trauma

Have a chance of developing symptoms of traumaHave a chance of developing symptoms of trauma

More incidence of hyperactivity and depression after a More incidence of hyperactivity and depression after a traumatic events.traumatic events.

Higher differences in cognitive development, emotional Higher differences in cognitive development, emotional development due to it being a time of large scale development due to it being a time of large scale neuroplasticity, less language abilities.neuroplasticity, less language abilities.

Young children often do not display symptoms of Young children often do not display symptoms of numbing. numbing.

There is a higher amount of diagnosis of oppositional There is a higher amount of diagnosis of oppositional defiant disorder and separation anxiety disorder.defiant disorder and separation anxiety disorder.


Yong Children (0 to 3) Display…Yong Children (0 to 3) Display… Difficulty sleepingDifficulty sleeping Night-terrorsNight-terrors Reduced attention spanReduced attention span Relationally, survivors of interpersonal trauma Relationally, survivors of interpersonal trauma

suffer from a loss of trust and a sense of suffer from a loss of trust and a sense of betrayal from a person who is loved.betrayal from a person who is loved.

Personality changesPersonality changes Increased separation anxiety Increased separation anxiety


Yong Children (0 to 3) Display…Yong Children (0 to 3) Display… Re-enactment playRe-enactment play Toy destructionToy destruction Aggression towards peersAggression towards peers Defiance toward parents and adultsDefiance toward parents and adults Living with domestic violence is related to more Living with domestic violence is related to more

aggressive and acting- out behavior, possibly aggressive and acting- out behavior, possibly due to modeling.due to modeling.

Key Points Key Points Trauma in Young Children Trauma in Young Children

Young Children Display: Young Children Display: More intense symptoms of trauma;More intense symptoms of trauma; Increased risk of developing PTSD; Increased risk of developing PTSD; More incidence of hyperactivity and depression More incidence of hyperactivity and depression

then older children.then older children.

Young Children:Young Children: Act out the trauma in play more often the older Act out the trauma in play more often the older

children; children; Tend to have a higher incidence of destructive Tend to have a higher incidence of destructive

behavior and violence; behavior and violence; Can display higher levels of oppositional Can display higher levels of oppositional

behaviors then older children. behaviors then older children.


Young children often do not display Young children often do not display “numbing/ avoidance symptoms.”“numbing/ avoidance symptoms.”

They often display what one researcher They often display what one researcher called, “New fears and aggressions.”called, “New fears and aggressions.”

Young children display an increase of Young children display an increase of externalizing (acting out) and internalizing externalizing (acting out) and internalizing (acting in) behaviors. (acting in) behaviors.


Trauma effects Seven Domains of a Child’s Trauma effects Seven Domains of a Child’s Functioning…Functioning…

1.1. Symptoms of PTSDSymptoms of PTSD

2.2. Psychological meaningPsychological meaning

3.3. Developmental disruptionsDevelopmental disruptions

4.4. The effects of developmental disruptions on later The effects of developmental disruptions on later developmentdevelopment

5.5. Direct Impact of the traumatic event on social Direct Impact of the traumatic event on social support systems. (Other’s symptoms of trauma).support systems. (Other’s symptoms of trauma).

6.6. Impact of child’s symptoms on others.Impact of child’s symptoms on others.

7.7. Cumulative Effects of Trauma. (Trauma Stacking).Cumulative Effects of Trauma. (Trauma Stacking).


Educators can create islands of safety.Educators can create islands of safety.

Children who have been traumatized often Children who have been traumatized often feel an “I can’t…” where other children feel feel an “I can’t…” where other children feel an “I can!”an “I can!”

A class room can be an island of safety where A class room can be an island of safety where the child can build mastery experiences and the child can build mastery experiences and learn to trust again.learn to trust again.

Key Points Key Points Trauma in Young Trauma in Young

ChildrenChildrenAdults who support children Adults who support children

with trauma Report on the CBCL with trauma Report on the CBCL that the child…that the child… Argues a lot. Argues a lot. Can’t sit still, restless, or Can’t sit still, restless, or

hyperactive. hyperactive. Fears certain animals, Fears certain animals,

situations, situations, or places. or places.

Key Points: School Age Key Points: School Age ChildrenChildren

Children have less difficulty remembering events Children have less difficulty remembering events and often experience feelings of isolation, Shame, and often experience feelings of isolation, Shame, Fear, and Guilt.Fear, and Guilt.

Children often have less re-experiencing Children often have less re-experiencing symptoms but participate in traumatic play.symptoms but participate in traumatic play.

Teacher reports of child aggression were Teacher reports of child aggression were associated with…associated with… The child’s age when exposed to the traumatic The child’s age when exposed to the traumatic

event; exposure to community violence and event; exposure to community violence and domestic violence. domestic violence.


• More then 60% of children who have been traumatized have More then 60% of children who have been traumatized have moderate to extreme difficulty with attention.moderate to extreme difficulty with attention.

• Adults Report that Children with Trauma: “argue a lot;” “can’t Adults Report that Children with Trauma: “argue a lot;” “can’t sit still, restless, hyperactive;” “have fears certain animals, sit still, restless, hyperactive;” “have fears certain animals, situations, or places”situations, or places”

In recent years the number of adults involved in a child’s life In recent years the number of adults involved in a child’s life have been reduced. Because of this there are decreases in have been reduced. Because of this there are decreases in positive transactions with adults and mentorspositive transactions with adults and mentors

• In the school age years emotion regulation centers in the In the school age years emotion regulation centers in the brain are growing. Interactions with adults build the ability to brain are growing. Interactions with adults build the ability to regulate.regulate.


Alertness (a key domain of attention) and arousal can Alertness (a key domain of attention) and arousal can be changed by PTSD in two ways: Hyperarousal (looks be changed by PTSD in two ways: Hyperarousal (looks like hyperactivity) and Dissociation (looks like like hyperactivity) and Dissociation (looks like withdraw)withdraw)

Stress Levels can effect the ability to maintain Stress Levels can effect the ability to maintain attentionattention

Educators can regulate arousal through social contact.Educators can regulate arousal through social contact.

It is always important to assess how much miss-It is always important to assess how much miss-attunement a child can tolerate.attunement a child can tolerate.

Emotions are thoughts plus sensations.Emotions are thoughts plus sensations.

Neuroception is the way that we intuitively assess if Neuroception is the way that we intuitively assess if we are safe or not. we are safe or not.

Trauma in the Teen Trauma in the Teen Years…Years…

Teen who have Face Teen who have Face Trauma Often experience: Trauma Often experience: Fear, Fear, Worry, Worry, Sadness, Sadness, Anger, Anger, Feeling alone and Feeling alone and

apart from others, apart from others, Feeling as if people Feeling as if people

are looking down on are looking down on them, them,

Low self-worth, and Low self-worth, and Unable to trust others.Unable to trust others.

Teen who have Face Teen who have Face Trauma Often Display Trauma Often Display Dysfunctional Behaviors:Dysfunctional Behaviors: Increased aggression. Increased aggression. Out-of-place sexual Out-of-place sexual

behavior. behavior. Self-harm. Self-harm. Abuse of drugs or Abuse of drugs or

alcohol.alcohol. Dropping out of schoolDropping out of school Risk of pregnancy at a Risk of pregnancy at a

young age.young age. Attempt suicide.Attempt suicide.

Externalizing BehaviorsExternalizing BehaviorsThe Hyperarousal TypeThe Hyperarousal Type

Increased Externalizing Behaviors: Externalizing behaviors Increased Externalizing Behaviors: Externalizing behaviors manifest in children's outward behavior.manifest in children's outward behavior.

The child acts out their hurt on the external world. Such The child acts out their hurt on the external world. Such as: as:

Disruptive behavior; Disruptive behavior; Hyperactivity; Hyperactivity; Aggressive behaviors; Aggressive behaviors; Delinquency; Delinquency; Impulsivity. Impulsivity. These Children are often referred to as having conduct These Children are often referred to as having conduct

problems; problems; Display antisocial behaviors. Display antisocial behaviors. Appear undercontrolled.Appear undercontrolled.

Internalizing BehaviorsInternalizing BehaviorsThe Dissociative TypeThe Dissociative Type

Some teens implode and don’t explode.Some teens implode and don’t explode.

Teens who are the most overwelemed sometimes appear Teens who are the most overwelemed sometimes appear quiet, withdrawn and isolated.quiet, withdrawn and isolated.

Increased Internalizing Behaviors: Increased Internalizing Behaviors: With-drawing into their own world; With-drawing into their own world; Acting and feeling anxious; Acting and feeling anxious; Being inhibited in normal exploration; Being inhibited in normal exploration; Feeling unsafe; Feeling unsafe; Depressed mood and behaviors. Depressed mood and behaviors. Negative Emotions and beliefs. Negative Emotions and beliefs. Can appear “overcontrolled." Can appear “overcontrolled."

Incident Driven Incident Driven DysregulationDysregulation

This is the main focus of the current PTSD liturature.This is the main focus of the current PTSD liturature.

Two main forms of dysregulation (These types are not Two main forms of dysregulation (These types are not exclusive but people show a predominance in a exclusive but people show a predominance in a direction) direction)

Hyperactivation: Reflects an upregulation of stress Hyperactivation: Reflects an upregulation of stress hormone production and an underactivation of emotion hormone production and an underactivation of emotion regulation centers. Display increased Cortisol and regulation centers. Display increased Cortisol and Heart Rate when read a trauma script. (70% of sample)Heart Rate when read a trauma script. (70% of sample)

Hypoactivation: Reflects an under-activation of stress Hypoactivation: Reflects an under-activation of stress response and an over activation cortical structures, response and an over activation cortical structures, which regulate stress. Displays a decreased Cortisol which regulate stress. Displays a decreased Cortisol production and Hear Rate when read a trauma script. production and Hear Rate when read a trauma script. (30% of sample) (30% of sample)

HyperactivationHyperactivation

The hyperactivated individual floods with The hyperactivated individual floods with information from the body and has less capacity to information from the body and has less capacity to regulate the intense sensation.regulate the intense sensation.

Ruth Lanius Found in an fMRI Study…Ruth Lanius Found in an fMRI Study… Over activation in the insula (bringing extreme Over activation in the insula (bringing extreme

amounts of information from the body’s interceptive amounts of information from the body’s interceptive cues)cues)

Under-activation of the anterior cingulate cortex Under-activation of the anterior cingulate cortex (ACC) (area needed to regulate the body sensations (ACC) (area needed to regulate the body sensations brought up from the insula)brought up from the insula)

Under-activation medial prefrontal cortex (mPFC) Under-activation medial prefrontal cortex (mPFC) (area needed to regulate the body sensations brought (area needed to regulate the body sensations brought up from the insula) up from the insula)

HypoactivationHypoactivation

For the hypoarousal type, only a small amount of For the hypoarousal type, only a small amount of interceptive cues get into the limbic cortex and interceptive cues get into the limbic cortex and are quickly squelched by cortical structures, are quickly squelched by cortical structures, leaving the individual feeling disconnected, leaving the individual feeling disconnected, emotionally flat, and dissociated.emotionally flat, and dissociated.

Ruth Lanius Found in an fMRI Study…Ruth Lanius Found in an fMRI Study… Down regulation of physical sensations from the Down regulation of physical sensations from the

insula cortex.insula cortex. Hyperactivation activation in the anterior cigulet Hyperactivation activation in the anterior cigulet

cortex (ACC). cortex (ACC). Hyperactivation in the medial prefrontal cortex Hyperactivation in the medial prefrontal cortex

mPFC. mPFC.

Two types of ADHDTwo types of ADHD

Hyperactive: Charicterized by Hyperactive: Charicterized by hyperactivity and poor impulse hyperactivity and poor impulse control…control…

Inattentive: Charicterized by Inattentive: Charicterized by inattention. inattention.

Some overlap with two types of Some overlap with two types of PTSD…PTSD…

Trauma and ResiliencyTrauma and ResiliencySome Good News to Some Good News to

CloseClose Resiliency is the ability to bounce back after a Resiliency is the ability to bounce back after a

difficult life event.difficult life event.

Resiliency is normal. Only between 10 and Resiliency is normal. Only between 10 and 25% of children who face life threatening 25% of children who face life threatening situations develop symptoms of trauma.situations develop symptoms of trauma.

There are many things clinicians can do to There are many things clinicians can do to promote resiliency. promote resiliency.

QuestionsQuestions

pres trauma in childhood

Health & Medicine