in Child Welfare - The Trauma Center

6 CW360 o Trauma-Informed Child Welfare Practice • Winter 2013The Impact of Trauma from Early Childhoodthrough Adolescence: A Developmental PerspectiveKeri LM Pinna, PhD and Abigail Gewirtz, PhD, LPThe impact of potentially traumaticexperiences on a child’s adjustment variessignificantly depending on the developmentalstage at which the child experiences trauma.This is true regardless of the nature ofpotentially traumatic event (i.e. whetherit be abuse, neglect, exposure to violence,or some other traumatic event). Children’sperceptions of threat during and following apotentially traumatic event (Kahana, Feeny,Youngstrom, & Drotar, 2006) and the natureof caregiver responses following the trauma(Scheeringa & Zeanah, 2001) are among thestrongest predictors of children’s adjustmentfollowing trauma. Children’s perceptionsof their experiences vary as a function ofdevelopment as do the outcomes associatedwith caregiver responsiveness. Manners inwhich trauma-related symptoms manifestfollowing a potentially traumatic experiencealso vary by developmental level. Thus, weexplore developmental variations in children’sperceptions of threat, outcomes associatedwith caregiver response to the child followingtrauma, and manifestations of trauma-relatedsymptoms across developmental stages frominfancy through adolescence.imagines could have happened if, for example,the police were not called when mommyand daddy were fighting near the kitchenknives. An adolescent is more likely to beable to gather and evaluate informationabout a potentially traumatic event todetermine the actual threat involved butmay also overestimate his/her sense of safety(Wickman, Greenberg, & Boren, 2010). Theadolescent child of an abused mother mayunderestimate the risk involved in steppingin to protect his mother from her abusivepartner. The adolescent’s sense of invincibilitymay lead him to becoming the victim of thepartner’s abuse in the process, or even anunwitting perpetrator.Caregiver Response & AttachmentWhen a child is traumatized in the presenceof supportive caregivers, his responsesmay mimic those of the parent (van derKolk, 2003). Children whose caregiversare unresponsive and/or inconsistent intheir responses to the child’s distress maydevelop insecure attachments and associatedemotion regulation deficits. Disorganizedattachment (one form of insecure attachment)develops when a parent responds to a childinconsistently, with frustration, violence,intrusiveness, or when a parent is severelyneglectful. Children with disorganizedattachment learn that they are unable torely on their caregivers becoming eitherOverviewPerceptions of ThreatUnderstanding how a potentially traumatizedchild experienced a traumatic event isthe first step in determining how best tomeet the child’s needs in the immediateand longer-term aftermath. For an infant,facial expressions, tones of voice, suddenloud noises, and experience of caregiverresponsivity to the infant’s cues (e.g. crying)serve as the basis for interpreting safetyversus danger (e.g. Moore, 2009). Whilean infant may not be capable of thinking“This is terrifying!,” angry voices and facialexpressions, and the sound of breaking glassin the next room are processed as threateningin the infant brain. Further, the absence ofcomfort in response to terrified cries leads aninfant to learn that her caregivers cannot betrusted to provide comfort in times of need.With each stage of development,perception builds on prior stages. Forexample, a toddler or school aged childalso perceives facial expressions, tones ofvoice, sudden loud noises, and parentalnon-responsiveness to the need for comfort.As cognitive development becomes moreadvanced, the capacity for imagining thepossibility of negative outcomes increases(Grist & Field, 2012). Thus, perceptionof threat begins to include what a child