by: Elizabeth Kallas, MA, OTR/L
Developmental Trauma
Trauma occurs when an individual experiences a chronically-activated stress response for any reason. Developmental trauma can occur when a child perceives or experiences a threat to their physiological safety, mental wellbeing, or caregiver relationships. Childhood trauma can be caused by one or more Adverse Childhood Experiences (ACEs), such as neglect, abuse (physical or mental), homelessness, food insecurity, unstable relationships, or witnessing crime. (Childhood trauma can also come from sensory processing challenges – for example hypersensitivity to sensory input – which, over time, result in an activated stress response (Barthel, 2019).) Not all ACEs cause trauma, and there is no “one size fits all” approach to diagnosing and treating developmental trauma.*
The Impact of Trauma
Developmental trauma impacts a child’s emotional and physical wellbeing during a crucial period in life when their brains and bodies are still maturing and developing. Trauma, therefore, contributes to many short- and long-term effects. In the short term, external stressors activate the autonomic nervous system, a part of the peripheral nervous system that controls vital functions, such as our breathing, heart rate, and digestion. The autonomic nervous system has two equally important components – the sympathetic and parasympathetic nervous systems – that work together to keep the body in a state of equilibrium (i.e., functioning well and feeling good).
The parasympathetic nervous system is often known as the “rest and digest” branch. This branch prepares the body for targeted activities like sleep and processing food and is a slower-acting system. Activities like breathwork and hanging upside down can elicit parasympathetic response (Barthel, 2021).
The sympathetic nervous system is activated when there is an environmental stressor or threat, and the body responds to protect us. This system is known as the “fight or flight” response and is fast-acting, with multiple generalized body responses to prepare our body to flee or face the threat. Activation of this system produces increased heart rate, blood pressure, blood flow to skeletal muscles, sweat production (regulating body temperature), and the secretion of stress hormones (such as cortisol) from the adrenal glands.**
“Trauma Lives in the Body”
Developmental trauma causes prolonged and repeated activation of the sympathetic nervous system and therefore ongoing and repeated stress to the body (Ranabir & Reetu, 2011). Due to this physiological response, trauma is often said to “live in the body” and can have the consequence of seriously damaging our physical health. Prolonged stress impacts physical health in several ways, such as creating a weakened immune system and memory deficits. In the long-term, studies prove that developmental trauma can lead to several negative outcomes – both emotional and physical – that can last for years after the trauma is experienced (Adverse Childhood Experiences, 2021). For example, children who undergo trauma are more likely in adulthood to struggle with addiction and alcoholism, as well as experience a lower socioeconomic status (SES), a higher mortality rate, and higher rates of illness (Felitti, 2002).
Signs of Trauma
“How people move tells you their story.” – Kim Barthel, OTR
Here are some potential signs and outcomes of developmental trauma:
How to Address Trauma
As mentioned above, there is no “one size fits all” approach when it comes to trauma, but early intervention is KEY to shifting the negative trajectory of ACEs and developmental trauma. A knowledgeable, multidisciplinary team might include mental health therapists, occupational therapists, social workers, case managers, and in-home support (like respite care or family therapy) for families to reduce burnout. These teams could suggest interventions such as:
Next Steps
If you are worried your child experienced or is currently experiencing trauma, please reach out for help. The good news is that there are many resources and actions you can take to help develop resiliency in your child.
You may find it helpful to write notes on the following information:
This type of data can be very helpful in identifying patterns and potential causes of stress in your household. Reaching out to your primary healthcare provider can be a good start in identifying what resources may be best for your family.
Here are some helpful websites for additional information and resources:
Resources on Trauma for Caregivers and Families – Child Welfare Information Gateway
NIMH » Coping With Traumatic Events (nih.gov)
All NCTSN Resources | The National Child Traumatic Stress Network
Fast Facts: Preventing Adverse Childhood Experiences |Violence Prevention|Injury Center|CDC
St. David’s Center for Child and Family Development is also here to support you and your family system. Our staff provide trauma-informed care across a variety of programs that operate on-site, in-home, and via telehealth. Please reach out to the CORE team to learn more via email at coreinfo@stdavidscenter.org or phone (952) 939-0396.
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*For a more extensive list of ACEs, please visit Adverse Childhood Experiences (ncsl.org).
**There is a new proposal for a third pathway – the Dorsal vagal pathway – which produces the “freeze” or shut-down response pattern and is known as the Polyvagal theory (Porges, 2009). This theory also includes a “social and emotional response” component, whereby stress can be mitigated and resiliency developed by supportive factors such as a well-regulated caregiver. Many interventions are grounded in this theory; however, it is still being researched.
References
Adverse childhood experiences. (2021, August 12). Retrieved May 9, 2022, from https://www.ncsl.org/research/health/adverse-childhood-experiences-aces.aspx#:~:text=1%20ACEs%20101.%20What%20Are%20ACEs%3F%20Adverse%20childhood,explore%20two%20critical%20components%20of%20a%20child%E2%80%99s%20development.
Barthel, Kim (2021, November 12). Psychosensory interventions, and (2019, February 8). Psycho-Sensory Processing Intervention
Felitti, V. J. (2002). The relation between adverse childhood experiences and adult health: Turning gold into lead. The Permanente journal. Retrieved May 9, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220625/?msclkid=98aee320ba1611ecb8555750b925ae82
Peter Bull Art Studio. (2019, November 13). Parasympathetic and sympathetic nerves: Bull Art, medical illustration, history infographic. Pinterest. Retrieved May 9, 2022, from https://www.pinterest.com/pin/352547477083440403/
Porges S. W. (2009). The polyvagal theory: new insights into adaptive reactions of the autonomic nervous system. Cleveland Clinic journal of medicine, 76 Suppl 2(Suppl 2), S86–S90. https://doi.org/10.3949/ccjm.76.s2.17
Ranabir, S., & Reetu, K. (2011, January). Stress and hormones. Indian journal of endocrinology and metabolism. Retrieved May 9, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3079864/
Elizabeth Kallas is a registered occupational therapist (OT) with over four years of experience working in outpatient pediatrics. At St. David’s Center, she provides services in the Autism Day Treatment program, outpatient therapy, and feeding therapy. She also works part-time as an OT in adult inpatient mental health and previously worked for three years as an adult rehabilitative mental health practitioner. Elizabeth loves combining her passion for pediatric occupational therapy and mental health services and plans to return to graduate school this summer for her doctorate in OT.
Oct. 09, 2024
Sep. 26, 2024