effects of trauma and family violence on the development of children dr larry cashion specialist...
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Effects of Trauma and Family Violence on the Development of Children
Dr Larry CashionSpecialist Consultant Psychologist
Presented at theCommunities for Children Connections Conference
Launceston, 29 June 2011
Trauma
A deeply distressing or disturbing experience– Oxford Dictionary
Posttraumatic Stress Disorder– DSM-IV-TR 309.81
The development of characteristic symptoms following exposure to an extreme traumatic experience stressor
Direct personal experience OR Vicarious experience with close relationship
Trauma without PTSD
PTSD requires specific outcomes in response to trauma
Some children experience incidents at being traumatic when others do not
Some children do not develop PTSD However, that does not mean there is no
effect on children simply by the absence of sufficient diagnostic criteria for a diagnosis of PTSD
Types of Trauma
This presentation will focus on family-based trauma
What we are considering includes:– Family violence– Deprivation and neglect– Exposure to high risk situations– Sexual abuse
Trauma, Deprivation and Neglect
These issues can affect the quality and quantity of social and emotional responses by children
Trauma can be directly or indirectly experienced
Deprivation is a lack of physical care and of social and emotional stimulation and interchange
Neglect is a failure of caregivers to fulfil their caretaker obligations to children
Trauma Effects
Children with traumatic experiences will often demonstrate avoidance behaviours
This means they will avoid thinking about their experiences by any means
Some will have affective numbing and will be highly unresponsive
It is often helpful to treat the child as a ‘survivor’ rather than a ‘victim’
Deprivation-Type Effects
Inability or dysfunction in forming normal social relationships or connecting with others
May manifest similarly to autism spectrum disorders– Repetitive stereotyped OCD-like behaviours– Poor eye contact– Delayed language
Mood and anxiety problems
Neglect-Type Effects
Limitations in the ability to appropriately read nonverbal facial and gestural cues
Language deficits below age normal Limited problem-solving skills IQ deficits nutritional, interpersonal and
environmental factors Learned helplessness no matter what I
do it won’t make any difference Fear of caregiver retribution
A Little Bit of Neuroscience
Ways of Examining Trauma Effects Psychological
– Cognitive– Emotional
Physiological– Stress responses by the body
Neurological– Changes in brain function – Changes in brain structure
Theories of Child Development
Erickson’s theory of psychosocial development– Each life stage has a psychological crisis that
needs to be met successfully
Maslow’s hierarchy of needs– Certain needs have to be fulfilled to move the
to next level of development
Attachment theories– Failure to develop significant and appropriate
attachments has lifelong effects
Erickson’s Psychosocial Crises
Infancy: Trust vs Mistrust Early childhood: Autonomy vs Shame Play age: Initiative vs Guilt Middle childhood: Industry vs
Inferiority Adolescence: Identity vs Role
Confusion
Maslow’s Model
Physiological Responses
Dizziness Headaches Chest pain/tightness Difficulty breathing Muscle tremors Sensitivity to sights,
sounds, smells, touches and tastes ‘associated’ with the traumatic event
Fatigue Elevated blood
pressure Profuse sweating Vomiting/nausea Teeth grinding Somatic disturbance
Physiological Effects
Increases in stress hormones– Cortisol– Adrenaline (epinephrine)– Noradrenaline (norepinephrine)
Long term depression of function Can lead to biological depression due to
long term effects on brain chemistry
Neurological Effects
Amygdala versus Hippocampus in memory formation
Failure to develop neural networks required for social, academic, and adaptive functioning
Unusual patterns of resource utilisation Over-excitement of some brain areas with
under-excitement in others
How to Help?
The world as a safe place (even though adults know it’s not)
Consistent behaviours have consistent outcomes – includes provision of clear boundaries
Positive regard in the face of challenging behaviour
The response to the child is more important that what is said – good behaviour needs to be modelled – good behaviour needs to be explicitly taught
How this Helps?
Consistency and safety allows resources to psychologically and neurologically recover resources for development, not just crisis coping
Children who experience trauma in their home environment often don’t know how to behave appropriate because it is not modelled
The 3-Phase Approach
STOP– The word ‘stop’ has one meaning – words such as ‘no’
and ‘don’t’ have multiple meanings
DON’T DO THAT– The child needs to know what not to do – carers often
say ‘don’t do that’ – vague/confusing
DO THIS– This is the most important part that is very often missed
– Children are not little adults – children who have experienced trauma more so – it cannot be assumed they will learn by osmosis
