1. Module 6
Trauma and the Child
6.0.1

2. Learning Objectives 6.0.2 Learning Objectives
Define “trauma”, to include persistent absence of responsive care during infancy and early brain development.
Define the term “child traumatic stress. “
Explain the types of experiences that constitute childhood trauma.
Explain how childhood trauma can be the result of numerous experiences related to life in general.
Describe how traumatic experiences affect brain development and memory.
Explain how traumatic experiences affect child development.
Explain the impact of trauma and subsequent changes in the child’s behavior, development and relationships in the long-term.
Explain how cultural factors influence how children may identify, interpret and respond to traumatic events.
Explain how childhood traumatic stress may impact people as current caregivers.
Own the reality of the impact of trauma (attitude).

3. Agenda
6.0.3

4. Trauma and Its Impact on the Child
Unit 6.1
Trauma and Its Impact on the Child
6.1.4

5. Learning Objectives 6.1.5 Learning Objectives
Define “trauma”, to include persistent absence of responsive care during infancy and early brain development.
Define the term “child traumatic stress. “
Explain the types of experiences that constitute childhood trauma.
Explain how childhood trauma can be the result of numerous experiences related to life in general.
Describe how traumatic experiences affect brain development and memory.
Explain how traumatic experiences affect child development.
Explain the impact of trauma and subsequent changes in the child’s behavior, development and relationships in the long-term.
Explain how cultural factors influence how children may identify, interpret and respond to traumatic events.
Explain how childhood traumatic stress may impact people as current caregivers.
Own the reality of the impact of trauma (attitude).

6. What is Trauma? Definition Types of Trauma Early Childhood Trauma
Domestic Violence
Physical Abuse
Neglect
Sexual Abuse
Traumatic Grief
Complex Trauma or Toxic Stress
6.1.6
Key Points:
Trauma is an emotional response to an event. There can be direct involvement in the event or indirect through witnessing the event. The emotional response is intense, distressing and/or painful and can overwhelm your ability to cope.
The stress that is caused by the trauma is called “traumatic stress.”
The seven (7) that you will typically see in your work as a child welfare professional include:
Early Childhood Trauma
Domestic Violence
Physical Abuse
Neglect
Sexual Abuse
Traumatic Grief
Complex Trauma or Toxic Stress

7. Early Childhood Trauma: Children ages 0-6
Intentional violence – child physical or sexual abuse or domestic violence
Physical abuse
Child neglect
Child traumatic grief
Complex trauma
6.1.7
Key Points
Early childhood trauma generally refers to the traumatic experiences that occur to children aged 0-6.
These traumas can be the result of intentional violence - such as child physical or sexual abuse or domestic violence - or the result of natural disaster, accidents, or war.
Domestic violence (Intimate partner violence, domestic abuse): actual or threatened physical or sexual violence or emotional abuse between adults in an Intimate relationship.
Three to 10 million children are exposed to domestic violence in the United States every year – most are under the age of eight.
Physical abuse: causing or attempting to cause physical pain or injury. It can result from punching, beating, kicking, burning or harming a child in other ways.
Child Neglect:
When a parent or caregiver does not give a child the care he or she needs according to its age, even though that adult can afford to give that care or is offered help to give that care.
When a parent or caregiver is not providing a child with medical or mental health treatment or not giving prescribed medicines the child needs.
When a parent neglects the child's education. When a parent keeps a child from school or from special education can be neglect.
Neglect includes exposing a child to dangerous environments, having poor supervision for a child (such as putting the child in the care of someone incapable of caring for children), or poor supervision for a child, including putting the child in the care of someone incapable of caring for children.
Child sexual abuse: takes place between a child and an older person or alternatively between a child and another child/adolescent.
Bodily contact, such as sexual kissing, touching, fondling of genitals, and intercourse.
No bodily contact: genital exposure ("flashing"), verbal pressure for sex, and sexual exploitation for purposes of prostitution or pornography.
Child traumatic grief, when someone important to the child dies - suddenly and unexpectedly, or even anticipated. The distinguishing feature of child traumatic grief is that the trauma symptoms interfere with the child's ability to go through the typical process of bereavement.
The child experiences a combination of trauma and grief symptoms so severe that any thoughts or reminders, even happy ones, about the person who died can lead to frightening thoughts, images, and/or memories of how the person died.
Complex trauma: a child’s exposure to multiple or prolonged traumatic events and the impact of this exposure on their development.
involves simultaneous or sequential occurrence of child maltreatment - including psychological maltreatment, neglect, physical and sexual abuse, and domestic violence - that is chronic, begins in early childhood, and occurs within the primary caregiving system.
Often sets off a chain of events leading to subsequent or repeated trauma exposure in adolescence and adulthood.

8. What is Child Traumatic Stress (CTS)?
6.1.8
Key Points
Child Traumatic Stress (CTS): a psychological reaction that some children have to a traumatic experience.
These reactions can linger and affect their daily lives long after the traumatic event has ended.
Untreated, CTS can interfere with a child’s healthy development and lead to long-term difficulties with school, relationships, jobs and the ability to participate fully in a healthy life.
Psychological trauma in childhood can be just as damaging as trauma that has caused physical injuries.
Three levels of CTS:
Acute stress refers to exposure to a single event such as a car accident.
Chronic trauma refers to repeated events such as physical or sexual abuse or exposure to ongoing domestic violence.
Complex trauma as we already discussed refers to exposure to chronic, multiple types of trauma.

9. How Trauma Impacts the Child
Early Experiences and Development
Attachment
6.1.9
Key Points
Trauma especially impacts attachment and social/emotional development.
Insert Handout X: Child Development Stages

10. Activity Jack at 0-3 – Impact of Trauma
6.1.10
Activity
The purpose of this activity is to help you better understand the impact of specific events in a child’s life and how these events can traumatically impact the child.
In this activity, you will be looking at the traumatic impacts on Jack of the dynamics and behavior of his father, Marc, and mother, Sandy. You will be using two handouts:
Handout X: Child Development Stages
Handout X: Jack at Ages 0-3 (bullet point versions of Module 2 narratives)
In your groups, each person reads each of the three narratives, making notes in the right hand margin identifying what they see occurring with Jack and how his behavior compares to what his behavior should be socially, emotionally and in his attachments.
Discuss your findings as a group. Then we will debrief as a class.
Handout X: Jack at Ages 0-3 (bullet point information based on the previously-read narratives from Module 2)

11. Impact of Trauma on the Child’s Brain
6.1.11
Key Points
Child brains exposed to chronic trauma and stress are wired differently.
The brain’s “fight or flight” response is activated through increased production of the powerful hormone cortisol.
Cortisol production can be protective in emergencies, but is toxic in situations of chronic stress. Cortisol can damage or kill neurons in critical regions of the brain. Unpredictable stressors create the most neurological damage.
Children are more susceptible to post-traumatic stress because in most situations they are helpless and incapable of either “fight or flight.”
The untreated injuries sustained by trauma or neglect early in life lead to sustained damage reverberating in all ensuing developmental stages.
During adolescence, the brain goes through another critical period of remodeling occurs in the pre-frontal cortex, the highest functioning part of the brain which is needed for good judgment, planning and other essential functions of adulthood.
Trauma can impact brain development in adolescence and the neuronal connections are interrupted or not made.
Development is sequential, meaning that we develop forward on a trajectory. Trauma caused by maltreatment in infancy and early childhood can significantly impact that trajectory.
Maltreatment makes infants and toddlers more vulnerable to:
Developmental delays in any of the four domains (physical, cognitive, social and emotional) as well as language development.
Feeding issues.
Regulation issues such as difficulty soothing.
Limited or impaired social-emotional functioning.
Aggression and,
Regression in language development and potty training.

12. The Impact of Trauma on Very Young Children
Development is sequential
Maltreatment and trauma lead to infant toddler vulnerability to several challenges.
6.1.12
Key Points
Development is sequential: to fully mature, a child must successfully complete on developmental stage before they can enter and engage in the characteristics and skills of the next stage.
Trauma due to maltreatment in infancy and early childhood can significantly and negatively impacted.
Maltreatment makes infants and toddlers more vulnerable to:
Developmental delays in any of the four domains (physical, cognitive, social and emotional) as well as language development.
Feeding issues.
Regulation issues such as difficulty soothing.
Limited or impaired social-emotional functioning.
Aggression.
Regression in language development and potty training

13. Factors that Influence a Child’s Response to Trauma
6.1.13
Key Points
Factors that Influence a Child’s Response to Trauma:
Developmental age or stage.
Number and severity of traumatic events or episodes.
Proximity to the event-how close were they to the event.
Relationship between the child and victim or perpetrator.
Perception of the actual event or threats of an event.
Presence of adults who can offer protection.
Interaction with “first responders” or helping professionals.
Support system before and after the trauma.
Parental capacity to protect, i.e. mental illness, substance abuse.

14. Activity Jack at 4-5 – Impact of Trauma
6.1.14
Activity
The purpose of this activity is to help you better understand the impact of specific events in a child’s life and how these events can traumatically impact the child.
In this activity, you will be repeating the prior activity, but this time you will be looking at Jack at ages 4-5, in pre-school. You will be using two handouts:
Handout X: Child Development Stages
Handout X: Jack at Ages 4-5 (bullet point versions of Module 2 narratives)
In your groups, each person reads each of the three narratives, making notes in the right hand margin identifying what they see occurring with Jack and how his behavior compares to what his behavior should be socially, emotionally and in his attachments.
Consider also what might be occurring with Jack in terms of his brain development.
Discuss your findings as a group. Then we will debrief as a class.
Insert:
Handout X: Jack at Ages 4-5 (bullet point information from the narratives on Pre-school Jack found in Module 2 – need to generate these)

15. Complex Trauma and the Child
Attachment
Biology
Affect/Emotions
Dissociation
Behavioral Control
Cognition Issues
Self-concept
6.1.15
Key Points
Refer to Handout X: Complex Trauma and How It Impacts the Child

16. Activity Jack at 6-11 – Impact of Trauma
6.1.16
Activity
The purpose of this third activity about Jack is to help you better understand in what ways Jack is experiencing complex trauma.
In this activity, you will be will be looking at Jack at school age (ages 6-11) through the lens of the Module 2 narratives and information on complex trauma.
. You will be using two handouts:
Handout X: Complex Trauma and How It Impacts Children
Handout X: Jack at Ages 6-11 (bullet point versions of Module 2 narratives)
In your groups, each person reads each of the three narratives, this time making notes in the right hand margin identifying what they see occurring with Jack as it relates to the information in the complex trauma handout.
Discuss your findings as a group. Then we will debrief as a class.
Insert
Handout X: Jack at School Ages 6-11 (bullet point information from the narratives on Pre-school Jack found in Module 2 – need to generate these)

17. Adverse Childhood Experiences (ACE)
6.1.17
Turn to Handout X: The Adverse Childhood Experiences (ACE) Study.
Insert Handout X: The Adverse Childhood Experiences (ACE) Study

18. Long Term Impact of Trauma
“Toxic Stress”
Generational Trauma
6.1.18
Key Points:
In childhood, we see developmental delays.
In adolescence we see higher rates of delinquency, mental health issues, sexual activity, drug and alcohol use and an increase in violence.
In adulthood we see an increase in psychiatric problems, as well as drug and alcohol abuse and participation in criminal activities.
Toxic stress: stress that causes an excessive or prolonged stress response. In toxic stress situations, our ability to cope is depleted or in worst case scenarios they are non-existent.
Generational trauma or transgenerational trauma is trauma that transferred from one generation to the next.
This pass-down of trauma can be either through duplicating the traumatic actions that occurred to the parent/caregiver such as physical abuse, or
It can be passed down in terms of affect or coping mechanisms such as not being responsive and nurturing.

19. Activity Jack at 12-18 – Impact of Trauma
6.1.19
Activity
The purpose of this third activity about Jack is to help you better understand in what ways Jack is experiencing complex trauma.
In this activity, you will be will be looking at Jack at school age (ages 12-18) through the lens of the Module 2 narratives and information on complex trauma.
. You will be using two handouts:
Handout X: Assessing Jack’s Trauma Based on Contributing and Mitigating Factors
Handout X: Jack as an Adolescent
In your groups, each person reads each of the three narratives, this time working together to complete Handout X: Assessing Jack’s Trauma Based on Contributing and Mitigating Factors.
Discuss your findings as a group. Then we will debrief as a class.
Insert
Handout X: Jack As an Adolescent

20. Influence of Cultural Factors Identification of Trauma
Culture and Trauma
Influence of Cultural Factors
Identification of Trauma
Interpreting Trauma
Responding to Trauma
It is important to not underestimate the trauma experienced by the child due to this kind of disruption.
6.1.20
Key Points:
Culture influences how children may identify, interpret and respond to traumatic events.
There are times when these rituals, roles or communication patterns are abusive and/or neglectful.
This is the child’s normal. Their family is all they know and for most
Children feel most attached and bonded to their families, even when their living circumstances are unsafe. Part of that attachment is related to the culture of the family and their com
munity. children, they do not have any other reference point.
When we remove a child from their home, we run the risk of additional trauma to the child. It is important to not underestimate the trauma experienced by the child due to this kind of disruption.

21. Activity From Father to Son to Grandson – and Father to Daughter to Grandson
6.1.21
Activity
Consider what you have learned about trauma and how trauma can be transmitted from parent to child.
Discuss in your groups what you identify as the trauma-related patterns that have passed down through the families generationally.
After you have discussed this, we will debrief as a class.
Insert Handout X: The Andersen Family Genogram