1. The Problem: Trauma Exposure  More than two thirds of Americans have experienced a significant traumatic event by age 16  More than one third have been exposed to multiple types of trauma  Traumatic experiences can result in significant disruptions in development & health

2. Traumatic Stress and People with Disabilities 1.Individuals with developmental disabilities are at increased risk for physical, sexual and emotional abuse as compared to the general population. 2.Individuals with disabilities are over 4 times as likely to be victims of crime as the nondisabled population. 3.64% of children maltreated had a disability. 4.Children with communication disorders were more likely to be physically and sexually abused.

3. Trauma-Informed Approach Persons with disabilities are vulnerable because they are: 1.trained to be compliant to authority figures. 2.dependent on caregivers more types of assistance than a nondisabled child. 3.isolated from resources to whom a report of abuse could be made. 4.sometimes impaired in their ability to communicate. 5.sometimes impaired in their mobility. 6.more likely than other children to be placed in residential care facilities

4. The Solution: Trauma-informed Client-serving Organizations Goal: Improve outcomes for all clients, using a Trauma Informed Approach while providing excellent standards of care by:  Increased awareness about the impact of traumatic stress on individuals.  Increase awareness of ways Human Service Agencies can intensify the impact of trauma on individuals.  Recognize the potential for secondary traumatic stress.  Recognize the resilience and courage of clients and families who have experienced trauma.

5. Elements of a Trauma- Informed Organization A trauma-informed organization understands: 1.The impact of current and past trauma on families. 2.How systems can either mitigate or add new traumatic experiences. 3.How to promote resiliency after trauma. 4.How trauma may interfere with families’ ability to support their loved one.

6. Traumatic Stress and People with Disabilities 1.Even when the abuse is reported, the charges are rarely investigated when the victim is disabled. 2.Victims typically have difficulty accessing appropriate services. 3.Immediate family members perpetrate the majority of neglect, physical abuse, and emotional abuse. 4.Extra- familial perpetrators account for the majority of sexual abuse. 5.99 percent of those who commit abuse are well known to, and trusted by, both the child and the child's care providers.

7. Special Characteristics of the Population that May Influence the Incidence of Trauma  Abuse and neglect have profound influences on brain development. The more prolonged the abuse or neglect, the more likely it is that permanent brain damage will occur. Not only are people with developmental disabilities more likely to be exposed to trauma, but exposure to trauma makes developmental delays more likely.

8. Trauma-Informed Approach Persons with disabilities are vulnerable and may have:  cognitive and processing delays that interfere with understanding of what is happening in abusive situations, and  feelings of isolation and withdrawal due to their differences, which may make them more vulnerable to manipulation because of their increased responsiveness to attention and affection.  a predisposition toward emotional problems and impaired resiliency before the abuse occurs  reduced protective factors that could lessen the effects of sexual abuse;

9. Trauma-Informed Approach Persons with disabilities are vulnerable and may: 1.find it more difficult to cope with normal life stressors given the limited resources the client has available. 2.open to abuse in the home, since these children are often very difficult to raise and place a high level of strain on the family. 3.open to abuse in the community because of their poor judgment and lack of self-protective skills. 4.have greater difficulty in getting help for mental illness due to communication and processing problems.

10. People with developmental disabilities often have communication problems and social issues which lead to trauma: 1.inability to perceive social cues, 2.difficulty utilizing or understanding nonverbal communication well, 3.frequent miscommunications and misunderstandings, 4.a tendency toward one-sided conversations, 5.a tendency to ask many questions, especially when uncomfortable with a conversation, 6.a tendency to return to familiar, rote questions, or subjects of personal interest when anxious, 7.intrusive behavior, 8.an ability to pretend to be normal, 9.a poor understanding of the impact of behavior on others, and 10.difficulty making and keeping friends.

11. Trauma Informed Best Practices 1.Slow down your speech. 2.Use visuals whenever possible. 3.Present information one item at a time. 4.Practice different ways of handling tough situations the client is likely to encounter. 5.Work on building coping skills. 6.Remember that with these clients change will occur more slowly than with others. Be content to measure change with a micrometer rather than a yardstick. 7.Effective treatment for people with developmental disabilities must also include a variety of support/education services for families/caregivers.

12. Creating a Trauma-Informed Client Serving Organization References:  http://www.nctsn.org/ http://www.nctsn.org/  http://www.nctsn.org/sites/default/files/assets/pdfs/trau matic_stress_developmental_disabilities_final.pdf http://www.nctsn.org/sites/default/files/assets/pdfs/trau matic_stress_developmental_disabilities_final.pdf