Trauma in young children: what can a professional do?

When Zoë joined the group, she was overwhelmed by everything. When another child approached her, she would hit or bite that child. She didn’t talk and closed herself off to others. Educational staff member Lotte carefully made contact with Zoë and showed her that she understood her. Lotte remained calm and predictable, even when Zoë was very angry. She gradually gained Zoë’s trust and eventually Zoë started to play with other children as well.

With the growing influx of refugees, increasing numbers of children who have suffered trauma enroll in Early Childhood Education and Care (ECEC) provisions. These children are at risk for developmental problems. Children who are victims of abuse, neglect, and/or domestic violence are also at risk. The consequences of traumatic events can have a profound effect on the development of children. But what is trauma, and what can you do as a professional?

Two types of trauma

The first, and most well-known type of trauma is PTSD (post-traumatic stress disorder). This is also known as single trauma, as it is the result of one (or a few) major dramatic events that cause the victim to re-experience the event or have nightmares about it. A second form of trauma is developmental trauma[1] (also known as complex trauma or chronic early childhood trauma), which can manifest in children who have been the long-term victims of traumatic events. This type of trauma can occur when the period of major traumatic events lasts longer and occurs in childhood, when the brain is still developing. Normal development may stagnate due to an overactive stress system. Children who experienced developmental trauma have difficulties with stress regulation and attachment and have a low self-esteem. Although both types of trauma have similarities, PTSD is not diagnosed in children under the age of 6.

Complex trauma: continuous stress and hyper-alertness

According to Peter Adriaenssens, a Belgian child and adolescent psychiatrist, trauma can be seen “as a toxic source of stress that has settled in your body and mind and therefore affects your entire being”. Children with complex trauma are generally hyper-alert and respond with a fight, flight, or freeze response to any (somewhat) negative trigger. As a consequence, they can have difficulties in establishing relationships with others.

Recognizing trauma

Many children who are traumatized show behavioral problems. Without background information on the child, these behavioral problems might look like symptoms of, for example, ADHD. It is not always easy to determine whether the behavior of children results from trauma. Nevertheless, there are some guidelines. For babies, trauma can manifest itself in eating less, restlessness or short sleep, crying a lot, being apathetic, being frightened easily, an anxious look, and less play. With toddlers and preschoolers, you will sometimes see a relapse to behavior fitting a younger child (e.g. peeing in bed again or thumb sucking). They can also be clingy and throw tantrums. Preschoolers can be difficult to calm down or are irritable. They can also argue a lot or withdraw. If you, as a professional, have any concerns about potential trauma, try to get more information on the child’s background by talking to the parents.

Trauma sensitive education and guidance

Trauma sensitive education means teaching or supervising with knowledge of trauma and its consequences for the development of children. By knowing more about trauma, you can better understand the behaviors of children who have experienced traumatic events.

• As a professional with a traumatized child in the classroom, it is important that your basic attitude offers peace, reliability, and predictability.
• It is also important to remain calm, as anger is seen as unsafe in the eyes of the child. Also, to help the child become calm, it is important that you remain calm. In case of a tantrum, you can give the child space to live out his temper or anger, but you can teach him/her to do this in the hallway, for example.
• Adding structure to the child’s day schedule and having clear expectations is important as well.
• Make sure to give children some extra attention, especially to those who withdraw. Have a chat but let them play in their corner if they want to.
• Encourage interaction in the group: let children take care of each other. Teach them how to respond to the behavior of the traumatized child: not by getting angry, but by waiting and talking.
• Be patient. You often do not immediately see the effect of an approach, but below the surface there might already be some effects.

References:

Fegert, J. M., Diehl, C., Leyendecker, B., Hahlweg, K., Prayon-Blum, V., & the Scientific Advisory

Council of the Federal Ministry of Family Affairs, Senior, Citizens, Women and Youth (2018). Psychosocial problems in traumatized refugee families: Overview of risks and some recommendations for support services. Child and Adolescent Psychiatry and Mental Health, 12. doi:10.1186/s13034-017-0210-3

[1] Van der Kolk, B. A. (2017). Developmental Trauma Disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401-408

More information on trauma:

https://www.nctsn.org/what-is-child-trauma/trauma-types/refugee-trauma

https://www.nctsn.org/what-is-child-trauma/trauma-types/complex-trauma