Recognizing child trauma and helping kids cope

If left untreated, kids who experience trauma can have mental and physical issues later in life

Recognizing child trauma and helping kids cope

It’s a heartbreaking reality that childhood trauma even happens in the first place.

And it happens a lot.

According to the National Center for PTSD, studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD.

Even in adults, the numbers are staggering. Roughly 6% of the population will have PTSD at some point in their lives. About 12 million adults in the U.S. have PTSD during a given year.

If there’s a child, or person in your life who doesn’t quite seem like themselves, it’s important to offer support when and where you can. And to let them know they’re not alone.

Studies show if left unresolved, trauma will show up later in life.

It’s why Nicola Herting, Ph.D., a licensed clinical psychologist and clinic director for both the Sanford Traumatic Stress Treatment Center, and North Dakota Treatment Collaborative for Traumatized Youth, each based in Fargo, North Dakota, said it’s imperative to identify causes, symptoms, and treatments for childhood trauma.

Causes of childhood trauma

Dr. Herting was born and raised in South Africa. She said she was surrounded “by a lot of pain and suffering,” leading her to pursue a career as a psychologist.

“I saw the impact of the AIDS crisis. So many children were losing their parents. There was a lot of pain and suffering and a lot of trauma,” she said. “I felt very compelled to work with underserved populations and help empower them and to find hope and purpose and heal from the pain they had experienced. Whether that be abuse, or traumatic grief, or racial trauma.”

Dr. Herting explained there are three types of traumas: acute, chronic, and complex.

Dr. Herting described acute trauma as a “once-off event.” Examples might be a dog bite, a car accident, a house fire, date rape, or a specific instance of community violence or physical abuse they experienced or witnessed.

Chronic trauma is multiple traumas over time. Chronic trauma could be due to the same trauma reccurring, or multiple traumas happening over time, Dr. Herting said.

“A lot of times in the clinic, we see kids who have had ongoing sexual abuse, ongoing physical abuse, ongoing witnessing of domestic violence, or a combination of abuse over time. They’ve been exposed to multiple traumas, or the same trauma over and over again,” said Dr. Herting.

Complex trauma, according to Dr. Herting, “is similar to chronic trauma, but the difference is the person engaged in that abuse or trauma toward that child is somebody in a caregiving relationship and the trauma started at a young age.”

The differentiation of complex trauma is important due to the extensive and different impact that trauma by a caregiver has.

“When all kids grow up, they learn about the world through their caregiver, right? They learn if the world is safe, if they can trust people, if they will be protected, if they’ll have their needs met,” said Dr. Herting.

“When the very person who’s supposed to meet your needs isn’t, you don’t learn that the world is safe, or that you can depend on and trust caregivers. You don’t believe that there’s good people who will or can treat you well. And so, cumulatively that really disrupts social, emotional, cognitive, and behavioral development.”

Signs of child trauma

Dr. Herting explained, and gave examples, of five categories of trauma symptoms:

  • Flashbacks, nightmares, and intrusive thoughts. “You can’t stop thinking about the trauma even when you don’t want to,” said Dr. Herting. “It’s constantly there, and you feel like you’re going through it again.”
  • Avoidance. “Any attempt to avoid any association or reminder about what happened,” she explained. “It can be people, places that remind the victim of the person or events, avoidance of activities, avoidance of talking about it. Over avoidance actually maintains trauma symptoms.”
  • Negative emotions and thoughts. “It’s difficult to feel happy, enjoyment or love,” according to Dr. Herting. “They might struggle to socialize, and (they might) isolate themselves. There may be a lot of feelings of shame or guilt, depending on the type of trauma.”
  • Hyperarousal. “You’re vigilant, on edge, and expecting something bad to happen. Signs can include irritability, concentration problems and sleep problems, and we also see aggressive or destructive behaviors in kids,” she said.
  • Dissociation. “You’re not present in the moment. You’re zoned out, daydreaming, and not in touch with reality or what’s happening in the present moment,” explained Dr. Herting.

“Not everybody who experiences trauma has all trauma symptoms, or develops post-traumatic stress disorder. If you experience these symptoms for longer than a month, you may be diagnosed with PTSD,” said Dr. Herting.

“It is vital to remember that it is normal to be impacted by trauma and there is help and effective treatment for children and adults to heal from trauma and address trauma symptoms,” she added.

Untreated trauma shows up later in life

Stephen Wonderlich, Ph.D., is the vice president at Sanford Research in Fargo. He’s also the chief behavioral health research officer.

To help further emphasize the importance of seeking help after a traumatic event happens to a child, Dr. Wonderlich referenced the ACEs (adverse childhood experiences) study, which was conducted by the Centers for Disease Control and Prevention.

The study asked a group of adults if they had experienced traumatic events as a child. Participants then received a physical examination, which assessed the participants’ medical history.

“What they found was those people who had more adverse childhood experiences, they were much more likely to experience a whole list of mental health problems like increased depression, increased suicide attempts, increased drug addiction,” Dr. Wonderlich said.

The study also found participants were showing physical symptoms.

“But also, people who have had traumatic experiences as a child are more likely to have serious respiratory problems, health problems, diabetes and cardiovascular disease,” Dr. Wonderlich said.

“So, you start to realize these sorts of early adversities not only affect us mentally, but they affect us physically. Probably because what happens is people who have a lot of adversity start to engage in problematic behaviors like too much drinking, maybe too much eating, maybe smoking. This in turn puts them at further risk for medical problems.”

According to the study, 1 in 6 adults have experienced four or more types of ACEs. At least 5 of the top 10 leading causes of death are associated with ACEs. Preventing ACEs could reduce the number of adults with depression by as much as 44%.

When and where to get help

The good news is there is help.

And it works.

“There are treatments for children and families who have been traumatized,” Dr. Wonderlich said. “They’re not terribly long. Maybe six months. The family is involved, the child is involved. It’s difficult to go through, but the evidence is clear. The kids and families who go through treatment do much better than those who don’t go through treatment.

“Probably about 80% of kids who get this treatment, their PTSD resolves, other symptoms go away, and more importantly they start feeling and doing much better. We’re getting good treatments, which we can get out there to clinicians.”

And Dr. Wonderlich said Sanford Health has some of the best clinicians for trauma. The Sanford Traumatic Stress Treatment Center in Fargo provides high-quality, evidence-based care to children, adults and families.

They provide assessments and treatments to children and adults who have experienced trauma. The multi-disciplinary team provides behavioral health services and care coordination to treat trauma and traumatic stress.

Since 2006, Dr. Wonderlich and Dr. Herting have spearheaded an effort to make world-class mental health care available to kids who have experienced trauma, wherever they live. In conjunction with the North Dakota Department of Human Services, they developed the Treatment Collaborative for Traumatized Youth.

This program includes research, education and training about traumatic experiences that improves trauma-informed care for children and families affected by trauma. They train providers in trauma-focused cognitive behavioral therapy and trauma-informed care, the gold standard treatment for children who have experienced trauma.

Over the last 17 years they have trained almost 500 mental health professionals.

You can help

By simply recognizing challenges individuals and families face, and offering support and encouragement to reduce stress, you can play your part in supporting treatment of, and preventing, childhood trauma, the CDC encourages.

Supporting local programs, whether monetarily or through volunteerism, that are geared toward providing safe and healthy conditions for all children and families is another great way to help.

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Posted In Behavioral Health, Children's, Fargo, Parenting