Effects of Trauma and Family Violence on the Development of Children

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Effects of Trauma and Family Violence on the
Development of Children

• Dr Larry Cashion
• Specialist Consultant Psychologist
• Presented at the
• Communities for Children Connections Conference
• Launceston, 29 June 2011

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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

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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

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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

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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

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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

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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

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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
  wont make any difference
• Fear of caregiver retribution

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A Little Bit of Neuroscience
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Ways of Examining Trauma Effects

• Psychological
• Cognitive
• Emotional
• Physiological
• Stress responses by the body
• Neurological
• Changes in brain function
• Changes in brain structure

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Theories of Child Development

• Ericksons theory of psychosocial development
• Each life stage has a psychological crisis that
  needs to be met successfully
• Maslows 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

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Ericksons 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

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Maslows Model
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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

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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

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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

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How to Help?

• The world as a safe place (even though adults
  know its 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

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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 dont know how to behave
  appropriate because it is not modelled

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The 3-Phase Approach

• STOP
• The word stop has one meaning words such as
  no and dont have multiple meanings
• DONT DO THAT
• The child needs to know what not to do carers
  often say dont 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

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Thank You

• Dr Larry Cashion
• larry_at_cashion.net
• www.drcashion.com.au