When a child experiences neglect or abuse early in their life, it has a significantly detrimental effect on their physical, mental and emotional development. Trauma can be a repeating event, a sudden single event or a pattern of interaction between an abuser and child. Severe neglect is the most common form of trauma and has the biggest impact on brain development.
The brains of children who have been abused and neglected develop differently. Even before they are born, many children in care will have developed the very first parts of their brain in conditions that were far from ideal. Many babies have been exposed to alcohol, drugs or violence, as well as fear, depression and anxiety that their mothers may have been experiencing.
Early traumatic experiences trigger a “stress response” in children – a physiological and behavioural coping response which manifests as the fight, flight or freeze response when under threat.
Trauma particularly affects the brains emotional control centre (the amygdala), which starts to to send a danger signal to a child even when there’s no real threat. It shrinks their hippocampus, which processes their memories, learning and emotions. Traumatised children can also end up with an underdeveloped prefrontal cortex, which is involved in rational thinking, planning, control their impulses and emotions.
A traumatised child becomes wired for survival. They become impulsive and anxious, act from instinct rather than reason, and are not able to understand or identify the different feelings they are experiencing.
When under threat, their brain releases the stress hormone, cortisol which, at high levels can be toxic to the brain (causing impairments in memory, recognition and regulation of emotions, and executive skills such as decision-making, planning and attention). Babies are thought to develop a “set-point” for cortisol levels by the age of 6 months, which means that what a child considers to be a normal and acceptable level of stress has become hard-wired before they are even able to utter their first words.
What this means is that children who have experienced trauma have brains that work and are wired differently to those who have not experienced trauma. The behaviour that follows is often a result of these changes to their brain rather than these children simply meaning to be naughty, difficult or challenging.
The effects of abuse and/or neglect and the excessive levels of cortisol that they cause the brain to produce, impacts most severely on the prefrontal cortex and the limbic system. These are the parts of the brain that, when they work well, help us to think about the future, understand cause and effect, have empathy and manage strong impulses and emotions. The limbic system is the part of the brain where understanding and expectations of relationships and emotional safety sit in our brains.
As a result of the damage caused to these parts of the brain, we might expect to see changes to a child’s behaviour. They can become disorganised. They might need to be repeatedly reminded to do ‘ordinary’ activities.
They might become socially or sexually inappropriate – acting impulsively or not using contextually relevant information to inform behaviour. They might find it challenging to learn from their experiences. They may need a strict routine, be inflexible and struggle with unexpected or changes to their everyday activities.
They might lack motivation or incentive and find it difficult to monitor their emotions and behaviours. They can find it difficult to develop or initiate plans or ideas and not always choose the most sensible action. They may also have an iInability to stop and think constructively and be emotionally impulsive.
The sort of difficulties you might expect after trauma can also include: disturbances in their sense of self and identity (including low self- esteem, self-harm, risk taking).Traumatised children will often misuse alcohol and drugs and find it challenging to link the cause and effects of events and behaviours. They can also find it difficult to recognise emotions in others and articulate their own emotions.
It’s important to say that these are illustrative examples not an exhaustive list of behaviours that you might expect to see as a consequence of abuse of neglect during early childhood.
Does this mean traumatised children are beyond help?
This is a reasonable question given everything I’ve just said. But the emphatic answer is that they are not beyond help. Far from it! We know that, from the beginning of life, our brains continue to develop and mature in response both to genetics but also the environments in which they are required to function and survive. This means that a child’s brain, if exposed to a safe and appropriate environment, can be re-wired to then develop along the trajectory that was first intended at the beginning of life.
This is possible both when the child is still young but also even when they're older and in their teenage years. This is because the brain remains “plastic” well into adulthood. Over 14 years between puberty and our mid-twenties, the brain completely re-wires itself, from back to front. During this period, all parts of the brain are in place, but they are not yet working un unison together. Basic behaviours like sensation and coordination to complex behaviours like emotional regulation and impulse control are completely rewired.
The teenage years are a window of opportunity to rebuild and rewire a brain and child that may have been traumatised earlier in life. Providing the teenager and their brain with opportunities that they have missed out on as a younger child, will allow healthy, appropriate connections to develop and strength, thus facilitating their growth and development into healthy adulthood.
How can you encourage healthy brain development?
To understand what your child’s emotional needs are, it can be really helpful to put their chronological age to one side. Close your eyes to your child’s body and open your eyes to what age their brain is.
Give yourself permission to ignore what the world around you thinks your child should be doing at their chronological age. You are far more likely to be successful at managing your child’s behaviour if you take a soothing rather than reprimanding approach.
Your child’s high-energy levels and provocative behaviour might be their brain’s attempt to recreate a “normal” level of stress/stimulation. Responding to this behaviour angrily or with punishment, as we might do instinctively, in fact means that we recreate the level of stress/stimulation they are seeking. This process of replicating the emotions of the past won’t help your child to feel soothed or to modify their behaviour.
Your child’s difficulties with impulsivity, empathy, planning and short term memory are likely to be hard-wired and therefore in need of re-wiring via relationship building and regressive (back to babyhood) techniques rather than reward-punishment strategies.
Give your child permission to regress and engage in activities/play that would typically match a much younger child chronologically. Allowing them the experiences they have missed out on will provide them with opportunities to “fill the gaps” and ultimately to “catch up” developmentally. Until they are given this opportunity, they will remain stuck at an earlier developmental stage.
The PACE principles of parenting can also be a great resource for parents or carers looking for guidance on interacting with children and young people who have experienced trauma. PACE stands for Playfulness, Acceptance, Curiosity and Empathy. PACE was developed as a way of thinking, feeling, communicating and behaving that aims to make the child in care feel safe. With PACE, the child can start to look at themselves and let others start to see them, or get closer emotionally. They can start to trust again.
I hope these strategies are helpful. But if you want additional support in working therapeutically with young people who have experienced trauma, you can always seek out professional help through child and adolescent mental health services.
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