1. Trauma and Brain Development
Presented by
Eileen Abrams, Psy.D.

2. Stages of Social Development
Infant
Trust vs Mistrust
Infant/parent feeding, being comforted
Hope and Drive are the virtues and strengths
Sensory distortion and withdrawal possible negative consequences
Lack of trust in themselves, other, or environment

3. Stages of Social Development
Toddler
Autonomy vs shame and doubt
Learning muscle control, toileting, walking
Will power and self-control are the virtues and strengths
Impulsivity and Compulsion are the possible negative consequences
They are working to control their environment while maintaining self- esteem

4. Stages of Social Development
Preschooler
Initiative vs guilt
Learning to explore and discover
Initiates activities, develops a conscience and sexual identity
Purpose and Direction are the virtues and strengths
Ruthlessness and Inhibition are the possible negative consequences

5. Stages of Social Development
School-Age Child
Industry vs Inferiority
Learning about friendships, achievement, and accomplishment
Competence and Method are the virtues
Tries to develop a sense of self worth by refining skills
Poor virtues and lack of forward progress are possible negative consequences

6. Stages of Social Development
Adolescent
Identity vs Role Confusion
Peer group influences, resolving identity and direction
Fidelity and devotion are the virtues and strengths
Fanaticism and Rejection of values are possible negative consequences
Tries to integrate many roles into self-image

7. Stages of Social Development
Young Adult
Intimacy vs Isolation
Learns to make personal commitments to work, family, and social life
Love and Affiliation are the virtues and strengths
Promiscuity and Isolation are the possible negative consequences

8. PTSD (Post-Traumatic Stress Disorder)
Once known as “Shell Shock”
The diagnosis first appeared in 1980
Currently, the accepted definition presented in the DSM IV: PTSD develops in response to events that are threatening to life or bodily integrity, witnessing threatening or deadly events, and hearing of violence to or the unexpected or violent death of close associates.
PTSD is a relatively new diagnostic category in the history of psychology. Especially with all the veterans returning from the current war this is a field that is being heavily researched. 8

9. Children are NOT Mini-Adults
Traumatic events impact children and adults differently
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
A child’s brain is not yet fully developed. They are unable to put their experiences into context or make sense of them.
Repeated exposure to trauma prevents normal brain development in children
In order to understand a traumatized child, we must first understand the fear response. The brain has a very elaborate and important set of neural systems involved in the response to threat. The abnormal persistent activation of these systems appear to lead to many of the symptoms seen in maltreated children. 9

10. As a Result…
It is highly adaptive for the traumatized child to be hyper aroused, hyper- vigilant, and ready to attack and defend
As part of the survival mechanism, extreme stress interferes with the functioning of the prefrontal cortex, the thinking part of the brain that inhibits the stress response.

11. So What does PTSD Look Like in Children?
Infancy through Preschool
-Helplessness and passivity; lack of usual responsiveness
-Generalized fear
-Heightened arousal and confusion
-Cognitive confusion
-Difficulty in identifying feelings
-Sleep disturbances/nightmares
-Separation fears/clinginess
In school-age kid’s, the brain is not growing as much, but is gaining greater ability to manage automatic reactions to danger, like the startle reflex.
During these years, trauma can delay this ability, leaving kids overly tuned into noises or other stimuli.
These traumatized kids will then find it harder to concentrate, study, and to control their everyday behavior 11

12. Effect on Affect
Lack of attachment focuses the child on survival, not emotional development
Children may not develop “normally” emotionally or cognitively
Children do not develop appropriate social skills
Lack of empathy apparent

13. Emotional Maturity
During a trauma ,intense fear easily overwhelms young children’s beginning effort to manage emotions
For school-aged children, the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme
-the normal sources of protection and help may be unavailable from an abusive or traumatized parent
-They may have difficulty modulating emotions
-They may “clamp down” on emotions and become numb
-Shame and guilt can lead them to be secretive about their feelings
-Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way 13

14. Conduct Disorders Behavior is the language of trauma
Most behaviors used by children to express themselves are considered “negative” behaviors
The capacity to moderate frustration, impulsivity, aggression, and violent behavior is age-related
Without sufficient motor, sensory, emotional, cognitive, and social experiences during infancy and childhood, the brain does not develop a mature capacity to tolerate frustration, contain impulsivity, and channel aggressive urges
Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves. Further, we talked about miss-matching human behaviors, like associating love with physical abuse. Also, they may have been punished for expressing any emotions at home, or told to not talk about feelings. They may also be numb to what they feel. 14

15. Conduct continued…
If a child is raised in an environment of persistent threat, the child will have an altered baseline state of arousal making an internal state of calm rarely obtainable
The traumatized child will have a “sensitized” alarm response, over-reading verbal and non verbal cues as threatening
This increased reactivity will result in dramatic changes in behavior in the face of seemingly minor provocative cues
Often, over-reading a threat will lead to a “fight or flight” reaction and impulsive violence. The child will view his violent actions as defensive. 15

16. Children exposed to significant threat will “re-set” their baseline state of arousal such that even when no external threat or demands are present, they will be in a physiological state of persistent alarm
Even a relatively small stressor can instigate s state of fear or terror
The cognition and behavior of the child will reflect his or her state of arousal
As external stressors are introduced such as a complicate task at school, or a disagreement with a peer the traumatized child will be more “reactive” 16