Behavioral and Developmental Effects of Trauma

Without help and support, children often develop a variety of negative coping
responses to traumatic stress.

A childs response to traumatic stress may manifest across multiple domains of

functioning and developmental processes, including emotional, behavioral,
interpersonal, physiological, and cognitive functioning.

Trauma
Can alter biological stress systems and adversely effect brain development,
cognitive and academic skills, and language acquisition
Changes in the levels of stress hormones similar to those seen in combat
veterans
Undermines brain development and affects different areas of the brain at
different stages of development
Can have serious consequences for the normal development of a child's
brain, brain chemistry, and nervous system

Attachment
Traumatized children feel that the world is uncertain and unpredictable
Their relationships can be characterized by problems with:
o Boundaries
o Distrust
o Suspiciousness
As a result, traumatized children can become socially isolated and have
difficulty relating to and empathizing with others

Biology
Traumatized children demonstrate biologically based challenges, including:
o Problems with movement and sensation
o Hypersensitivity to physical contact
o Insensitivity to pain
They can have problems with:
o Coordination
o Balance
 o Body tone
o Unexplained physical symptoms
o Increased medical problems (e.g., asthma, skin problems, and
autoimmune disorders)

Mood Regulation
Children exposed to trauma can have difficulty regulating their emotions. One
of the signs to look for is whether a child has the ability to self soothe or
exhibit coping skills
Children have difficulty:
o Knowing / Identifying feelings
o Describing feelings and internal states
o Describing wishes and desires to others
o Regulating his/her mood
o Showing coping skills

Dissociation
Some traumatized children experience a feeling of detachment or
depersonalization, as if they are observing something happening to them
that is unreal
They can also withdraw from the outside world or demonstrate amnesia-like
states

Behavioral Control
Traumatized children can demonstrate:
o Poor impulse control
o Self-destructive behavior
o Aggression towards others
o A heightened awareness of potential dangers to themselves or others
Traumatized children can also manifest child traumatic stress through:
o Bodily reactions such as fast heart rates, churning stomachs or
sweatiness
o Sleep disturbances including dreams of the events that have occurred
 o Eating disorders

Cognition
Traumatized children can have problems:
o Focusing on and completing tasks
o Planning for and anticipating future events
o Understanding their own contribution to what happens to them
Some traumatized children demonstrate:
o Learning difficulties
o Problems with language development

Self-Concept
Traumatized children can experience the lack of a continuous, predictable
sense of self
May develop a stutter
Traumatized children frequently suffer from:
o Disturbed body image
o Low self-esteem
o Shame
o Guilt
 Effects of Trauma in Young Children

Behavioral Consequences
Young children who have experienced trauma may:
Become passive, quiet, and easily alarmed
Become fearful, especially regarding separations and new situations
Experience confusion about assessing threat and finding protection,
especially in cases where a parent or caretaker is the aggressor
Regress to recent behaviors (e.g., baby talk, bed-wetting, crying)
Experience strong startle reactions, night terrors, or aggressive outbursts

Developmental Consequences
Child traumatic stress reactions vary by developmental stage
Children who have been exposed to trauma expend a great deal of energy
responding to, coping with, and coming to terms with the event
This may reduce childrens capacity to explore the environment and to master
age-appropriate developmental tasks
The longer traumatic stress goes untreated, the farther children tend to stray
from appropriate developmental pathways
 Effects of Trauma in School Age Children

Behavioral Consequences
In school-age children, trauma undermines the
development of brain regions that would normally
help children:
Manage fears, anxieties, and aggression
Sustain attention for learning and problem
solving
Control impulses and manage physical
responses to danger, enabling the adolescent
to consider and take protective actions
As a result, children may exhibit:
o Sleep disturbances
o New difficulties with learning
o Difficulties in controlling startle reactions
o Behavior that shifts between overly fearful and overly aggressive

Developmental Consequences
School-age children with a history of trauma may:
Experience unwanted and intrusive thoughts and images
Become preoccupied with frightening moments from the traumatic experience
Replay the traumatic event in their minds in order to figure out what could
have been prevented or how it could have been different
Develop intense, specific new fears linking back to the original danger
School-age children may also:
o Alternate between shy/withdrawn behavior and unusually aggressive
behavior
o Become so fearful of recurrence that they avoid previously enjoyable
activities
o Have thoughts of revenge
o Experience sleep disturbances that may interfere with daytime
concentration and attention
 Effects of Trauma in Adolescents

Behavioral Consequences
In adolescents, trauma can interfere with development of the prefrontal cortex,
the region responsible for:
Consideration of the consequences of
behavior
Realistic appraisal of danger and safety
Ability to govern behavior and meet
longer-term goals
As a result, adolescents who have
experienced trauma are at increased risk
for:
o Reckless and risk-taking behavior
o Underachievement and school failure
o Poor choices
o Aggressive or delinquent activity

Developmental Consequences
In response to trauma, adolescents may feel:
They are weak, strange, childish, or going crazy
Embarrassed by their bouts of fear or exaggerated physical responses
They are unique and alone in their pain and suffering
Anxiety and depression
Intense anger
Low self-esteem and helplessness
These trauma reactions may in turn lead to:
Aggressive or disruptive behavior
Sleep disturbances masked by late-night studying, television watching, or
partying
Drug and alcohol use as a coping mechanism to deal with stress
Over- or under-estimation of danger
 Expectations of maltreatment or abandonment
Difficulties with trust

Increased Risk of Re-Victimization

Adolescents are at a higher level of risk especially if he/she has lived with chronic
or complex trauma.
Adolescents who have experienced trauma may use alcohol or drugs in an
attempt to avoid overwhelming emotional and physical responses. In these
teens:
Reminders of past trauma may elicit cravings for drugs or alcohol
Substance abuse further impairs their ability to cope with distressing and
traumatic events
Substance abuse increases the risk of engaging in risky activities that could
lead to additional trauma

Child welfare workers must address the links between trauma and substance
abuse and consider referrals for relevant treatment(s).