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Trauma Informed Care

Understanding How to Support Children Who Have Experienced Trauma

What is trauma?

  • Shock trauma– An experience of an overwhelming event which is perceived as life-threatening.
  • Developmental trauma– Ongoing childhood abuse or lack of nurturing during developmental periods in childhood. This includes; emotional, physical, or sexual abuse, as well as neglect, attachment disruptions, and medical trauma.

How it affects brain/development:

Trauma, especially during childhood, can disrupt the process of decision making. If an event occurs that triggers a trauma response in a typical day for a child with those experiences, the child could go into fight or flight, as their body tells them they are unsafe. This stops the decision making process from traveling to the higher levels of the brain and instead stops at the lower level (brain stem), which allows the most basic instincts to take over the body. A child may exhibit behaviors due to this physiological response. This disrupts sensory regulation and therefore, overall regulation of the body and the ability to respond to situations in a typical way.

Strategies for caregivers/parents:

In occupational therapy, we work on getting a child to participate as independently as possible in their daily tasks and occupations. There are often many layers to this participation, and on the surface, it may look like a child is being avoidant or defiant if they have difficulty engaging. If we dig deeper, we can see that all a child wants is to feel loved, supported, and successful. Part of supporting children who’ve encountered trauma is to demonstrate what healthy coping strategies and regulation are. Children imitate what they see, as their brains are filled with mirror neurons to help them explore and learn from adults and their environment. Before we can expect them to self-regulate, we must first teach them how to co-regulate. Below are some strategies to help provide safety and stability. These things encourage attachment and will help teach kiddos to regulate and feel like they have control over their bodies.

• Offer choices to encourage feelings of control when appropriate.

• Respond with a calm, even voice. They will often mimic your response to stress.

• Encourage deep breathing and even practice with them in times of stress.

• Always ask permission to help with a task if it requires touching and encourage autonomy.

• Animal walks, wall pushups, or carrying something heavy (otherwise known as heavy work). These actions calm the body.

• Offer a sensory choice (listen to rain sounds or watch lava lamp).

• Deep pressure (weighted blanket, rolling up in blanket on the floor, compression clothing).

• Rocking movements in a chair or swing in a linear pattern. Vestibular movement helps to reorient the body to provide feelings of safety and stability and teaches rhythm and regulation that is typically developed in infancy through rocking and soothing.

• Gentle squeezes on hands, arms, shoulders, and head.

• Allow your child to feel heard by saying phrases when they are upset like; “I hear your words”, or “I know that is so hard”.

• Remember that building trust and safety is the best way to help regulate and decrease behaviors.

Katie Collins Stotts, OTR/L