Food, housing insecurity among factors
We know that major trauma can have a long-term effect on a child’s development, both physically and mentally. The loss of a parent, living through an environmental or man-made disaster, abuse, neglect, or abandonment can all impact a child or adolescent’s wellbeing and mental health.
Over the past few decades, psychology has come to see that other types of trauma, sometimes referred to as “trauma with a small t,” can also change the trajectory of a child’s psychological growth.
Things like food or housing insecurity, or the overall stressors of living in poverty, can affect a child’s brain development. It is something Alice Connors-Kellgren, Ph.D, clinical psychologist at Tufts Medical Center, has witnessed in her research and work.
Connors-Kellgren spoke with New England Psychologist’s Catherine Robertson-Souter about why trauma affects children differently and about the positive direction the field is moving in to help create better outcomes across the world.
Trauma, from food insecurity to a lack of employment or housing, can be especially harmful to children. Why?
Well, to borrow a line from pediatricians, children are not just tiny adults. Their brains and their nervous systems are very different. Brains don’t just start out small and then grow while maintaining the same structure. Rather, there are different parts of the brain that grow at different developmental stages.
For the reason children’s brains are still developing and the different structures are developing at different times and at different rates, when trauma happens to children, it affects the way in which the brain develops.
So, when children experience trauma, their amygdala light up and all the energy goes to surviving, to keeping themselves safe, and to protecting themselves.
If this happens once or twice, a kid has a near miss with a traffic accident or something like that, it’s probably not going have a huge impact.
But, when it happens repeatedly, it means that the areas of their brains that need to be developing at that time are not getting the opportunity because all the energy is going to their survival response.
So, when someone has experienced trauma as a child, versus experiencing trauma as an adult, it has a much bigger impact on the developmental skills that they are supposed to be picking up at that time, whether it’s personal development, social emotional regulation, cognitive skills, etc.
Does this type of trauma also affect a child’s faith in and ways of interacting with the world around them?
They don’t learn that they are safe in the world and that is really the foundation for humans to be able to experience psychological health and wellbeing.
Has this understanding of brain development and the effects of trauma evolved over the past several decades? Does this affect treatment?
Yes, to both. As we have gotten more advanced brain imaging technology, we have learned much more about the specific ways in which trauma affects brain development.
We also have a broader understanding of what trauma is. Originally it was just thought of as only referring to things like combat trauma for veterans. Now, we understand it as encompassing many kinds of experiences that might threaten a person’s capacity to cope.
Because we are learning so much more, we are also developing new methods for treatment. In the last 10 or 15 years, a variety of body-based strategies for treating trauma have emerged and have started to gain an evidence base.
These are particularly effective with kids who do not yet have the verbal skills to be able to engage in something like talk therapy or the metacognition required for a more nuanced treatment like cognitive behavioral therapy.
When you talk about body-based treatment for children, what does that include?
It encompasses many different types of treatment like neurofeedback or eye movement desensitization, and reprocessing therapy. There is a therapy called SMART, or sensory motor arousal regulation treatment, that incorporates occupational therapy strategies with a psychological understanding and targeting of social / emotional issues.
Occupational therapy used in conjunction with psychotherapy can be really helpful for kids.
What do you find are the biggest issues for children right now? What are the concerns that you are seeing?
The big ones that I see are these economic stressors that lead to food insecurity, to homelessness, to general instability. The opioid crisis is also a huge contributor to trauma for children. There are many, many people who have substance use disorders who are also parents.
Overall, I would add exposure to things that are happening in the world. I would even say that, still, the social isolation and the uncertainty that came along with COVID was definitely traumatic for a number of kids.
What are the typical outcomes for children in trauma treatment?
One of the great things about working with kids is that their brains are still really plastic. They are still growing at a faster rate than adults. So even after kids have experienced traumatic events, their environment will continue to shape the way their brain will continue to grow.
If a kid has experienced trauma prior to age seven and, at age seven, we can start providing a safe and secure and loving environment, that will help their brain to develop in a way that gives them that sense of safety and will lay that foundation for health and wellbeing.
What if we can’t give them a safer space? You cannot always remove a child from a situation. Are there other ways to teach resiliency?
That mostly must happen within the caregiver/child relationship. I spend a lot of time working with parents, helping them to create the most safe and secure environment that they can within that relationship.
Even if a child is living in a war-torn area, for instance, if there is a relationship or a place that they can go where they feel safe, that is what makes a big difference.
Looking at the bigger picture and the millions of kids out there that can’t be reached, how can the field of psychology improve their lives?
I think a really cool thing that is happening for psychology right now is that we are very much moving out of the individual therapy-based model and figuring out how to address more systemic issues and how to reach more people.
It is happening everywhere, from therapists on TikTok giving psycho-education about ADHD, to psychologists working with the UN to consult around how to support people in a natural disaster or a war.
Individual therapy has historically been such a privilege and there simply are not enough of us to be able to do therapy with every single person who needs it. So I love that we are moving towards this idea of how to promote healing and mental health on a much larger scale.
There are a lot of people who have experienced scary, horrible things and everybody deserves to have a life where they feel safe.