Recovering from Trauma - Childhood Trauma
HGSE Associate Professor Catherine C. Ayoub
Significant conflict or loss affects the social and emotional development of children in fundamental ways. Catherine Ayoub – associate professor of education at HGSE, and associate professor of psychology at Harvard Medical School – believes that helping children learn to build trusting, positive relationships is essential to their recovery. This article examines the ways in which children are affected by trauma, how the behavior of traumatized children may differ from other children, and how some programs support recovery from childhood trauma.
Childhood trauma comes in many different guises. It may stem from parental abuse or neglect, but trauma can also develop as a result of living through a natural disaster such as Hurricane Katrina, or a war, or witnessing a random act of violence on the street. Whatever the causes, Catherine Ayoub believes that the vital steps to recovery from childhood trauma lie in developing trusting, positive relationships.
"A trusting relationship is the basic foundation that we all build during the first two years of life," explains Ayoub in a recent interview with Usable Knowledge. "When a child is born, they're unable to lift their heads or to roll over until three months of age. But they can see, they can hear. Our emotional and perceptual systems are much more developed at birth than our gross motor skills."
According to Ayoub, children create a set of models early in childhood about how to get along with other people, and they build on these models as they develop relationships over time. These models develop as a web with multiple strands for different aspects of relating that are woven together with development and experience. The strands vary from child to child, and are molded powerfully by emotional experiences. As the child develops, parts of the web converge – and the child begins to integrate different domains of emotional knowledge and cognitive understanding.
Children who have experienced serious or prolonged trauma, however, frequently follow an alternative developmental pathway and make connections and organize their emotions in a completely different way. They may find it particularly hard to manage positive emotions. As Ayoub explains, "The preschool teacher may say, 'Let's all sit down for circle time and listen to this nice book.' That's a task that involves positive emotions and positive problem solving. Children who have experienced chronic trauma through abuse are much less able to perform that task than some other activity that is quite negative."
"It makes sense really," says Ayoub, who gathers her research material by establishing long-term relationships with families and their service providers, "because these children have had lots of practice at handling negative experiences but not a lot of practice at experiencing positive ones."
Children who have lived through violence or other trauma later reflect that there was one person — perhaps a family member, a teacher or a neighbor — who provided the positive support they needed to survive. Ayoub stresses the importance of educators recognizing the needs of traumatized children and responding appropriately. "You can intervene at any time," says Ayoub, "and it's really important to do so. These children react differently and it's really essential to understand why."
So how do educators recognize children suffering from trauma? And how should educators respond to them? Ayoub offers the following guidelines:
- Traumatized children often expect the unexpected, so be clear and consistent about your role and purpose.
- Expect erratic and unpredictable responses, especially around issues of connection and attachment to other individuals.
- Sometimes we see these children as the bad kids acting out, but most often they themselves are victimized by other children.
- Do not ask for disclosure or information too soon.
- Be aware of the use of drugs and alcohol as a numbing agent against anxiety and the pain of recall, even in young children.
- Do not anticipate long-term positive relations or trust with these children.
- Physically abused children are intensely aware of the wrongfulness of abuse, but may not be able to integrate this knowledge base with their own experience.
- The child's wary orientation to the world serves as protection against current and possible future danger.
Of course, children respond best to any kind of therapy with the involvement of a parent figure. Even abusive parents usually love their children. Although this is not always possible, Ayoub believes that supporting the whole family is important because "you want to build as much resilience as you can into the parent-child relationship." Putting theory into practice, HGSE and Harvard Medical School have recently teamed up with Children's Hospital, Boston, to create the Family Connections Project.
Family Connections, which currently works in five Head Start and Early Head Start Centers across Boston, aims to provide preventative support for families facing adversity. With recent statistics revealing that up to 48 % of Head Start mothers are depressed, Ayoub and her colleagues, William Beardslee, Caroline Watts, and Mary Watson Avery, hope to provide the support families need to raise healthy children. Family Connections places teams of early education and mental health professionals in the centers not only to help the families suffering from depression but also to educate the staff who work with them.
"We're trying to help staff understand depression," explains Ayoub. "A staff person needs not only to recognize depression, but to know what they can do, and what they need to refer out to a specialist." With prevention programs like Family Connections, Ayoub hopes to reach families before children are exposed to abuse or neglect, sometimes identifying parents who might need extra support before the baby is even born so that they can then be better parents.