Trauma caused by child abuse can take many forms. The key is to identify it, interpret it and deal with it. This is often left up the caregivers of the abused child/children. The main question that we are going to focus on is: How can these caregivers interpret and deal with the signs of child abuse trauma? But first we must see what the definition of trauma is and what Child Abuse trauma looks like. According to the Meriam-Webster dictionary the definition of trauma is “A disordered psychic or behavioral state resulting from serve mental or emotional stress or physical injury” (Merriam-Webster's dictionary, 1999)
Some of the symptoms of trauma are depressive withdrawal, hypervigilance, and sleep disturbance. Each of the symptoms can cause behavioral changes, nightmares, develop new fears, avoid new people that remind them of the event, or maybe even lose interest in the activities they start and even start to lose friends they may have at the time. These symptoms often lead to Post Traumatic Stress Disorders (PTSD) and or Potentially Traumatic Event (PTE).
How a caregiver deals with the PTSD or PTE will determine how the child will react and live his or her life later.
The caregiver needed to focus on the child and not on what happened to them, for example the act of the abuse or defining the activity that led to the abuse. According to Fadeflci, there must be four things that caregivers need to understand in trying to take care of children with PTSD.
Acknowledge and respond to the PTE’s impact on the child.
Maintain, restore, or increase structure in the child’s life (particularly those that increase the expression of affection or comfort and those that focus on the child’s competencies).
Recognize misbehavior and withdrawal as attempts to regain controls and respond to them with opportunities to cooperatively increase their control.
Take care of yourself. (Fadeflci, 2019)
The parents still must remember that the children are still unable to identify how they feel and how they tend to express the different behaviors. Which means that the parents are responsible in deifying how the children are feelings but not the children. When a parent is not in tune with the child’s emotional states, the child may not feel understood but will also feel held and protected simply by the fact that an adult is focused on both their external behaviors and their internal experiences (Fedeflci, 2019).
The caregiver of the child should always maintain a structure schedule to include eating time, bath time, play time, and sleeping time. As a caregiver you must respond to the misbehaviors by setting up events where they, being the caregiver, can take back control from the child. Finally, as a caregiver if you do not take care of yourself you will not be able mentally or physical be able to take care of a child with PTSD.
These things will not necessarily resolve themselves quickly, but the caregivers can help with it. When a child you love is hurt, it’s normal for you to try and fix it and make it go away. “Remembering a bad thing can be a good thing. It is why human beings have evolved to have such effective memory capacity; remembering helps to safeguard against repeating past errors and against remaining vulnerable to aggressions” (Fedeflci 2019). Also forgetting condemns us to live in a state of anxiety. (Fedflic, 2019). Having bruises all over you and not knowing where they came from can cause tremendous anxiety because of not knowing what had happened to you at the time can lead for fearfulness of everything. There is also fear that may come after that. The caregivers are there to help the children get thought the hard time they are going through. They are there so they can talk to the children when they need someone to talk too and help the child movement forward. “Research has demonstrated and discussed how maternal acceptance tends to offset anxious avoidance in children” (Fedflic, 2019). The less they get the more they become symptomatic.
In assessing trauma symptoms in children, a study was done specifically on preschoolers. Here we go back to the premise that trauma can lead to PTSD in children especially those who have been abused. This maybe an especially detrimental type of trauma in child development. (Choi & Graham-Bermann, 2018)
Preschool children who have experienced trauma have the tendency to either keep everything in or act out. These behaviors can be emotionally and socially difficult. It has been proven that trauma in the early childhood developmental stage can impair the child’s overall development. So, many of the trauma issues did not resolve with time but manifested themselves later in life.
In a most recent study of the Diagnostic and Statistical Manual of Mental Disorders, PTSD was broken down into two subtypes. The two subtypes recognize more specific types of PTSD, and they are a step towards partially capturing the unique symptom profile for child maltreatment survivors: (1) a preschool subtype of post-traumatic stress disorder (PTSD) that allows a lower symptom threshold for introspective symptoms and more emphasis on behavioral symptoms; and (2) a dissociative subtype of PTSD that includes symptoms of depersonalization and derealization. (Choi & Graham-Bermann, 2018) This is where avoidance if addressing that trauma can make things worse. Many preschoolers are often too young to fully vocalize what has happened and therefore will act out. Here is where the caregivers must not use avoidance to control the trauma but work towards getting a diagnosis and treatment for the preschooler.
Understanding Child abuse and its diagnostic operationalization is a critical challenge in the field of traumatic stress studies. One particularly challenging area with important implications for diagnosis, treatment, and research is how to measure trauma symptoms in young children with abuse histories. (Choi & Graham-Bermann, 2018)
Among those studies that included at least one analysis that was stratified by age group, children were more likely to experience more trauma exposure and to display symptoms of trauma symptoms as they aged. Preschool-age or younger children who were exposed to trauma displayed symptoms of behavioral and affective dysregulation (Levendosky et al. [59]; Scheeringa et al. [80]), intrusion (Hulette et al. [50]; Scheeringa et al. [80]), arousal (Hulette et al. [50]), and dissociation (Hulette et al. [50]; Chae et al. [9]). Preschool-age children demonstrated fewer overall PTSD symptoms—particularly avoidance symptoms—than older children or adolescents and were less likely to meet diagnostic criteria for PTSD even when they were highly symptomatic for other emotional or behavioral problems and were experiencing functional impairment (Gomes-Schwartz et al. [35] ; Griffin et al. [40] ; Kletter et al. [54] ; Liotta et al. [62] ; McCrae [65] ; Scheeringa et al. [78] ). These findings were consistent with studies that studied only a single age group (infants, toddlers, preschoolers). (Choi & Graham-Bermann, 2018)
So can trauma be treated, controlled or diagnosed in young children? Trauma is found to vary in children of all ages. Some show very open symptoms while others demonstrate behavioral problems. Often it is left up to the caregiver to notice these symptoms, identify them and bring them to the forefront. In the meantime, as the children get older, the symptoms tend to manifest themselves in many ways. Often those ways may lead to more serious consequences that the parents can no longer control. For now, a parent can talk, make the child feel comfortable and not avoid the situations. Calming fears, working with therapists and letting the child know that the or she is in a safe environment may quell some of the trauma that may arise later in life. Addressing the situation is the most important thing a parent can do.
References
Choi, K. R., & Graham-Bermann, S. A. (2018). Developmental considerations for assessment of trauma symptoms in preschoolers: a review of measures and diagnoses. Journal of Child and Family Studies, 27(11), 3427–3439. doi: 10.1007/s10826-018-1177-2
F, K. (2019, November 4). Avoiding Avoidance. Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/fostering-freedom/201911/avoiding-avoidance
Fadelici, K. (2019, November 1). How Caregivers Can Help Children Heal from Trauma. Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/fostering-freedom/201911/how-caregivers-can-help-children-heal-trauma
Trauma. (n.d.). Retrieved November 30, 2019, from https://www.merriam-webster.com/dictionary/trauma.