Childhood trauma: Overview
Simple trauma: extenternal events such as car accidients and earthquakes.
Complex trauma: physical, emotional or sexual abuse, events that happen one after the other
Children often feel a sense of guild and shame and that the circumstances are their fault. There is often a sense of helplessness around an inability to control situations. W
Adults often acknowledge the struggle of the child however, often feel that they are unable to help
Children in care are more likely to experience complex and enduring trauma with the impacts or effects being accumulative overtime
Oranga tamariki
63% of children will experience at least one adverse childhood event
Adverse childhood events include: abuse, domestic violence, household substance abuse, mental illness parental divorce or relationship break down. All these are considered adverse childhood events if they occur before the age of 18
TYPES OF TRAUMA:
Simple trauma: one off event
parental mental illness
Trauma and the impact on the brain: Trauma impacts on the development on the brain and how it functions
Amygdala: Becomes larger and more active
More active, quick responding to fight or fligt responses
Frontal lobes: grows smaller and less active
Poor impulse control and organisation, difficulty responding and reading social cues
Corpus callosum: grows smaller resulting in poor problem slowing, not being able to verbalize or express what is happening in situations
Hippocampus: Grows smaller, resulting in poor memory and recall of past events
Exposure to trauma or repeated traumatic events results in heightened stress responses which impedes on other normal developmental tasks
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Fight or flight response: a physiological reaction in response to a potiential threat, event or situation
Can be 'accidentally' triggered when not needed such as when a patient has a fear of open spaces and food. A freeze response, can also occur when neither flight or fight are stimulated. this happened when the vody becomes 'self paralised or numbed out without releasing hormones. It is seen as a way from disconnecting from reality. Most often happens and children who often feel smaller and less powerful in traumatic situations
- prolonged fight or flight response
Constant state of being on edge
Repeated trauma/ stress
Prolonged exposure to trauma leads to an over activation of the flight or fight response can lead to a continual state of arousal or hypervigilance, with body and brain prepared for potential threats
The nurses role is to develop a sound relationship with the child, provide theme with a positive spae to rewire the brain, to counteract the effects of trauma sometimes all it takes is a solid relationshop with a caring adult
Complex
Impact of trauma on emotional regulation
Emotional regulation is being able to identify, express and manage emotions. Individuals must have repeated experiences of having needs met by a caregiver.
Infants are born with little self control, during infancy the main task is for them to develop emotional states and behavior regulation
When an infant cries and adult soothes them, from this they learn that they can rely on others to help then regain control of emotions.
Toddlers playing with an object that they aren't supposed to is often calmly redirected to a more appropriate toy, from this they learn about appropriate behavior, dealing with disappointment and accepting the alternative
Emotional regulation difficulties
Easily triggered and have strong reactions
overwhelmed and shut down
Difficulty to calm
Enduring depressed mood which may present as irritability and difficulty to soothe
hyperarousal appearing very anxious, constantly aware of threats, and easily startled
being unresponsive or have difficulty expressing oneself
difficulty focusing
Silly and hyperactive
What helps with emotional regulation
being warm, caring and responsive
use words to show the child what they are experiencing, validate their experiences with words
Show interest and engage in what is being said
Use of appropriate body language
appropriate facial expressions
face the child when talking to you to show that they have your attention, however monitor posture to ensure that it is not to assertive
Engage in positive touch when it is safe and appropriate (hugs, high fives, sitting close to a child
Impact of trauma on physical health: trauma impacts on physical health in numerous ways. When children are in stressful environments their body is in an elevated state or high alert. this has a lasting impact on the normal development of the body's immune system and stress response.
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