It can be challenging to understand and apply key concepts to child welfare practice due to the sheer volume of research on trauma, brain development, and outcomes for children. All of these complex systems and activities work together for one overarching purpose: survival (Goldstein, 1995, cited in Perry et al., 1995). The brain is built by neurons. During development, neurons link to form networks that create systems. These systems regulate all brain functions, which are organized from the simplest to the most complex. The development of these functions occurs sequentially, meaning prior events affect future development. Child welfare professionals, judges, and others who work with child welfare-involved families should be aware that there are critical developmental periods when neural pathways are forming, which can be significantly altered by traumatic events (Perry, 1995, 2009).
Children exposed to chronic, prolonged traumatic experiences may experience long-term effects in the following areas:
- Attachment: An attachment disorder is characterized by difficulties with relationships, boundaries, empathy, and social isolation.
- Sensorimotor Development: Impaired sensorimotor development, coordination issues, increased medical problems, and somatic symptoms.
- Emotional Regulation: Difficulty identifying feelings and communicating needs due to emotional regulation issues.
- Dissociation: Symptoms of dissociation include altered states of consciousness, amnesia, and impaired memory.
- Cognitive Functioning: Problems with focus, learning, processing new information, language development, planning, and spatial orientation.
- Sense of Self: Lack of consistency, body image issues, low self-esteem, shame, and guilt.
- Behavioral Control: Problems controlling impulses, oppositional behavior, aggression, disturbed sleeping and eating patterns, trauma reenactment.
The brain develops rapidly in infancy and early childhood, with neural pathways formed by repeated experiences. Experiences teach the brain what to expect and how to respond. When experiences are traumatic, the pathways getting the most use are those in response to the trauma; therefore, other pathways for adaptive behavior are reduced. Early childhood trauma can disrupt attachment, cause cognitive delays, and impair emotional regulation. Additionally, certain pathways may be overdeveloped while others are underdeveloped, resulting in impairment later in life (Perry, 1995). At three years old, the brain is about 80% of its adult size, and by age five it reaches 90%. This emphasizes the importance of early intervention. However, it is worth noting that infancy and early childhood are crucial periods for brain plasticity, offering a prime opportunity for positive change. While prolonged trauma during this time can have severe consequences, it also presents a window for interventions that can positively impact the brain (CWIG, 2011).
Adolescents and children
During the school-age years, brain development progresses at a slower pace. It involves the elimination of unnecessary neural pathways to enhance efficiency and the coating of existing ones for protection and reinforcement (Shonkoff & Phillips, 2000). This enables children to acquire more advanced abilities, such as managing emotions, controlling impulses, and sustaining attention. However, it should be noted that experiencing trauma during this stage can greatly influence learning, social connections, and academic achievement (NCTSN, 2008). The severity of trauma during this stage is influenced by its onset. If it persists from early childhood through the school-age years, it can significantly affect overall functioning.
Research suggests that trauma starting in the school-age years has a distinct impact compared to trauma that begins in early childhood. Specifically, school-age onset may lead to more outward behaviors, while early childhood onset may lead to more internalized behaviors such as withdrawal, depression, and self-blame (Manly, 2001; Kaplow, 2007).
During adolescence, the brain undergoes another phase of rapid development, much like in early childhood. This improves the efficiency of the brain, particularly in areas that support attention, concentration, reasoning, and advanced thinking. However, trauma during this critical stage can hinder both the development of these functions and their ability to effectively communicate with other systems. As a result, individuals may be more prone to risk-taking behaviors, impulsivity, substance abuse, and criminal activity (NCTSN, 2008; Chamberlin, 2009; Wilson, 2011; CWIG, 2009). Trauma-informed practice requires a comprehensive and collaborative approach. A comprehensive understanding of the issue is the first step toward trauma-informed practice.
