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Children and teens who have endured chronic trauma because of abuse, neglect, parental drug use and more (see ACE study) have brains that have developed for the primary purpose of survival. Their fight, flight, and freeze responses, avoidance, or “manipulation” of adults are often interpreted as willful misbehavior instead of symptoms of chronic and complex PTSD. In fact, it is estimated that children in the foster care system have twice the incidence of PTSD than veterans have. Yet until recently, the effects of trauma on a child’s development and functioning have not been well understood.

This is beginning to change. With the growing awareness of the Adverse Childhood Experiences Study (1998) as well as advances in neurobiology, we now know that the hypervigilance and reaction to “trauma triggers” in these hurt children are not intentional or volitional, but are reactions designed by nature to ensure survival.

We also know that traditional child management strategies do not work and can even backfire badly!

Trauma Informed Care is a model of child management designed to prevent further harm to children who are significantly damaged already. Anyone in a caring role with these children and teens, including parents, foster parents, teachers, youth leaders, therapists and more, can learn to reframe the maladaptive behaviors of these children, through a “trauma lens.” The priority goal of trauma informed care is to build safe nurturing relationships through empathy, acceptance, and a sincere attempt to elicit the causes behind the behaviors. Only when the child has secure, stable, and nurturing relationships at home, at school, in the community---can they begin to trust, calm themselves and begin to heal. So much pain and fear fall away when a child feels understood and knows they will always be cared for.

The Trauma Informed Care model is used with children who have endured adverse childhood experiences which have resulted in trauma. This specialized parenting framework, consists of strategies, techniques and principles used in lieu of traditional parenting techniques such as behavior modification, and designed to promote attachment and healing between caregiver and child. TIC has been successfully adapted for use in schools, the juvenile justice system, residential treatment centers, and more. At San Antonio Center for Childhood Trauma and Attachment, we counsel, coach, and support parents and others on how to view their child’s behavior through the “trauma lens,” and provide techniques that work!

A landmark study which conclusively linked adverse childhood experiences with adult onset chronic medical issues, mental illness, adult incarceration, drug and alcohol abuse, education disruptions and learning difficulties, poor interpersonal skills, and employment problems. A surprising finding is that, on average, 2/3 of the adult population have at least 1 ACE. ACEs are very common.

Attachment refers to the way an infant attaches to it’s caregiver, usually the mother, and then the father. Because humans are social and develop within relationships, the quality of a child’s attachment will set the trajectory for brain development, personality development, and ability to form healthy relationships, cognitive skills, and competencies. A child who has not have enough care or nurture will not have a secure base from which build the proper foundations for a healthy and typical growth.

There are four attachment styles, the first three of which are considered within normal, and the last which is not.

• Secure. 55% of children have this style. They had caregivers who were responsive, attuned, and nurturing. This is the optimal attachment style and gives a child the foundations needed for a healthy development. These children explore the world with confidence, are curious and have good self-esteem. Because they’ve been comforted, they eventually learn to comfort themselves when distressed and reach out to others with empathy.
• Insecure/ambivalent. About 8% of children have this style. Their caregivers were inconsistent; sometimes responsive and loving while at other times unavailable to meet the child’s needs. These children can become clingy and insecure, seeking comfort from caregiver, but then turning angry and rejecting. As adults, they can become co-dependent.
• Insecure/avoidant. 23% of children have this style. Their primary caregivers met their children’s physical needs, but weren’t adequately responsive emotionally. Because the children weren’t shown enough empathy and nurture, they grow to be independent and self-contained, preferring to solve their own problems, and expecting others to solve theirs. They tend to be analytical but have weaknesses in social and emotional skills.
• Disorganized. It’s within this attachment style, where we see the most trauma. 15% of children have this style. Their caregivers were overly intrusive, neglectful, angry, and even abusive, resulting in a very frightened dysregulated child. A disorganized attachment is very damaging because it puts the child in a no-win situation. He can’t turn to the parent to get his physical (diaper changing, food, warmth) needs met, or the comfort and nurturing he needs to feel safe. The child’s brain does not develop normally, but instead becomes structured for survival. The child’s energy is not directed toward play, learning, and exploration, but for constant hypervigilance to possible danger. Staying out of harm’s way and having to look after and protect the self-become the priorities.

Nothing strikes more terror in the hearts of parents than the term RAD. “Does my child have RAD?” is one of the questions anxious parents ask me the most. It brings up terrifying visions of children murdering their parents in bed or burning down the house! Personally, I think it’s a useless term that should be discarded because it scares people and doesn’t even describe the problem! The word reactive refers to how a child relates to an attachment figure in the face of danger. Does she run to mom and hide under her skirts? Does she ignore mom and run to anyone who is handy? Does she become frozen and act invisible? The response of the child will give clues to the quality of the attachment. Another problem with the term RAD is that it suggests hopelessness. “This kid is so dangerous that she’ll probably grow up to be a career criminal and there’s nothing I can do! I’ll be seen as a horrible parent because my kid’s going to be a career criminal! I’m a failure as a parent! What will the neighbors think?” Relax! This child’s fate is not written in stone. Her brain is still malleable and she can heal. With the right parenting strategies, your child can have an earned attachment. The child you have can become your real son or daughter. I should know. I’ve been where you are. Fortunately the parenting techniques and strategies I learned to use with my attachment challenged child led to slow and steady improvement. My formerly rejecting child has become my loved and cherished daughter and, do you know what? She now loves me back!

You’ve been through a thorough vetting process and much training in order to be eligible for fostering and/or adopting the child who has been placed in your care. You think you’re prepared. Then your child enters your home and it feels like a boulder has just been tossed into your tranquil family pond! The truth is that nobody can be adequately prepared for a child so filled with anger and fear. The child is rejecting, disrespectful, non-compliant, maybe even destructive. You try the old parenting standards---time-out, taking away privileges, grounding, behavior modification charts, but it all backfires and makes the child more rejecting, angry, and disrespectful. There may come a point where you’re so discouraged and chronically upset, that you begin to back away and even avoid the child. Parents can become desperate when nothing is working.

The problem is that unlike a typical child who has attached, this child cannot trust you, and techniques like time-out, lectures, and grounding only serve to convince the child that you’re another dangerous adult who means to reject them and do them harm. Of course, most parents don’t know that, and continue traditional parenting techniques which actually escalate the behavior.

What parents don’t understand is that behavior is only a symptom, and we don’t treat symptoms. If a child has scarlet fever we don’t merely give them aspirin to treat the fever, we look for the underlying disease and treat that. In the case of kids who have been through trauma, the first priorities are building an attachment relationship which will facilitate trust and healing. This child must not only be safe, she must feel safe. These are two different things. The parenting techniques used at SACCTA, can seem paradoxical and non-intuitive, but they have been tested and they work. They can work for you, too! Furthermore they’re fun, playful and build attachment through nurture and attunement. They’re designed to draw the child instead of directing them away!

Foster and adoptive parents can themselves become traumatized by repetitive exposure to their child’s manifestations of trauma. When your child has been sent home from other children’s homes for inappropriate behavior, picked up by the police for the third time, or you’re getting calls from the school several times a week, your own brain and nervous system begin to adapt for hypervigilance and the anxious anticipation of trouble. You might begin to isolate, lose your ability to concentrate, and notice that people and things you used to enjoy have ceased to bring you pleasure. You feel depressed, anxious, and hopeless. Many of us experience our own PTSD, otherwise known as “vicarious trauma.” This was certainly true for me!
When this happens, you absolutely must get support, preferably from other parents who have been there, and have gotten through it. Secondary PTSD can feel so isolating because your family and friends won’t “get it” because they might not see it. They certainly won’t understand the constant stress because they haven’t experienced it themselves. Even your spouse may be too tapped out to be able to give much support.
If this is the case, I can lend an ear, support you, and counsel you in techniques that work, and help get you back on your feet emotionally. I’ve been deep in the trenches myself, and have emerged by learning to see my child through a “trauma lens,” and responding appropriately. The loving relationship I have with my daughter can be yours too! I’d like to help. Call me for a free 30 minute consultation.