Because children who have experienced traumatic stress may appear restless, fidgety or have trouble paying attention and staying organized, the symptoms of traumatic stress can be confused with symptoms of attention-deficit/hyperactivity disorder or similar conditions, according to the U.S. Centers for Disease Control and Prevention.
PSD’s mission is to identify traumatic stress in children as early as possible to help those students develop effective coping mechanisms and to support their educational development.
Pierce County has a significantly higher rate of child abuse than the rest of the state, according to a 2013 Pierce County Community Health Assessment that was based on individual cases reported and investigated by Child Protective Services.
For any child, a traumatic event considered to be an ACE can come because of painful injury or illness, a death of a close family member, witnessing physical harm of a caregiver, separation from a parent, or an event such as natural disaster, fire or war. But in a healthy home environment with parents sensitive to their needs, most children can recover, including children diagnosed with post-traumatic stress disorder (PTSD).
For other children, stress and trauma are a part of daily of life. The physical and emotional scars of child abuse and sexual abuse are not only suffered at the time of occurrence but often continue to negatively impact physical and emotional health well into adulthood.
“Children trust their parents and family members,” said Jackie Furrey, a retired Lakebay therapist who spent the bulk of her career working with child victims of sexual abuse and who is herself a survivor of childhood trauma. “So the implicit message a lot of kids get is that there really is nobody to help them, because if there were somebody to help them it would not have happened. Even worse, is if a trusted person is witness to the event, but does nothing to help.”
ACEs include a variety of stressful conditions found to negatively impact health outcomes from childhood on, such as living with alcoholism, drug abuse, mental illness; an incarcerated parent or witnessing domestic violence. Living in poverty without access to mental health care is also a challenge, according to both the Tacoma Pierce County Health Department and the Washington State Department of Health Injury and Violence Prevention Report.
While most children exposed to a traumatic event do not develop PTSD, a significant number of children do, whether the trauma arose from a single event or from ongoing abuse.
Young children are especially vulnerable to the impacts of trauma. With brains not yet fully developed, preschool-age children are susceptible to the reordering of neural pathways between the thinking cerebral cortex and the amygdala, the fight-flight-freeze response area of the brain, increasing the potential of ongoing physical and mental health challenges, and a classic PTSD response to extreme stress.
Childhood PTSD is often diagnosed because of sexual abuse, which by its nature is secretive and underreported, exactly the scenario that allows PTSD to become more fully entrenched and difficult to treat.
“One of the major consequences of any type of abuse is being silenced,” Furrey said.
“The silencing itself contributes to a major part of the trauma, because if you can talk about it openly, you can recover. Yet, so often children are told to be quiet.”
Recent studies on ACEs explain the long lasting physical and mental health consequences of growing up exposed to trauma. As the number of exposures to trauma rises, so does the risk of developing detrimental health consequences, such as depression, anxiety, anger, substance abuse, obesity, sexually risky behaviors and suicidality.
“What a child grows up with inside their little family is what they expect the world to be, so they may not even know that what is going on in their family is what we think of as out of bounds,” Furrey said. “Most often, the abuse of children is part of the family culture. Usually it is a family member who is either threatening them or coercing them. The perpetrator, whether they are a young kid or an older person, is always using one of those two techniques.”
Jud Morris, director of the Children’s Home Society of Washington on the KP, said one of his organization’s priorities is to get rid of the shame of both the parents and the children.
“We’re approaching families and children with ACEs in a nonjudgmental way,” Morris said. “From our perspective, it’s not about why it happened, but how we can help parents understand and give them tools to do some beefing up of support at home to help their children get up to speed after the toxic results of stress. If we can start helping these children before and during preschool age, we know parents can begin to make a positive impact on their child.”
ACEs training is having a positive effect on students and teachers, according to one PSD employee who spoke on condition of anonymity.
“We are helping these kids devise a strategy to learn how to cope, to have empathy for others and for themselves. For educators to be able to step back and be aware of their own triggers and to deal with the stress of coping with these kids has been huge. I marvel at their willingness to learn how to help their students.”
For more information on the effect of trauma on children, go www.cdc.gov/violenceprevention/acestudy. To report suspected child abuse of any kind, call 1-866-ENDHARM.