“When a child is met with loving, attuned, and responsive relationships on a moment-by-moment basis, they are literally learning that life is safe; that they matter; that others can be trusted. With this, they can feel safe and stay open to explore, be curious, learn and interact with other people in a positive way. Such nurturance makes sure the ‘fight, flight, or freeze’ stress response does not take hold and stall a child’s healthy development.”
Johns Hopkins Bloomberg School of Public Health in Baltimore
Children and families thrive when they have access to safe, stable, nurturing relationships and environments. These relationships and environments are essential to creating positive childhood experiences and preventing adverse childhood experiences.
Exploring the subject of Adverse Childhood Experiences (ACEs) can be a sensitive topic. If you are comfortable to share details of any adverse childhood experiences remember it is okay to feel upset and you should never feel judged for sharing what has happened to you.
Adverse Childhood Experiences (ACEs) are traumatic experiences that children experience before the age of 18 that can have lasting impacts on their mental health, physical health, and general well-being. This is not about blame. These experiences could have occurred in the school system or community. Poverty and parents who have had their own adverse experiences could also impact a child’s experience.
It is important to talk about ACEs because it helps to raise awareness and understanding of the impact of trauma on children and young people.
The impact of ACEs can last with us but please remember that even someone who experienced several ACEs can heal and recover from the experience. Help is out there, and it’s possible to live a full life even if you have endured trauma in childhood. If you or someone you know is struggling with the effects of trauma or adversity, there are resources available to help.
Adverse Childhood ACES
There are a wide range of adversities which may be in the home environment or outside of the home. For example, an unsafe environment at home, parental separation or divorce, parental mental illness, or witnessing violence but there are other adversities such as parental death, being bullied at school, experiencing racism, exposure to environmental disasters or growing up in poverty can also have an impact. There are many different reasons why a child might experience an intense source of stress whilst growing up.
Trauma can present in children in many ways. One of the most usual ways of noticing how trauma affects children is behaviours when feeling stressed.
The body has an amazing way of responding to stress in order to survive and it’s the boy’s natural reaction to perceived danger or potential threat that the body reacts in various ways which can lead to having lots of energy to fight (back) or run away or freeze and shut down. In the right situation these responses work well, but if a child has experienced frequent or high levels of stress during childhood, then they may begin to respond for small stressors as if they are bigger ones. Sometimes feeling stressed can happen when in a safe place too. Feeling stressed and anxious can be very tiring and emotionally draining.
Adverse Childhood Experiences (ACEs) are stressful or traumatic life events, situations and circumstances that happen during child’s life and can have a lasting impact on their development. Examples of Adverse Childhood Experiences (ACEs) include physical, emotional and sexual abuse, physical and emotional neglect, growing up with a parent who struggles with substance abuse or mental illness, parental separation or divorce, domestic violence, imprisonment, bereavement, experience of war, experience of prejudice and discrimination, bullying. Most people experience at least one ACE in their lifetime and not everyone who experiences adversity goes on to develop physical or psychological difficulties. However, those who experience multiple ACEs also have an increased risk of worsened physical and psychological health. Research has also found that ACEs often repeat themselves in families and across generations.
Stress and trauma increase levels of hormones like cortisol and adrenaline, and this leads to fight/flight/freeze response in our bodies. Children’s brains and bodies are especially sensitive to this as they are still forming. Experiencing large and prolonged amounts of adversity impacts on the developing brain’s structure and its emerging functions. The child’s immune and hormonal systems are also impacted. If the trauma is ongoing or repetitive the child’s brain adapts to this circumstance and keeps them in a constant state of anxiety, hypervigilance, and defence. Even when the person is safe again, it can be difficult for the brain to recognise this and unlearn the hardwired threat response. ACEs can therefore have an effect on the brain development and, over time, lead to numerous physical and psychological difficulties that will demonstrate across person’s lifetime.
Many children/young people who experienced trauma in their early life might find it difficult to seek support and comfort, to communicate and express their needs, to seek and follow guidance and advice and manage autonomy as they grow older. They might also struggle identifying, recognising, and communicating basic bodily sensations such as hunger, tiredness and pain. It can also be challenging for them to recognise and name their feelings and let you know when they are worried, sad or angry.
Some children can withdraw into fantasy worlds in order to escape difficult real-life circumstances and past memories. When dissociation happens, children are not present in the here and now and can appear to be daydreaming. Dissociation is different from just being inattentive (eg. due to lack of interest or boredom), it is a response of the brain that happens without the person’s awareness and helps them to cope with stressful experiences, memories and feelings. When disconnected from here and now the child will miss out on information from the environment and what is happening around them. During dissociation their mind is somewhere else, and this makes it difficult for them to learn from their experiences and to take on new information. This can impact on their education, skills and academic abilities. Our brains and bodies need to feel safe and regulated in order to explore and be able to learn about the world.
If a child has experienced multiple or prolonged unpredictability and lack of safety their attention, concentration, memory, decision-making and action-planning might be impacted. Some young people might not have the ability to reflect on their inner life and actions. They might also make negative assumptions about the motivation and actions of others. If they are not able to trust others or to say how they are feeling they might rely on behaviours to communicate their distress. Some children/young people might struggle separating from their carers and need to constantly seek reassurance to feel safe. Some young people might become overly independent as they got used to not relying on others to meet their needs. Some people might shut down and lose contact with their feelings as a way of protecting themselves from overwhelming emotions or memories. Some young people might become very acquiescent and attempt to please others as a way of keeping carers near and ensuring their needs are met. Some children and young people might attempt to exert as much as control over their environment and other people as a way of creating sense of safety and predictability and making sense of the world. It is important to see these reactions and behaviours as adaptive responses – children and young people developed these to adapt to the challenges they face and to survive.
Children and young people who have experienced abuse, neglect or bullying might develop a sense of shame and low self-esteem, often blaming themselves for their experiences. They might believe that they are bad, lazy or responsible for the difficulties of those around them. When a child/young person has a negative image of self, they might struggle accepting love, nurture and praise as these might initially feel unfamiliar to them. They might also behave in a way that will reinforce the negative view they hold of themselves (eg challenging behaviour towards others).
Trauma | Anna Freud
www.annafreud.org/resources/under-fives-wellbeing/common-difficulties/trauma/
Neurodivergent people can experience a higher amount of traumatic events such as bullying, abuse and isolation. They also often experience additional difficulties such as sensory overstimulation, being misunderstood by their environment, having to mask in order to fit in, difficulties telling others how they are feeling and difficulties accessing help. Stress and trauma can also be brought on by difficult or unexpected changes and transitions, difficulties navigating social situations and relationships, difficulties making sense of their inner experiences, being prevented from engaging in rituals that they find soothing (eg stimming), having reduced options or choices and/or reduced agency and control over their lives.
Being a parent is equally demanding, parents can feel stressed too and the stress response may affect the way we think and feel. When stress levels are high it can be
- Hard to calm down
- Easily lose your temper
- Feel impatient
- Feel less able to listen to your children’s needs
- Be less able to model good behaviour and emotional regulation to others
Parenting with your own childhood stressors, means you can experience a harder time trying to make life feel safe for yourself and your children.
If you are worried about the connection between your own childhood stress and how safe you feel as a parent, you may wish to seek help from a professional.
Use the Incredible Five Point Scale to visually support the child to self-regulate.
Reassure the child that you do not expect eye contact – you know they are listening.
Clear, appropriate language that the child will understand. Do not overwhelm the child with long sentences, questions or multiple options. Use concrete (not abstract) words and phrases. Be mindful of your tone of voice, facial expression, eye contact, physical proximity to the child.
Provide the child/young person with simple options and choices to allow them feeling of agency and some level of control over their life.
Consider whether they might be in pain, tired or overstimulated by the environment.
Provide plenty of warning about activities starting and finishing. It can be emotionally difficult to finish an enjoyable activity so allow the child time to prepare and transition.
Recognise signs of sensory over-stimulation or under-stimulation. These might including avoiding or escaping from certain stimuli (noise, colours, smells, sounds), withdrawal, running away, increase in self-soothing behaviours (eg. rocking, pacing, hand flapping, vocalising). Or alternatively seeking out certain stimuli and sensations (eg. bumping into objects, inspecting objects, focusing on certain types of play).
Attempt to identify the function of the behaviour the child/young person is displaying and think what they are trying to communicate. If they are experiencing sensory overload, help them to find and move to a lower stimuli environment where they can feel safe and calm. If they are seeking out certain sensory stimuli help them to find safer alternatives.
Use ground skills and techniques to connect with the present moment. You can start with few deep breaths. Then you can notice things around you – name 5 things you can see, 4 things you can feel, 3 things you can hear, 2 things you can smell and 1 thing you can taste. You can also name and describe objects around you or search for different colours in your environment.
Rhythmic and repetitive activities can help to move the child brain from state if hypervigilance and anxiety into a calmer, more regulated state. These activities work best when they are incorporated into the child’s daily routine. Try activities like: walking, listening to music, singing and dancing, physical exercise (eg running, yoga, swimming), drumming, tapping.
Start with regulating the child’s stress response (fight/flight/freeze). Then focus on connecting with the child and their experience, tuning into their emotions, bodily feelings and urges. Only once the child/young person feels safe and calm we suggest working on helping them to think, reflect and learn. Then connection with the child needs to come before attempts at correcting any behaviours.
Ideas to try
- Help your child to take Deep breaths in and slow breaths out
- Finding a special thing to do that helps them to relax like listening to music or reading a book
- Having a quiet place to ‘just be’ for a moment
- Having a bath or playing with some water
- Taking a short walk, being outside in nature
- Take time to talk – walking alongside
- Validate feelings – naming what you feel
- Offer reassurance
Please refer to the link about Emotional Regulation.
Emotional20Regulation1.pdf (srhd.org)
Teaching self-regulation may take a very long time; be patient and practice.
https://www.youngminds.org.uk/parent/parents-a-z-mental-health-guide/trauma/
PACE
PACE – Playfulness, Acceptance, Curiosity, Empathy is a trauma informed approach to supporting children and young people who have experienced trauma. Using PACE enables the adult to see the strengths and positive features that lie underneath more negative and challenging behaviour.
Playfulness – attitude of lightness and openness, this can be communicated verbally but also non-verbally, such as through body language, eye contact, tone of voice, laughter (where appropriate). Communicating to the child/young person that the relationship comes before the conflict or disagreement helps to create a sense of safety and stability. Model voicing and labelling emotions. This communicates to the young person that emotions are safe to have and share with trusted people. Feelings alert us to something that needs attending in our lives and so play an important role for us. They also help us to make a sense of our lives and what happened to us. Acknowledge that sometimes number of strong and/or conflicting feelings can happen at the same time.
Acceptance is about actively communicating to the child that you accept the wishes, feelings, thoughts, urges, motives and perceptions that are underneath the outward behaviour. It is about accepting, without judgment or evaluation, her inner life. The child’s inner life simply is; it is not right or wrong. Accepting the child’s intentions does not imply accepting behaviour, which may be hurtful or harmful to another person or to self. The parent may be very firm in limiting behaviour while at the same time accepting the motives for the behaviour. One hopes that the child learns that while behaviour may be criticised and limited, this is not the same as criticising the child’s self. The child then becomes more confident that conflict and discipline involves behaviour, not the relationship with parents nor her self-worth.
Curiosity – express desire to understand the young person’s feelings. Taking non-judgemental stance. You can seek their permission to ask certain questions, to provide them with some sense of control and agency. Curiosity can be used to explore child’s emotional world, links between past experiences and current emotions and links between feelings and behaviour. This can help the child/young person to develop an understanding of their life story. Maintain sense of curiosity when faced with the child’s/young person’s distressed behaviours – what feelings or needs are they trying to communicate to you? How that their behaviour today makes sense in the context of their previous life experiences? When we help children to make sense of their emotions, the emotions become less overwhelming for them.
Empathy – is crucial to establish emotion connection with the child. Reflect back child’s emotions and experiences. Empathy for child/young person’s experience should be happen before any disciplinary measures.
https://girfec.fife.scot/__data/assets/pdf_file/0032/187484/PACE-School.pdf
SPELL
The SPELL framework recognises the unique needs of the individual. This guidance tool emphasises that planning and intervention should be organised on this basis. SPELL stands for Structure, Positive Approaches and Expectations, Empathy, Low arousal and Links.
Structure– Some children are unable to cope in situations when they cannot predict the outcome or fully understand what is happening. A consistent routine or specific structure in these situations can support children to understand what may be expected of them in certain situations, which may reduce any heightened confusion and anxieties. Environments can be modified to ensure each person in the household (or learning environments) understands what is going to happen so that they can support the structure which may contribute to the creation of a calmer home.
Families can obtain ideas and resources to enable them to create structured environments which are predictable for their children. Structure can also aid personal autonomy and independence by reducing dependence on others (e.g. prompting).
Positive– Self-confidence can be reinforced by building on and encouraging the child’s natural strengths and specific interests. This positive approach can help to reduce anxieties and aid in the development of new skills. Many neurodivergent children may avoid new or potentially aversive experiences, but with structure that is positive, sensitive and supportive, it can help to reduce their level of anxiety and in turn help them to tolerate and accept new experiences whilst aiding in the development of new or existing skills.
Empathy– It is always important for parents, families and caregivers to try and see the world from the child’s locus of evaluation as this will help them to understand what motivates and interests them. This may also enable them to see what is potentially causing the child any stress or distress. The quality of the relationship between caregivers and the child is vital. By aiming to be as calm, predictable, realistic and empathetic as possible, this can improve the quality of relationships and support positive family dynamics.
It also doesn’t harm to be ‘thick skinned’ and have a good sense of humour. Look out for our social platforms where you can share your views with us and other parents.
Low arousal The low arousal approach to supporting distressed behaviours, focuses on the child’s wellbeing, stress levels and how caregivers respond in moments of crisis.
Links– It is beneficial to be calm and organised with the aim of reducing the anxiety and aid concentration and reduce distressing behaviour. Some children may need more time to process information, therefore it is important that information is presented to the child with care, Regular low arousal breaks throughout the day will aid self-regulation and reduce anxiety and associated behaviours.
We understand from personal experience that supporting a child with additional needs can feel like a constant battle when trying to obtain support or additional services. Fighting for your voice to be heard can be very tiring, demoralising and adds more stress and anxiety to an already fraught situation or family dynamic. We know that there can be barriers to accessing support for your own children. Nonetheless there is huge benefit in positive collaboration between all parties that can be involved in a child’s care and welfare.
This can be as simple as sharing information, tools and approaches that the child responds well to. This enables consistency in all settings, reinforcing expectations whilst respecting autonomy.