ACEs can be long term or sudden separate events; both can traumatise a child.
It is often difficult to separate a child’s trauma response from their neurodivergent needs but a low arousal, empathetic approach positively addresses both these areas.
Maintain structure and routine wherever possible. This can provide the child/young person with sense of familiarity and predictability and over time improve their sense of safety.
Establishing new routines or putting routines in place can be initially difficult especially with children/young people that find changes difficult to adjust to. It is helpful to do this gradually but persistently. Once routine is established it will become just a part of regular schedule and will become accepted and containing. Having safety and predictability present in life (through routines and schedules) communicates to the child/young person that they have a place in the world and that the world is a safe and predictable. This reduces the stress response of the brain and therefore the fight/flight/freeze response. It also allows the child to relax and rest and cope better with unexpected and unavoidable changes (eg change in teacher).
If the world feels like a difficult to understand, unpredictable and dangerous place, the young person will need support preparing for changes or transitions. Allow plenty of time (but not too much to increase anxiety even further) to let them know about an upcoming change. You can use timetables or visual materials to help them to prepare.
Maintain consistency in the child’s/young person’s life as much as possible. This means the same strategies applied both at home and at school. It is helpful to keep in regular contact with the school, other professionals, other carers and work together to ensure similar boundaries, demands and coping strategies are applied across all environments around the child.
Ensuring all professionals and carers involved the child’s life have a shared understanding of the difficulties and strategies that help. Simple document can be created to state the most important information about the child/young person (eg their medical or sensory needs), their likes and dislikes, what they find upsetting and how to calm and sooth them in times of upset or crisis. This prevents miscommunication and misunderstanding and is especially important when child or young person presents very differently in different environments (eg behaves differently at the school and at home).
Helping child/young person to learn to manage their emotion (see Emotion regulation section), start with co-regulating their emotion. This means that that the carer needs to stay regulated and calm. When tuned-in to the child’s needs and emotions, the carer can quickly recognise and identify these, respond to them and help the child to calm down.
Helping the child/young person to recognise what ‘triggers’ remind them of trauma/difficult experiences. These triggers can be external (in the environment around them or internal (their thoughts, feelings, memories, bodily sensations). Help them to identify what helps them to feel safe (eg engaging in an enjoyable activity, talking to a trusted adult or peer, art, music or a particular place).
If possible, consider whether the carer has faced challenges similar to the child’s/young person’s challenges. How did the carer cope or respond then? How did other carers or grandparents respond? Consider what parenting strategies does the carer want to keep and which ones they would like to replace or move away from.
Having calming and soothing resources ready for when the child/young person becomes distressed. A soothing box with materials the young person finds comforting can be helpful. This can consist of soft materials like blankets, items with a favourite smell on them, favourite toy or item of clothing. A child can have a larger soothing box at home and a smaller one for when out in school or community.
Children and young people who have experiences Adverse Childhood Experiences can struggle with initiating, developing, maintaining and managing close, nurturing relationships with others. It is important to support children and young people to experience and develop healthy, attuned relationships with trusted adults, peers and professionals. To facilitate this:
- Listen to and validate child’s feelings and thoughts
- Give the child full attention, be aware of your eye contact, facial expressions and body language. Some neurodivergent people might struggle tolerating eye contact. Be aware of the child’s preferences.
- If the child can express themselves verbally demonstrate that you are listening and understanding their viewpoint. You can do this by reflecting what they say, naming unexpressed emotions and offering summaries of your discussion.
- Some people cannot tell others how they are feeling and they have to rely on communicating their feelings, pain and thoughts through actions and behaviour. When the person shows worrying or upsetting behaviours think what they might be trying to communicate and what needs they are attempting to meet
- Help child/young person to notice and label unspoken emotions and put these into words where possible
- Validate young person’s experiences and behaviour based on their past history and current situation
- Show and model to the young person respect, kindness and compassion for self and others
- Children and young people likely have not yet developed ability to regulate their own emotions and therefore rely on trusted adults to do this for them. Be mindful of your own feelings in the situation, your own thoughts, bodily sensations and urges to act certain way. Take a moment to attend to your own wellbeing before working on calming the young person/child. You can take few deep breaths as this helps your body and mind to calm, become more self-aware and think through next steps/actions. This will allow you to respond in an attuned and thoughtful manner rather than being overwhelmed with difficult emotions.
- Explore relationships, boundaries and expectations of relationships with them. Social stories, emotion cards and diaries can be used where child/young person has difficulties with understanding and memory.
- Teach how to recognise emotions in others, how to respect self and others and how to initiate and manage relationships with others.
- Explore and discuss (if possible) the balance between attending to own needs and the needs of others.
- Teach child/young person how to repair relationship after an argument. Best way to do this is by modelling, eg when you notice you made a mistake acknowledge this and apologise. Discuss with the child/young person that is alright to make a mistake as we can learn from it.
- Some neurodivergent children and children with learning disabilities might struggle with understanding some concepts of politeness. It is better to focus on helping them to understand and communicate their feelings and needs and not to put too much pressure on saying ‘please’ or ‘sorry’.
- For children with developmental delay or learning disabilities it is more helpful to think about their developmental age rather than their chronological age. If child appears to be and acts much younger than their chronological age, it is better to focus on their actual abilities and needs rather than think about how they ‘should’ behave according to their age. This can mean using language, communication, play and demands that are suited for a younger child.
- Support the young person to confidently and safely share their opinion as without it others might struggle knowing how they are feeling. Teach them that is it alright to say ‘no’ to people and to opt out of activities and places. Teach them how to clearly ask for what they need.
- Support the child/young person in regularly taking part in activities that they enjoy and find meaningful. Help them to identify these activities and support them in engaging in them on regular basis. Make a list of pleasant activities that the young person can access with their carer and incorporate these into their daily and weekly schedule. This will improve their mood, quality of life and also help them to bond with trusted adults or peers.
Children and young people might need professional support making sense of their trauma and their life experiences. Consult your GP about services available in your area. Many school also apply trauma-informed approaches (TIS) so it is worthwhile speaking to your child’s teacher.
Just like most of adults, the child/young person might have ‘better’ days and days when are struggling more. Some days it might be easier for them to tolerate and manage emotions associated with their life experiences. On another days, they might need more support from their carers. Just because a child/young person appear to be coping well and calm one day, it does not mean they will feel equally well the next day. Children can also develop ‘people pleasing’ as coping strategy and this can make it more difficult to establish their feelings and respond to them.