June 2018Vol. 19, No. 5Study Assesses Trauma-Impacted Development in Early Life, Potential Corrective Interventions
Children age 2 and under are particularly vulnerable to child abuse and neglect and account for over one-fourth of all substantiated cases of child maltreatment. However, child welfare workers are faced with a shortage of interventions for mitigating trauma in this sensitive population. A new study emphasizes that social workers are uniquely poised to spot trauma and intervene on a family's behalf with developmentally sensitive and trauma-informed treatments for infants and toddlers.
Untreated trauma from early childhood abuse and neglect has the potential to disrupt a child's cognitive, behavioral, social-emotional, physical health, mental health, and well-being over a lifetime. Children who suffer early maltreatment are most at risk for attachment-related disorders and impaired brain development. Because of this, therapeutic interventions are most successful when they strengthen the caregiver-child relationship and repair disrupted attachment.
The study provides an overview of two evidence-based interventions that address infant and toddler exposure to trauma: Child-Parent Psychotherapy (CPP) and Attachment and Biobehavioral Catch-up (ABC). CPP is for children from birth through age 5 who have experienced disruptions with their primary caregivers due to early traumatic experiences. CPP seeks to restore attachment patterns and developmental trajectories through clinician-monitored free play between the parent (or primary caregiver) and child, which allows observers to note their spontaneous interactions with each other. It focuses on both the child and parent, including any potential trauma and insecure attachments in the parent's or primary caregiver's past. Research has found that CPP results in enhanced maternal empathy and parent-child interactions as well as decreased infant avoidance, resistance, and anger issues.
ABC is a 10-session relational model aimed at addressing the physiological and behavioral impacts of early childhood trauma through play. During the sessions, the clinician focuses on common trauma responses in attachment relationships, such as the child pushing the parent away; the parent's own experiences that may interfere with attachment, such as past or current stressors; and the child's adaptive physiological and behavioral responses. The clinician guides the parent to follow the child's lead and respond to his or her cues and uses videotaped interactions to help parents or primary caregivers understand their automatic responses. Research has shown that ABC interventions result in reduced stress hormone levels and behavioral problems.
The report also lists considerations for treatment, such as taking into account the past experiences of caregivers as well as any current stressors they may be going through and whether the intervention is able to increase mutual sensitivity between children and their caregivers.
"Trauma-Exposed Infants and Toddlers: A Review of Impacts and Evidence-Based Interventions," by Alysse Melville (Advances in Social Work, 18), is available at https://journals.iupui.edu/index.php/advancesinsocialwork/article/view/21287/20835 (PDF - 491 KB).