Monday, January 30, 2012

Trauma and Post Traumatic Stress Disorder (PTSD) in Children.

The more I look at the factors impacting on a child’s ability to learn to read, the more I find out that we may not be paying enough attention to psychological and emotional factors.
Trauma is one of these, which affects children in all aspects of their school work, not only in learning to read. I obtained the information for this post from “Surviving Childhood: An Introduction to the Impact of Trauma” on .You may be interested in visiting this site to learn more, but for those readers who would like a summary, here it is.

Trauma is a psychologically distressing event that is outside the range of usual human experience. It often involves a sense of intense fear, terror and helplessness. Examples of traumatic events are physical abuse, hurricanes, fires, traffic accidents, witnessing violence, multiple painful medical procedures, sudden death of a parent, threat of violence at school or home.
Humans respond to threats with what is called the ‘fight or flight’ reaction—heart races, palms sweat, mouth becomes dry and stomach churns. With an increase in the threat level, the response moves from vigilance to alarm, then fear and finally terror. During a traumatic event, all of the person’s thinking, behaving and feeling are directed by more primitive parts of the brain, and the person tunes out all non-critical information. (So much for people telling us not to panic—do we have a choice?)

A second common reaction pattern to threat is dissociation—the mental mechanism by which one withdraws attention from the outside world and focuses on the inner world. A person may have the feeling that he is an outside observer of what is happening to him. In extreme cases, children may withdraw into an elaborate fantasy world where they may assume special powers.

When the trauma ends, there should be a return to normal within a month. The child moves from terror to fear, then vigilance and with time and support, back to calm. The brain will resume pre-trauma styles of thinking. The child that has dissociated will begin to pay attention to external stimuli.

During this time also, the child will remember the event and play it over and over in his mind, as he tries to make sense of what has happened. He may feel more fear at this time than during the actual threat. All of us can identify with this—we think of what might have happened and are fearful of a repeat. Traumatic memory involves the storage and recall of memory at several levels, not only what, where and when, but also memories of feelings such as fear, dread and sadness, which are stored in sub-conscious parts of the brain. The more life-threatening the experience, the more difficult it will be for the normal mental mechanisms to work efficiently to process and master that experience.

Long after children have experienced a severe traumatic event, about half of them still suffer from confusion, emotional pain, distress and fear so severe that they are not able to function normally. They are suffering from post traumatic stress disorder, (PTSD). This is because, when the child remembers the event, they can recall and relive the emotional and physiological changes that were present in the alarm reaction. They remember how they were feeling and what state they were in, causing a state of hyperarousal. There is an increased startle response, increased muscle tone, a fast heart rate and elevated blood pressure. In addition, the fearful child has a tendency to be defiant and aggressive.

Trauma can have a devastating effect on an individual child, profoundly altering physical, emotional, cognitive and social development. Ultimately we all pay the price exacted by childhood trauma, whether we are dealing with individual children or large numbers of scarred adults assuming their places in society. Social problems of traumatized children can manifest in teenage pregnancy, drug abuse, school failure, victimization and anti-social behavior. The escalating cycles of abuse and neglect of children in some communities can, in turn become a major contributor to many other social problems, such as proliferation of violence and social disintegration.

However, early and aggressive treatment of traumatized children decreases the risk of developing PTSD and other stress-related problems seen later in life. Typical approaches include individual and group therapy. In individual therapy, the child has one-on-one contact with a clinician.

We can also do our part. Here are some guidelines for living or working with traumatized children.

1. Don’t be afraid to discuss the traumatic event when the child brings it up.

2. Provide a consistent, predictable pattern for the day.

3. Be nurturing, comforting and affectionate when the child asks for it.

4. Discuss your expectations for behavior and your style of discipline with the child—use positive reinforcement and rewards.

5. Talk with the child, giving age-appropriate information.

6. Watch closely for signs of reenactment, avoidance and hyperreactivity. Record the behaviors and try to notice a pattern.

7. Protect the child. Stop activities that are upsetting or retraumatizing for the child.

8. Give the child choices and some sense of control.

9. If you have questions, ask for help.

How many of our Jamaican children are suffering from PSTD? Are there any statistics on this? We only have to watch the evening news (which is certainly not suitable for children) to see that children witness or are involved in motor vehicle accidents, and acts of violence with knives and guns, and have their houses burnt down. The available support services are certainly insufficient to cope with the numbers of children, many of whom may receive no help whatsoever. Teachers may be unaware of their condition, regarding them as lazy or badly behaved.

Please help to spread knowledge of PTSD in children by recommending this post to people you know.


Pamela K Witte said...

A very relevant and informative post. I'll help spread the word by Tweeting it right now!

Helen said...

Thanks, Pam.