Childhood Trauma

By Dr Megan Yap - PaediatricianGeneral29 Sep 2019

Today’s topic has been requested by several readers, and I will admit it is a tricky one.  I have perhaps been subconsciously putting off writing the article, because of how hard I think it is to both write about and deal with in the clinical setting.

Childhood trauma.

In the context of the requests, I have been asked to write an article for foster carers and potential foster carers regarding what they might expect in receiving a foster child. But before I go into “what to expect” and also in a real sense, what we can practically do to help kids who have been traumatised, we first need to understand what trauma is.

What is trauma?

The National Institute of Mental Health (USA) defines childhood trauma as: “The experience of an event by a child that is emotionally painful or distressful, which often results in lasting mental and physical effects.”

There are quite a lot of different types of trauma, ones related to the relationships the child has with other people (interpersonal trauma) and then trauma related to scary, dangerous or life threatening events that happens to a child or when they witness or hear about them happening to someone else.

Examples of interpersonal trauma can include (but are not limited to):

  • Bullying
  • Physical, emotional or sexual abuse
  • Profound neglect
  • Grief through loss of a loved one
  • Domestic violence
  • Trauma due to the child’s parent or caregiver being affected by their own trauma (eg parental illness, parental incarceration, divorce or separation)

Examples of trauma related to events can include things like:

  • Acts of terrorism and violence
  • Medical trauma
  • Disasters (eg cyclones, earthquakes, floods, fires) or accidents (eg car accident)

Early childhood and complex trauma

Trauma that occurs very early in life can be especially harmful.  Early childhood trauma generally refers to traumatic experiences that affect children under the age of 6 years.  People often think that children will not be affected by this kind of trauma because they were “too young to remember it” or because the infant or young child was not able to verbalise their reaction to a certain traumatic event. However, the truth is that the aftereffects of childhood trauma (if not treated appropriately) can last well into adulthood.

Complex trauma is a term we use to describe a situation where a child has multiple exposures to traumatic events that are severe and pervasive and often of an interpersonal nature. An example of this would be child abuse or neglect.  Because children under 6 are dependent on a caregiver, this kind of trauma negatively interrupts many aspects of a child’s development as well as the development of their sense of self.  It also interferes with the child’s ability to form a secure attachment.

Ahhhh… there is that word again.  Attachment.

What does it actually mean?

Do see why I was procrastinating writing this article?  Trauma is such a complex topic and it is difficult to explain simply.

Let’s talk a little bit about attachment.

Attachment is what we call the invisible emotional bond that develops between an infant and the person or people who care for it (most often its parent/s).  It forms the basis on which that child’s social, emotional, and thinking and reasoning skills eventually develop.  Early experiences stimulate the growth of nerve pathways in the brain and these form lasting patterns of how that child will respond to situations and stimuli in the future.

Attachment affects the development of an individual’s traits and personality, sense of security, and eventually influences the ability of that person to form stable relationships throughout their life. The importance of the development of secure attachment for children is that it provides the first coping system by setting up a comforting mental presence (of the child’s caregiver) in difficult moments. This ability is then built upon over time with many other factors and life experiences and eventually contributes to the formation of resilience, or a child’s ability to “bounce back” from an adverse experience.

So where am I going with all of this background?

If I were to try to sum it up neatly, childhood trauma in the form of an experience that leaves a child with an overwhelming sense of fear and/or loss, makes them feel unsafe and out of control.  This in turn has a damaging result on their ability to function effectively in their day to day life and prevents them from being able to develop normally (in an emotional, social, physical and intellectual way).  Complex trauma, can be even more damaging.  It affects a child’s ability to bond to their caregiver at an early stage which then subsequently affects almost every aspect of that child’s life – their personality, sense of security, relationships and their ability to cope with different aspects of life.

Why is this important in the context of FOSTER CARE and children who end up in foster care?

Because you can be sure that EVERY CHILD who has ended up in the care of the Department of Child Safety, has been removed from the situation they were living in because it was UNSAFE for them to be there.

So every child who is a foster child, has been exposed to potentially complex traumatic events.

There are a couple of important points to note at this point:

  1. Not all overwhelming or life threatening experiences have a traumatic impact.
  2. And not all children will display signs of trauma in a way we might expect, or even sometimes at all.
  3. Different children make meaning out of their life experiences differently.  This means that
    • A life event that is traumatic for one child, may not necessarily be traumatic for another (eg their sibling subjected to exactly the same even and conditions)
    • One child might find a certain event in their life traumatic, but not another event (even if we might think those events were similar)

Okay, so with just a simple lead in, we have already made 2 pages.  I am going to follow up with an article about what new foster parents might expect and some practical ways that we can help kids who have been exposed to trauma at home, and at school.

Stay tuned for the next exciting article, and until then – stay well.

xxDr Megs


For more articles from Dr Megan Yap visit her blog – “Dr Megs – Paeds & Feeds” at




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