What is Complex Trauma?

Topics: Education Equity

By Whayne Herriford, SCP, SPHR

Many people think of trauma as an isolated event that someone experiences that has longer term impact on them, such as a military person whose vehicle explodes because of a buried bomb in the road and returns home with difficulties driving his or her vehicle on city streets. The diagnostic criterion for Post-Traumatic Stress Syndrome (PTSD) includes the direct or indirect experience of an actual (or threatened) death, serious injury or sexual violence that the person experiences at least sixty days after the event and their reaction includes avoidant actions, negative changes in their mood or thoughts or increased arousal/anxiety that affects their activities of daily living.

While PTSD can be experienced by people of all ages, another term is used to describe children’s exposure to multiple traumatic events, frequently simultaneous or sequential, that occur within their primary care-giving system: trauma. The events can include abuse, neglect or household dysfunction. The result of this exposure is that the child loses the ability to regulate their emotional responses to external stimuli, are unable to appropriately detect or respond to threats in their environment and even develop neurological responses that can inhibit the usual development that children experience.

Three source of adverse childhood experiences:

See three source of adverse childhood experiences. Source: Centers for Disease Control and Prevention
Credit: Robert Wood Johnson Foundation

Data shows that trauma is prevalent across the United States, particularly in children and adolescents:

  • 26 percent of children in the US will witness or experience a traumatic event before they turn four years old
  • Four out of every 10 children in America say they experienced a physical assault during the past year, with one in 10 receiving an assault-related injury
  • Two percent of all children experienced sexual assault or sexual abuse during the past year, with the rate at nearly 11 percent for girls aged 14 – 17
  • More than 13 percent of children reported being physically bullied, while more than one in 23 said they were emotionally bullied
  • More than 10 percent of children and adolescents experienced child maltreatment, were injured in an assault or witnessed a family member assault another family member

Research suggests that children in foster care systems, LGBTQ children, homeless children, children living in poverty, children with intellectual or developmental disorders and children of military and veteran families are more likely to experience complex trauma.

The impact of these events on children and adolescents is powerful.

  • Trauma is experienced primarily in the nervous system and has physiological effects as much or more so than psychological. Just as the soldier might be triggered by a sound or sight that reminds them of the event on the battlefield, children in traumatic environments will be triggered by the sights and sounds present in that environment as much – if not more so – that a repeat of the event itself. Traumatic events are essentially experienced through images and sensations, more than cognitive memories of the event.
  • Interpersonal violence or neglect is much more impactful than the effect of a natural disaster in that it is often experienced as intentional rather than an accident of nature. And interpersonal violence or neglect from a primary caregiver or someone in a trusted role has lasting impacts as it disrupts a child’s fundamental sense of trust and attachment.
  • Infants can experience trauma, even if they are unable to communicate or express their thoughts and feelings. It is often internalized and can emerge in adolescence (or even adulthood) when triggered by an experience.
  • The earlier in life traumatic events are experienced the more significant the impact will be. It is also possible – and unfortunately frequent – that traumatic reactions are misdiagnosed as Bi-Polar Disorder, Attention Deficit/Hyperactive Disorder, Oppositional Defiance or Severe Mood Dysregulation as opposed to a child’s reaction to an environment that they perceive to be hostile, threatening or dangerous.

Being aware of childhood trauma is important, particularly for those of us working in school systems. Throughout this week, I will be sharing information about the Adverse Childhood Experiences (ACE) Assessment and tips for how to create a trauma informed environment. By being informed and creating safe, supportive environments for children, we can better support successful future for our students.