ParentLine

Dear ParentLine,

We are the foster parents of a little girl, age 6, who we saved from a terrible situation. She witnessed (though we believe she didn’t experience first hand) abuse that happened to her older brother and her mother. While she seems pretty well-adjusted, we wonder about some of the ways she responds to certain things and are concerned that she isn’t learning properly and developing socially. Please advise.

Signed, Concerned and Caring in Carroll County

Much as you wish you could wave a magic wand to make your daughter’s private horror show go away, you may not be able to do so without skilled help from professionals along with a whole lot of love and patience from you. Among foster children, physical and sexual abuses are common sources of trauma. However, all children are subject to the impact of a psychologically distressing event that is outside the range of usual human experience; an experience that induces an abnormally intense and prolonged stress response.

Experts at the Child Trauma Academy (www.ChildTraumaAcademy.com) report that when some children are witness to or victims of experiences that are so traumatic, terrifying and disturbing, the memories of these events can become problems in and of themselves. These experts say, “After the event has ended, the experience plays itself out repeatedly in their minds. The thoughts, emotions and feelings of being out of control and threatened are re-experienced, as is the fear, anxiety, and pain associated with the event.”

Here’s some info that may help define trauma and its causes and impacts from an article found in Fostering Perspectives (www.unc.edu/fcrp) titled, Trauma and Children: An introduction for foster parents,” written by the folks at the Jordan Institute for Families at University of North Carolina.

“Events that can induce trauma include the sudden death of a loved one, assaultive violence (combat, domestic violence, rape, torture, mugging), serious accidents, natural disasters, witnessing someone being injured or killed, or discovering a dead body. For a foster child, adversities experienced for an extended period after the trauma (such as a series of different placements or separation from care-givers) and the supports available to a child can influence the severity of their trauma reactions.”

The experts at the Jordan Institute advise that with informal support, the majority of trauma survivors recover on their own within a few weeks, though some need longer to heal. For a small minority, however, traumatic events trigger various mental disorders, including posttraumatic stress disorder (PTSD), a particularly serious reaction to trauma.

Left untreated, PTSD can put children at risk for school difficulties, attachment problems, additional psychological disorders, substance abuse, and psychical illness. However, if a child does develop PTSD, timely and appropriate treatment often helps to reduce the severity of stress reactions, or to eliminate them altogether. Call the number listed at the end of this article for help to find a trained professional.

Or, another great resource for foster parents is the New Hampshire Foster and Adoptive Parent Association ( http://www.nhfapa.org )

When a child experiences trauma, the only ways they are able to deal with memories that are terrible beyond words is to develop behaviors to avoid, defeat, and make them go away. These coping skills can range from faking being sick to nightmares, regressive behaviors, depression, and acting out. Your daughter’s learning problems and social development could be the ways she deals with memories of her trauma. Each child processes traumatic memories in a different way.

Susan Swanwick, LISCW and family therapist with Child and Family Services, says, “You didn’t say if your daughter was in therapy with someone to talk about things she witnessed and is dealing with. If she isn’t, you may want to consider this avenue. Therapy can be a safe place to share uncomfortable thoughts and feelings, and find ways to start to deal with stressors differently. Your actions, more than your words about having a safe home will help your child to feel more secure with you. You can ask her what about you and your home helps her feel okay, and what, if anything doesn’t help. She may be hesitant to say things, which is the reason therapy may be a good tool.”

Here are some things the folks at the Jordan Institute suggest that you can do:

Don’t be afraid to talk about the traumatic event. Children do not benefit from “not thinking about it” or “putting it out of their minds.”
Provide consistent, predictable pattern for the day. Make sure the child has a structure for the day and knows the pattern.
Be nurturing, comforting, and affectionate, but be sure that this is an appropriate context. For children traumatized by physical or sexual abuse, intimacy is often associated with confusion, pain, fear, and abandonment. A good working principle for this is to be physically affectionate with the child seeks it. If the child walks over and touches you, return it in kind.
Discuss your expectations for behavior and your style of discipline with the child. Make sure that the rules and the consequences for breaking the rules are clear.
Talk with the child. Give them age-appropriate information. The more the child knows about who, what, where, why, and how the adult world works, the easier it is to make sense of it.
Watch closely for signs of reenactment (in play, drawing, behaviors), avoidance (being withdrawn, daydreaming, avoiding other children) and physiological hyperactivity (anxiety, sleep problems, behavioral impulsivity). All traumatized children exhibit some combination of these symptoms in the acute posttraumatic period.
Protect the child. Do not hesitate to cut short or stop activities that are upsetting or re-traumatizing for the child.
Give the child choices and some sense of control. When a child, particularly a traumatized child feels that they do not have control of a situation, they will predictably get more symptomatic. If you have a question, ask for help.

In Belknap County, three organizations including New Beginnings, Genesis Behavioral Health and Child and Family Services, have formed a Trauma Intervention Program that is designed to help children who are direct or indirect victims of trauma. The number at the end of this article can get you to the right people who can consult with you, share important expert insight, and refer you to any services that may be in your area.

ParentLine is a free and confidential service of Child and Family Services, a statewide, independent, nonprofit organization dedicated to advancing the well-being of children and families. Call ParentLine, 1-800-640-6486; write ParentLine, c/o Child and Family Services, P.O. Box 448, Manchester, NH; email parentline@cfsnh.org or visit our website at www.cfsnh.org.