Trauma

Trauma is the lasting emotional response to experiencing a distressing event and a possible outcome of exposure to adversity. A traumatic experience can negatively affect a person’s sense of safety, sense of self and ability to regulate emotions and experience of relationships (UK Trauma Council, 2023).

Childhood trauma can also be described as adverse childhood experiences (ACEs) which include domestic violence, parental abandonment through separation or divorce, a parent with a mental health condition, being the victim of sexual, physical, or emotional abuse and or neglect, having a member of the household in prison and growing up in a house were adults experience alcohol or drug use problems. 

Childhood trauma can cause an increased risk of mental health problems in later life, difficulties in personal and social relationships, increased risk of future abuse and violent behaviour (van der Kolk, 2005). Experiencing or witnessing traumatic events in childhood is associated with adaptations in brain structure and function and impacts a child or young person’s cognitive, emotional, and social development.

For a brain to effectively work, all areas of the brain, the brain stem, the limbic area, the prefrontal and frontal cortex, must communicate. When the lower part of the brain that is used for survival is repeatedly activated in childhood for prolonged periods of time, the child’s ability to learn, form memories, regulate emotions, be calm, and respond in reflective, planned ways becomes affected (NIH, 2006). A developing brain remembers traumatic events and abusive experiences causing a survival response to be triggered in the absence of danger. Trauma can cause your brain to remain in a state of hypervigilance that suppresses your memory and impulse control leaving you in a constant state of emotional reactivity or impulsivity.

Trauma and ASD/ADHD/Anxiety

There are many similar observable behaviours attributed to ASD, ADHD and trauma/anxiety in children and young people. The ‘naughty’ child in school that has been identified by staff as needing support may fulfil all the diagnostic criteria for ADHD when looking at the bigger picture could highlight a link between the child’s behaviour and possible trauma (Mendel, 2023). Research has shown that child traumatic stress can be mistaken for ADHD or ASD due to the overlap of symptoms between ADHD and ASD and the effects of experiencing trauma (Ruiz, 2014).

There has been growing recognition of the relationship between trauma and ADHD/ASD (Daud and Rydelius, 2009) as cognitive and emotional difficulties occur with both. Children that have experienced trauma or ACE’s can present with a wide range of developmental issues, anger control and behaviour problems, anxiety, depression, and additional learning needs. There are multiple studies showing the inextricable link between ASD, ADHD and trauma, with trauma worsening ADHD symptoms and ADHD complicating the effects of trauma (CHADD, 2023). Typical responses to trauma in children of numbing of emotions, avoidance and disengagement may exaggerate problems linked to ADHD when functioning at home and in school (Szymanski et al 2011).

What can help?

Play is an integral part of the human experience. It has a vital role in our social, cognitive, physical, emotional and language development. Imagine a childhood without toys, games or make-believe? Even children who struggle with or have limited verbal communication can understand play, as play is a universal language. Therapeutic play is a highly effective approach for children and adolescents with ASD and/or ADHD and can be used to increase social skills, improve emotional control, increase verbal expression and activity, strengthen relational connections and increase coping skills and adaptability (Crenshaw & Stewart, 2014). Therapeutic play can take various guises such as art, sand play, drama, gaming and general play all help children develop a sense of control over their experiences and emotions.

Art can be especially helpful for children who struggle with verbal expression or have difficulty accessing their emotions allowing them to create and manipulate their artwork to express themselves.

Sandplay is another type of therapeutic play that involves creating scenes or worlds using miniature objects in a sandbox or tray. This technique can help children process traumatic experiences and feelings by creating physical representations of their experiences in a safe and contained environment.

Drama uses improvisation, role-playing, and other dramatic techniques to facilitate emotional expression and exploration. Through drama children may act out scenes from their trauma or create new scenarios to explore different outcomes or perspectives. This can be helpful for children who enjoy imaginative play and have a creative approach to problem-solving.

Gaming is a type of play therapy that utilizes video games as a means of engaging with children and helping them process their trauma. Video games can provide a safe space for children to explore and express their emotions, as well as a sense of control over their experiences. This can also be particularly effective for children who are resistant to traditional forms of support.

Finally, play therapy may also incorporate more traditional play techniques, such as games, toys, and imaginative play. These methods can be adapted to meet the specific needs of each child, allowing them to explore their emotions and experiences in a safe and supportive environment

In therapeutic play, “the play becomes transformative in providing a new perspective on the self and/or the environment, which is at the heart of resilience as a therapeutic power of play” (Crenshaw et al., 2015).

As the child acts out their feelings, directly or symbolically, you can gain insight into their emotional state. Playing together offers a safe environment for the child to express how they feel while interacting with the world and those in it and developing coping, problem-solving, and resilience-related skills (West, 2022).

Disclaimer:  The views and opinions expressed in this blog post are those of the author and do not necessarily reflect the official policy or position of any professional organization or guidelines. The information provided is for educational and informational purposes only and is not intended as a substitute for professional advice, diagnosis, or treatment. Always seek the advice of your therapist or other qualified health provider with any questions you may have regarding a medical or mental health condition.