Traumatised children need the best quality care. They thrive on consistency, calm and order as this is unlikely to have been their previous experience. They need predictability in their lives and both children and their carers’ are likely to benefit from clarity in family routines and habits.
This is especially true of children who are also experiencing Attention Deficit Disorder, Learning Disability or Anxiety. Each child needs to be confident that their carer is in control. Carers are strongly encouraged to help the child understand the pattern for days, weeks and when new or different activities are going to occur. A visual guide will be helpful for many children. It is particularly important to talk to the child prior to any changes. A household that is disorganised, and chaotic will induce anxiety, stress for the child and subsequently will negatively impact on the whole family.
Carers who create a nurturing, affectionate and warm home environment are likely to contribute to provide a therapeutic place for the traumatised child, when used appropriately. It is necessary to be aware that physical contact and touch will have a range of meanings to traumatised children and those who have been physically or sexually abused could be particularly triggered by touch.
It is therefore important that the child initiates affection/appropriate physical contact themselves in their own time, as this will allow the child build to trust. The child will be able to make better sense of the world if carers create clear and open communication. It is really helpful to make regular space and habit for this from the beginning. Family meetings, mealtime chats, or other regular opportunity to talk as a family is a good habit to establish early on.
Traumatised children also need boundaries. It is important to make your expectations and rules very clear. Implement reasonable consequences if these expectations are not met. However children who have experienced trauma may be emotionally and socially delayed. It’s important to have realistic and individual expectations of the child. Expectations that are based on the ability and development of the child and not necessarily the chronological age of the child.
Be flexible and consistent when imposing consequences, but offer a level of flexibility as this will demonstrate to the child reason, fairness and empathy towards them. Physical chastisement of any kind is never appropriate, and would/can result on the removal of a child.
Allowing children choice helps them develop decision making skills and gives them a sense of control. However it is a good idea to limit choices as like adults children can be overwhelmed by too many options! Two or three options will be plenty in most situations.
Parents need to be proactive in protecting the child where possible from activities and situations which create stress for them. Being aware of the child’s limitations and vulnerability, in different situations. It is helpful to keep a mental or even better a written note of activities that result in stress or anxiety. Some situations can result in significant “melt-downs” or arguments, creating situations which can re-traumatise the child. This will allow parents to avoid them where possible.
It is not uncommon for the traumatised child to exhibit symptoms such as sleep problems, impulsivity, anxiety, low tolerance of noise, and social stress long after the event(s). When the child is comforted, with adults being as tolerant as possible, these symptoms are likely to come and go over time.
While a small percentage of adopted children will be diagnosed with Reactive Attachment Disorder, others may exhibit milder versions of attachment disorder or insecure attachment. There is a view by some experts that rather than abuse the majority of attachment problems are caused by parental ignorance of child development. This has resulted in an estimate 1 in 3 people with avoidant, ambivalent or resistant attachment (1). Whatever the cause adoptive families need appropriate information, training and support raising children with attachment difficulties.
While this can be a daunting prospect and it can appear that adopting children is risky, there is lots of research and anecdotal evidence that adoption can be successful and adopted children can develop strong and healthy emotional attachments with their new families.
In the United Kingdom although there are no official UK statistics of adoption breakdowns, it is believed that only 3% of adoptions end in breakdown. Using these strategies and being open to and prioritising the needs of the child is likely to ensure that though the child may experience challenges coming to terms with the loss and trauma they experienced before adoption, they can develop the strategies they need to have to make sense of their early experiences and life story.
(1) Perry, B.D. (2001) Bonding and attachment in maltreated children: consequences of emotional neglect in childhood. Retrieved February 15 2008, from http//www.childtrauma.org/CTAMATERIALS/Attach_ca.asp.
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