Helping children coping with trauma
This article first appeared in the St. Louis Beacon, Oct. 12, 2010 - When St. Louis attorney Tracy Ring was 8 years old, his world fell apart when his parents divorced. Going back and forth between mom's and dad's houses amid their frequent bickering, the once outgoing, 'A' and 'B' student began to falter in school and withdraw from friends.
"Not only did my parents not live together; they couldn't even get along together," Ring said.
Kicking and screaming, Ring resisted but eventually gave in to their attempts to get him into counseling at Kids in the Middle, an organization aiding children of divorce. Now 33, Ring is glad he got the support he needed.
"I learned it was nothing I did, and there was nothing I could do," Ring said. "That helped me to let go of the pain and anguish, and move into the next step of healing."
Ring was lucky for two reasons, according to Houston-based expert on the neuroscience of child trauma, Dr. Bruce Perry, who will speak in a sold-out lecture at the Ethical Society on Oct. 14: He was over the age of 5 and he got counseling.
Perry's lecture is sponsored by the St. Louis Psychoanalytic Institute. The lecture is given in honor of the distinguished psychoanalyst Paul Dewald, a founder of the St. Louis institute, and an emeritus member of its board.
Perry has studied the impact on children of many of the major devastations of our time: the Branch Davidian siege in Waco, Texas; the Oklahoma City bombing; the Columbine school shootings; the Sept. 11 terrorist attacks; hurricane Katrina; the shooting deaths of the FLDS polygamist sect members; and the Haitian earthquake.
But children don't have to experience life-threatening horrors to be scarred by distress. Conflict during divorce can be a major disturbance whose impact persists into adulthood because early encounters have a deep, physical impact on the rapidly developing brain.
"Your brain acts as a mirror reflecting all your developmental experiences," Perry said. "When children grow up in environments permeated by stress, the parts of their brain involved in de-stressing become abnormally organized and overactive, and can lead to children who are inattentive, have self-control problems, sleep problems and anxiety."
The Earlier The Trauma, The Worse The Impact
Neglect or any sort of trauma ranging from witnessing parental squabbling or domestic violence to simply living in a chaotic household can be particularly damaging for children younger than 5.
"If you look at the 'heavy lifting' of brain development, that all takes place in the first four or five years of life," Perry said. "It's a time of great potential for a child to either take advantage of positive things or be shaped by negative things."
Children 5 and older will have fewer symptoms and respond better to treatment if they have empathic, consistent caregivers early on. The general rule is, the older the child, the less severe the impact.
"If you have two months of a really stressful, overwhelming or emotionally depriving experience when you're a 19-year-old kid, that's not good for you and it will be hard, but you probably will not be damaged for the rest of your life," Perry said. "But if you have that very same experience in the first two years of life, there's a very high probability of having long-term, chronic problems."
TV, Technology Impair Development
Neglect comes in many forms. It's not hard to comprehend that a depressed, emotionally disengaged mother who doesn't talk much to her baby can result in a child who has problems not only with language, but also with empathy and relationships.
Less obvious is the impact of letting young children watch too much -- or even any -- TV.
"Children younger than 3 should never watch television," Perry said.
The issue is not so much the content of the shows babies and toddlers watch; it's what they're not experiencing when they're glued to the tube.
"That's three, four or five hours of the day that they are not involved in large motor activity or social interactions," Perry said.
Even the brains of older kids are negatively affected by television, constant texting and special-effects movies.
"Your brain develops preferences for how it will process information. You can see it in our culture, the current generation of children score well below on measures of empathy than even 20 years ago," Perry said. "I don't want to sound like everything is evil and we need to go back to the cave but I do think we need to learn how to regulate these things."
Neglect Can Shatter Adoptive Parents' Dreams
The effects of early negative experiences may wreak such havoc on brain development that even a loving adoptive family can't fix it. For example, children whose infancy was spent in an institution that provided food and a crib but no consistent meaningful interaction with a caregiver may have attachment problems that are very difficult to overcome despite having a good adoptive home.
Some children become withdrawn; some act out. But others appear to be fine, for a time, according to therapist Sarah Boeker, who works for the Children's Home Society, an agency providing adoption assistance among other services.
"Oftentimes parents think, 'Oh this child is very friendly to everybody and he or she doesn't cry or have any issues with separation,'" Boeker said. "Yet, that may be an indication that a secure attachment or bond with a parent has not formed. The child may have an overwhelming feeling of emptiness -- but it's not just a feeling; it's like an empty shell and they don't know how to relate in the world."
Even children who seem to be OK when they are younger may have problems later.
"What seems to be functional on the outside may break down over time under increasing stress," Boeker said. "It may be triggered by a subsequent loss or other life events. A child may exhibit all kinds of behaviors and the parents have no idea where the behaviors are coming from."
Worsening behavior can take parents by surprise, even those who have been thoroughly educated about the effects of early trauma. But successful intervention is possible, especially when parents are willing to keep trying and connect with enough support.
"Parents are incredibly resourceful," Boeker said. "Being persistent and knowing the resources in the community -- people who understand the complexities of trauma and child development -- are essential."
Watch Perry speak about the neuroscience of child trauma and neglect to an Australian audience organized by Berry Street and its Take Two program for children affected by family violence.
Nancy Fowler Larson, a freelance writer in St. Louis, writes frequently on health issues.