Want the Best Trauma-Informed Care? Watch the Prequel

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I continue to be, at once, intensely interested and wholly distressed by the manifestation of early childhood stress, anxiety, and trauma. The signs and symptoms surround the caregivers in child care programs, but can either be misinterpreted, misunderstood, or ignored.

I recently spoke at a national conference to a packed room of Head Start teachers, who do their best, on a daily basis, to provide the best care for the children in their programs. And yet, they are baffled at times by children’s unexplained and unprovoked behaviors and responses. We talked about triggers- a catch word now- meaning something that sets off a memory or flashback that may be imperceptible or innocuous to other people.

I noticed in the conference program, quite a few speakers who would talk about “trauma informed care.” I told my group they should probably attend at least one of these sessions, because it was such an important topic. But, I also told them that the topic of our discussion was actually a precursor… a prequel, if you will, to those sessions. If we are to be successful in providing TIC, we first need to identify, define, understand, and validate the trauma.

And, this is not easy, by any means. The ways young children present symptoms of these issues can easily be set aside as transient behaviors, or missed entirely. One of the most interesting aspects of children’s stress and distress is how it surfaces and becomes apparent.

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Infants and toddlers can’t verbally express how they feel. And while preschoolers can talk about things, they have an underdeveloped ability to explain abstract feelings of being overwhelmed, afraid, or helpless. So, for these very young children, functioning shifts to a sensory level. They become hyper tuned-in to incoming stimuli… things we, as teachers and care providers, may not even notice.

When the child is awake and alert, he is vulnerable to sight triggers. It could be a person- someone who resembles an abuser, in terms of demeanor, clothing, or movement. It might be an object or even a general characteristic of the environment that opens up a raw memory of an incident or event.

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Sounds can be particularly upsetting- especially anything that sounds like anger or fear or pain. Care providers often report seeing a child begin to cry uncontrollably if his friend is injured or cries. Sometimes the upsetting sound can be ambient noise… a humming neon light, a door opening or closing, an object falling on the floor, or water running.

For a child who is functioning in survival mode, the senses or touch, smell, and taste are highly sensitive. It can be a momentary scent that reminds him of a certain person or of a particular place. He may react strongly to a certain physical touch- or any physical touch. In some cases, he doesn’t have to be touched at all to react. It might be someone standing too close or just the way someone approaches.

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Certain fabrics, textures, or surfaces can set him off. It is easy to see that any of these reactions can mimic a sensory processing disorder.

These sensory triggers can snap a child back to memories that are so realistic, they may seem to actually be occurring- so intense, they are unspeakable. And, the raw emotion simply pours out.

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It is important for us to note that troubled young children are actually more vulnerable to triggers during quiet times, like bedtime or naptime- when the environment is quiet for the rest of us, but for them can be deafening. These children will often fight falling asleep at all cost, because they are driven, on a base level, to stay awake. They may slip into sleep out of exhaustion, but will startle and awake with no apparent provocation.

So, how can we identify these triggers in order to take action? Well, many times we can’t. But, what we can do is pay attention to the sequence of cause and effect- take running records if we notice a vague pattern emerging. Make note of unexplained behaviors and reactions. Trust your gut feelings. Investigate. Ask questions. Be a child’s voice.

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