Closing the gap between trauma and disability
I’ve been away from my blog for a while, busy with family and work and all the things that life throws at you, but I have been itching to write about this topic, and this week gave me the push I needed to put my fingers to the keyboard.
Earlier this week, I attended a training day about strategies for managing aggressive and violent behaviour in traumatised children and youth. The focus was on understanding the impact of developmental trauma on the developing brain, and being aware that when a child who has experienced trauma is being aggressive or violent, it is usually a fight or flight response and the child is actually terrified. The strategies were all designed to keep the child and yourself safe and to stay connected to help them de-escalate without the use of restraint.
While much of the information about trauma was not new to me, the techniques regarding safety and connection were a breath of fresh air – they were respectful, logical, and focussed on relationships. I could also see how relevant they were to many of the children I support who go into fight or flight for other reasons and may become aggressive as a result (sensory or cognitive overload, severe anxiety, etc.) – not just those who have experienced trauma.
As I listened to the speaker talk about the needs of these young people, what struck me most about it was the stark contrast between the world of trauma and the world of disability. When a child has experienced trauma, there is acknowledgement of neurological and physiological changes as a result of the child’s adverse experiences, that mean they can’t control their emotional reactions and need love and support to heal and become better able to regulate their emotions and behaviour. When a child is Autistic or has another developmental disability, there is an assumption that the child with neurological and physiological difference as a result of their genetics is choosing to act in inappropriate ways when emotionally triggered and needs to be trained to behave differently.
How is it that we can view behaviour that is driven by the same nervous system response to threat in such starkly different ways? And why are disability and trauma so often viewed as separate, when having a disability makes an individual more susceptible to adverse experiences and trauma than those in the general population?
It concerns me greatly that Autistic children in particular continue to be exposed to ABA based interventions and restraining techniques to manage their aggressive behaviour, when what they need is love, support, understanding and guidance. Now I do recognize that there are extreme situations in which restraint is the only means to keep a child and others safe, but it should be a last resort to put a hand on a child – not the first port of call.
While it feels like there is a long way to go before we see the necessary changes to thinking and practice, there is hope. Clinicians and researchers are starting to recognise and talk about neurology, physiology and child development in ways that acknowledge a child’s need to feel safe, secure and loved, and that challenging behaviour can be an indication that these needs are not being met. There is also increasing awareness that it is not only ongoing abuse or neglect, or experiencing a single traumatic event, that can have an impact on a child’s development – adverse childhood experiences (ACEs) and toxic stress can also have a significant and lasting impact on any child.
Ultimately, what we need to remember is that all children, regardless of their neurology, genetics or circumstances, deserve to be acknowledged, nurtured, understood and supported, and what works for one may not be right for another.
When we can see a child for who they are and take the time to be curious about where a behaviour is coming from, rather than making judgements and assumptions, we can support them to grow and develop the skills they need to flourish.
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