The science of trauma

Childhood trauma can literally get under a child’s skin, potentially stealing its future. Dr. Stacy Drury points out that a trauma-informed approach to diagnostics is key for effective help.

Last month 25 journalists from across the world gathered at New York’s Columbia University to learn about the impact of trauma on early childhood development. Funded by the Jacobs Foundation and three other organisations, the four-day workshop was delivered by the Dart Foundation for Journalism and Trauma. One of the internationally-recognized scientists, policy experts, and practitioners from the field of early childhood development sharing their knowledge and expertise was Dr Stacy Drury, associate director of the Tulane Brain Institute.

Dr Drury is based in New Orleans, one of the most violent cities in the US. She described how childhood trauma can literally get under a child’s skin, potentially stealing their future. Traumatic and stressful experiences in early childhood, like exposure to violence, family instabiity and ongoing poverty, are known to be associated with a wide range of negative outcomes in later life, from obesity and diabetes to poverty and involvement in crime.

“What we think is happening is that adverse childhood experiences are accelerating the aging process,“ says Dr Drury.

Dr Drury told journalists attending the event about her own research, which shows how early adverse experiences may actually alter the DNA sitting on the tips of a child’s chromosomes, called telomeres. Telomeres act as a marker of a cell’s lifespan, and shortened telomeres will instruct a cell to stop growing: in humans shortened telomeres are linked with aging and higher risk of chronic disease and death. Dr Drury’s studies have found that children exposed to adverse childhood experiences (ACEs) had shorter telomeres than children who were less exposed. “What we think is happening is that ACEs are accelerating the aging process,“ she says.

Reslience

Many researchers are interested in children and young people who go on to do well despite their traumatic start in life. What do these young people have that the others don’t, they ask, and can we somehow replicate it for all children in adverse circumstances? Dr Drury, however, argues that current research into resilience may be missing the biological price that can be paid for success. “When it comes to looking at how a kid is doing, most of the time it is how they are doing in school, or how they are behaving, “ she says. “If there are biological changes that affect organs and so on, this can be missed. We sometimes see that kids may have good educational outcomes but worse health outcomes, so their academic and career success came at a biological cost. Whatever they did to be successful aged their cardiovascular system.“

PTSD is not ADHD

Education and youth justice professionals can often misread the reactions of children who have been exposed to violence, so a trauma-informed approach is key. “Kids exposed to violence have an attention bias to threat, either they orient to it much faster or they have difficulty disengaging,“ says Dr Drury. In school children may find it hard to concentrate, and may over-react to perceived threats. “Research shows abused kids identify angry faces much quicker, they take longer to identify happy faces,“ she explains. “If I am teaching a kid with trauma and I show my frustration this is easily interpreted by them as anger, or if I like something and say “great job” they think that is just neutral. Trauma-informed practitioners have to increase the intensity when we express positive things.”

“Research shows abused kids identify angry faces much quicker, they take longer to identify happy faces,“

In the course of her work Dr Drury sees many children who have been affected by violence, their parent’s incarceration and other issues to the extent that they suffer from Post Traumatic Stress Disorder, something more usually associated with returning soldiers. Unfortunately, she says, this is often misdiagnosed as Attention Defecit Hyperactivity Disorder (ADHD), as one symptom of PTSD is difficulty in concentrating. While ADHD in children can respond to medication, PTSD does not. “I spend a lot of time getting kids off ADHD medication, becase they do not have ADHD, ” says Dr Drury. An increased understanding of the impact of trauma on children can help buffer them against its effects.

“I spend a lot of time getting kids off ADHD medication, because they do not have ADHD, ”