Tag Archives: Complex Developmental Trauma

Developmental Trauma

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I want to straighten a little something out (from my point of view anyway.)  

trauma face

There has been an evolution for me over the last 10 years about what it is I am seeing in traumatized children and what usual diagnoses children from difficult beginnings are given by mental health professionals.
 
There are really only a few diagnoses that routinely get applied to our children: 
Reactive Attachment Disorder of Infancy and Early Childhood (RAD), 
Posttraumatic Stress Disorder (PTSD), 
Bipolar Disorder 
Attention Deficit Hyperactivity Disorder (ADHD)
 

Trauma Boy 2

The fact of the matter is that most of our children are traumatized by attachment breaks, toxins in utero, pervasive maltreatment, neglect, and other abuses in the first 10 years of life.  The abuse that takes place during the first 33 months of life, of course, globally rewires the child’s brain for high alert that becomes cellular and can last a lifetime.
 
I used to stomp my feet and insist that mental health practitioners stop misdiagnosing attachment trauma  as ADHD and PTSD because those labels were inadequate (and they still are.)  I encouraged instead using Reactive Attachment Disorder of Infancy and Early Childhood because it was the only diagnosis that pointed in the developmental direction and I thought early correct labeling would get better, more focused attachment treatment for our kids.  Well, I have moved on from that, too.  Calling all traumatized children RAD is not correct and again points to too narrow of a viewpoint on treatment. And, frankly, some mental health practitioners misinterpret the RAD diagnosis as a “hopeless,” untreatable condition.
 
There is a new diagnosis Developmental Trauma being bandied about, but it has not made it into the Big Book of mental health disorders, the DSM-V.  There was a whole political push for and against this diagnosis just prior to the publication of the latest DSM-V, so it was left out.  Boohoo.
 
Once again, I find myself on the side of advocating mental health labeling that is more effective for treatment.  Labels are intended to support correct treatment, nothing more. Developmental Trauma is usually what we are dealing with when we are parenting children from difficult beginnings.  If we called it by a more attuned name, perhaps we would be more attuned to the various ways their history has impacted their development.  We would also be less scared our children will grow up to be criminals, right? Developmental Trauma can be treated.
 

trauma boy

Developmental Trauma, in my opinion, is a huge public health issue across the world. I saw a statistic that nearly three million children in the U.S. alone are diagnosable with this every year.  EVERY YEAR! My heart aches about this.
 
Developmental Trauma is all about developmental deficits, relational misattunement, and chronic patterns of dysregulation that lead to life-long issues negatively impacting brain development, the nervous system, the endocrine system, and memory.  This is likely a better diagnosis for your child. RAD, PTSD, ADHD, Bipolar Disorder are all too narrow and miss the boat on effective treatment.
Love Matters,
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Ce Eshelman, LMFT 
UPCOMING EVENTS:

  • Next Trust-based Parenting Course is scheduled for July 19th and 26th.  Sign up here
  • The Attach Place is embarking on our second round of scholarships for families with adopted children who need services but have no funding to get them. We used up the last of our scholarship money last summer and are ready to start fundraising again. This time we have a pie-in-the-sky, big, hairy, audacious goal of $25,000. If you have a dollar you can afford to contribute, that is how we will pave the way–one dollar at a time. Go to: Love Matters Scholarship Fund. We are working on non-profit status, so these donations can be tax deductible.  Yay!
 
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Falling On My Nose

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trippingI fall a lot.  Just this week I fell right on my nose.  Didn’t break it, so all is well.  I fall so often that when I texted my husband about an accident outside the house between a bicyclist and a SUV, he texted back, What hospital are you going to?  Huh, wah?  It took three texts to clarify to him I wasn’t talking about myself, but rather about a stranger in the front yard (bicyclist hurt her foot, not too serious, for those of you with inquiring minds.)
Both of my kids had and still have proprioceptive and vestibular deficits.  They fall a lot, have trouble riding skate boards and bikes, slam into closed doors to seemingly stop, spill stuff, drop stuff, put things away with lids ajar, hug like jellyfish, and clean up like blind-folded raccoons.  Physical life is hard for them and my empathy was not always as high as it is now.

Frankly, I didn’t understand the constant physical mayhem running around me, but I wish I had. If so, I would have participated more fiercely in Occupational Therapy with them.  As it was, I sent them, but didn’t realize I could have contributed to making their lives easier by providing–Wilbarger Brushing Technique (as prescribed), Full Body Deep Pressure Touch, Joint Compression Activities, Interactive Brain Gym Play, Crash and Bump Play Space, Massage, Sensory Engagement, and Rough and Tumble Play.

What are YOU doing every day to help your child integrate and organize the sensory input of living?  It matters more than soccer practice.

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Love Matters,
Ce Eshelman, LMFT 
UPCOMING EVENTS:
The link code was wonky, if you had trouble clicking into the Love Matters Scholarship page this week. I think it is fixed now.
 
The Attach Place is embarking on our second round of scholarships for families with adopted children who need services but have no funding to get them. We used up the last of our scholarship money last summer and are ready to start fundraising again. This time we have a pie-in-the-sky, big, hairy, audacious goal of $25,000. If you have a dollar you can afford to contribute, that is how we will pave the way–one dollar at a time. Go to: Love Matters Scholarship Fund.
 
Next Trust-based Relational Parent Training is scheduled for May 10th and 17th.  
 
Check out our three blogs:
 
Feel free to invite your friends and family to receive Daily YOU Time emails, too. Click here to sign them up.  All you need is an email address and first name.

PTSD + Attachment Challenge = Complex Developmental Trauma

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Children who have been traumatized by maltreatment of neglect, physical, sexual and emotional abuse, and/or exposure to various forms of environmental toxins and violence, plus they have been taken from their birth mother in the first few years have Complex Developmental Trauma.  YOU or your therapist won’t find that in the DSM (Diagnostic Statistical Manual for diagnosing mental health conditions) because it hasn’t been accepted into that tome yet. There is a long, laborious process to get any new diagnosis into the manual, so it will be years before Complex Developmental Trauma Disorder can be diagnosed officially.
 
That doesn’t mean that it cannot be known and treated.  If your child has been diagnosed with PTSD and has attachment breaches, then very likely Complex Developmental Trauma is a more accurate diagnosis. YOU might ask why that distinction is important.  The number one reason is so that your child will get the most effective treatment for what is actually going on.
 
So many of my young clients have been misdiagnosed with ADHD and Oppositional Defiant Disorder, and half diagnosed with PTSD. They have received every kind of intervention under the sun–PCIT, CBT, DBT, Trauma Focus-CBT, hospitalization, stimulant medications, medical restraint medications, various behavioral (stick and carrot) programs, and best buddy supports.  There is a place for these interventions, but you can be sure that none of them will be effective without a comprehensive approach that includes sensory interventions, therapeutic environmental interventions, attachment therapy based on relationship and play, narrative therapy that builds a coherent personal story, brain-based therapeutic parenting, parent support and treatment for early trauma, and child trauma therapy to bring down the child’s anxiety that “looks” like ADHD, but isn’t.
 
Just thought YOU might like to know.

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Love Matters,

Ce Eshelman, LMFT 
UPCOMING SPECIAL EVENTS:
 
Get more information and reserve your spot here for our upcomingHold Me Tight Couples Workshop for Parents of Adopted, Attachment Challenged, and/or Special Needs Children in Sacramento, CA on April 25th, 26th and 27th.
 
Next Trust-based Relational Parent Training is scheduled for May 10th and 17th.  It is close to full already, so go to www.attachplace.com to register soon to reserve your space.  
Check out our three blogs: