First Steps, Giant Leaps: Trauma Among Toddlers and Young Children

Last week, to kick off Foster Care and Mental Health Awareness month, I wrote about the impact of trauma on infants [LINK] like Janelle, and how trauma that occurs in the context of relationships can only be healed through relationships. For each of the remaining weeks this month, I’ll offer perspectives on trauma and healing across three other developmental stages: this week, toddlerhood and early childhood; next week, school-age children; and, at the end of the month, I’ll write about trauma among teens and young adults.

The extraordinarily rapid physical and neurological development of babies continues right into toddlerhood. Children use their bodies to actively explore the world. They roll balls, push strollers, walk along walls, and jump from steps.  As they move and manipulate their bodies in relation to their physical surroundings, they begin to learn how things work. Children also watch the people around them, imitating and copying their actions, for example, pretending to make dinner, feed the baby, or hammer a nail.

Verbal comprehension and expression develop seemingly overnight at this age. Toddlers often begin speaking in single words, progressing to two- and three-word sentences. As they learn that they can use words to influence people, they begin to ask for what they want and express their feelings. With these new physical and verbal abilities, children can begin to exercise restraint and collaborate with adults regarding simple rules.            

Yet emotional difficulties that result from trauma, like depression and anxiety, can interfere with emotional and social development, affecting relationships with other children and adults; they can also interfere with cognitive functions such as the ability to focus and embed new memories, both of which can interfere with learning. For example, a traumatized child who is preoccupied with disturbing memories will be restless and easily distracted while a caregiver is reading aloud.  Unlike her non-traumatized peers, she will have a hard time sitting still, which can be annoying or distracting to others, and she’ll have a harder time following the story, which makes her less likely than the other children to retain any new vocabulary the story offered.

As they get older, children begin to show more interest in making friends.  They move from playing next to each other to playing with each other. They develop particular interests, and bond with others who share them.  Spending time with other children becomes fun, and children seek out favorites.  While most children become interested in being around large groups of kids, toddlers and preschoolers suffering from trauma may be easily over-stimulated by other children, particularly when the play becomes boisterous or when there are several (or more) children involved. They will likely need adults’ help in learning how to initiate and sustain play with other kids,.

Traumatized children are often confused or unaware of their own feelings, both in terms of the signals they receive from their bodies and their emotions.  A traumatized child might become suddenly impatient with another child and lash out when she is actually just hungry; or she has a harder time sharing toys; or she becomes possessive of the adults at the daycare center she attends.   She may become overstimulated by too many toys, and overwhelmed by too many choices.  Trauma has an extraordinarily powerful effect on neurological functioning,. Increased levels of stress hormones in the brain keep the body primed to take action (the “fight or flight” response); an observer might witness either increased aggressive behavior or a withdrawn child who appears very flat or numb.  In either case, other children may be disinclined to seek out such a child for play

The adults who were supposed to care for children who’ve been traumatized have often ignored or criticized the children’s feelings; these children to believe that their feelings don’t matter, or even that their feelings led to bad things happening  These children need a lot of help from both in naming their feelings and in learning that feelings aren’t dangerous, even unpleasant ones. Young children who have suffered trauma may be particularly emotionally sensitive, with rapid and intense shifts in mood. This may require that caregivers respond frequently to their distress and spend significantly more time soothing them than they would with other children.


Alberto hasn’t told his foster parents why, but he is very scared of mice.  He wont go into a room unless someone looks inside first and checks for mice.  If he thinks he sees a mouse, Alberto will usually scream and cry, and cant be calmed down.  Bedtime can be difficult because hes worried about the mice appearing when everyones asleep.  Alberto will stay awake for hours until he finally passes out, exhausted.  He has just started preschool, which has not been going well.   The teachers have called home several times because Alberto became scared, and they dont know what to do to help him

Its likely that Alberto believes that if he can avoid mice, he can avoid being scared. Because feeling scared at times is an inevitable part of life, Alberto  needs help learning how to manage feeling afraid.  .

Albertos foster parents, Luis and Marta, start by telling him that mice are not so scary. They read him stories about how helpful mice can be, such as the tale of the mouse who pulled the thorn from the lions paw. When Alberto thinks he spots a mouse, they pick him up and tell him he is safe.  Once he calms down a bit, they ask him if the mouse he saw might be a nice mouse who is there to help.  Together, Luis and Marta look around with Alberto to see if they can find the mouse and ask him if he’s a nice mouse.  They also have a meeting with the preschool so that his teachers will also know to help Alberto identify if mice are friendly and helpful.

While it’s important that Luis and Marta give Alberto a different idea about mice that he can draw on, it’s also important that they dont dismiss his fear.  They pick him up when he gets scared, and assure him that he is safe and not alone.  Coordinating this approach with the preschool allows his teachers to reinforce the message that scary things can be approached together with others, and might not even be that scary after all.

Luis and Marta have found a way to respond to Alberto’s fear that soothes his anxiety, reinforces his ability to learn about and manage his feelings, and supports the development of their own bond with him. The very process of addressing his fear in this way can thus have long-term effects. At the heart of our work at A Home Within and Fostering Relationships is the understanding that relationships matter because relationships heal. For caregivers and other adults supporting traumatized toddlers and young children in their early experiences of the world, simply remembering the power of relationships is an essential first step...

Starting At the Beginning: Trauma During Infancy

May 2015 is both Foster Care Month AND Mental Health Awareness Month. This spring we’ve seen a lot of attention to the mental health needs and well-being of foster youth, whether talking about ways to safely reduce the use of psychotropic medications (as I discussed in a previous post), or about the related need to recruit and support relatives, foster parents, and community members to create an essential network of support and healing so that all foster youth have a chance at a happy, healthy future.

Tax Day

While April 15th is far from a national holiday, it is an occasion that brings together millions of Americans, often for complaining and commiserating rather than celebrating. Indeed, in 2014 the IRS received 136,887,000 tax returns, some eligible for refunds and others accompanied by a payment to make up a shortfall in money owed. Some of those tax dollars go toward maintaining the child welfare system and supporting the foster children whose parents are, for a myriad of reasons, unable to care for them.

Love That Lasts

It was 1995, and we had just started A Home Within. Seven-year-old Kelsey was one of the first foster children referred for open-ended therapy, but she was NOT happy about it. She routinely and loudly told her therapist, Dr. B, that he was dumb and didn’t understand anything at all about kids. She didn’t like his toys and didn’t want to play any of his games. Mostly, she announced that she didn’t understand why he didn’t have snacks, which was for her the clearest evidence that he was stupid.