COVID-19 as Trauma - Information from the Child Trauma Training Event presented by Jelly Beanz
While many topics relating to the effects of COVID-19 on South African children were discussed, we found this particular topic worth adding to our Blog page. In practice, we often find that children have been diagnosed with barriers to learning, but the impact of trauma has largely been set a side and ignored when making diagnoses. The following little snippets highlight children's responses to trauma based on their developmental phases.
Developmental Phase: Ages 0 - 2 years
During this phase, infants are particularly receptive of and sensitive to non-verbal behaviour. There is a need for connection with a caregiver, and nurturing and responsive care. They need play and physical touch such as being held.
When infants experience stress, loss, trauma or crisis they respond in the following ways:
excessive crying,
refusal to eat,
hypersensitivity to touch,
sleep disturbances,
separation anxiety,
non-responsiveness/withdrawal
Developmental Phase 3-7 years
In this phase, children start to learn to have the same emotions as adults and often express this through their body language as they have not yet developed the vocabulary or the social skills to do so. Generally speaking, they are still quite concrete in their thinking and take information in quite literally. At this point they are considered as egocentric (not able to put themselves in others' shoes). Their attention span is quite limited. Boundaries, routines, and consistency are needed during this developmental phase. They need to be encouraged to recognise, name, and express their feelings. Patience is key.
Their responses to stress, loss, trauma or crisis is very similar to those seen in infants.
Developmental Phase 7-11 years
At this stage, children start learning to empathise with others and peer relationships become more important. As they develop an awareness of their behaviour and how this impacts others, they become more easily shamed by their actions. This can have a very negative and lasting effect as it shapes their experiences of themselves and their relationships.
Children in this developmental phase require a lot of affirmation and need their feelings to be validated. It is important to allow them into decision making about things that may affect them. They should also be provided with reasonable choices as they develop a sense of independence.
When confronted with stress, anxiety, loss, trauma or crisis, children in this age group may respond in the following ways:
They may take on more responsibility as they seek to be helpful in reducing the stress of others.
Some they may show less emotion and put on the front that they are coping because they do not want to add to the stress of others.
Others may act out more and become more aggressive behaviour because they can verbalise and show their feelings, but they have not yet developed appropriate coping strategies to process these feelings.
Developmental Phase Adolescents 12-18 years
Adolescents (teenagers) become more future-focused and they are able to reason and demonstrate logical thinking. Their peers are central to their lives while key adults are still crucial in their lives and home is still their place of safety. During this time, adolescents develop a sense of independence as they try to define themselves, their values, and their beliefs. They require continued support and acknowledgement of their feelings and experiences.
Reactions to stress , loss, trauma and crisis may be shown in the following ways:
self-blame or blame others
acting out (truancy, substance use, etc)
withdrawal from friends or family
depression
anxiety
self-harm (cutting, etc)
What will this look like in the classroom environment for children at school-going age?
Children may display emotional dysregulation and seem oversensitive to perceived criticism or additional stressors.
Their sensory systems might be affected as they become hyper (over) or hypo (under) responsive to their sensory experiences.
In some cases children become more focused on non-verbal communication and less responsive to verbal communication. This may also result in them showing a decline in their verbal skills.
They may be more sensitive to negative cues and seemingly unable to see the positive cues.
A decline in memory and processing speed might also be observed.
Poor academic performance.
What we see in Practice - Psychometric Assessment
In practice, we are frequently confronted with children who have been exposed to significant stressors or crises. More recently, we are seeing many children who have lost family members, stable home environments, and increased abuse as a result of the COVID-19 Pandemic.
The reason for referral is often academic underperformance, screening for ADHD and ASD (Autism Spectrum Disorder), and behavioural difficulties. In many of these cases there seems to be an underlying expectation that a learning disorder will be found, or that there will be sufficient evidence for diagnosis of ASD and ADHD. Sometimes, these children come to us with the diagnosis already made (recently) and the family and school want guidance for intervention at an academic level.
We are seeing an increase in low verbal abilities, working memory problems, executive functioning delays, social withdrawal, general anxiety, phobias of death, aggression, and depression. When we see these results we have to be mindful of the impact of COVID-19 in all these areas of cognitive and emotional functioning. While it may be easy to diagnose any number of psychological disorders and prescribe a host of medications, caregivers and teachers are urged to consider the negative effects of childhood trauma.
Rather than rushing for diagnosis and medication, patience, kindness, compassion, acknowledgement, and reassurance need to be offered first and foremost. That is not to say that some of these children do not need intervention, but it is to say that a wholistic assessment of the child's functioning to determine where the trauma is being experienced. Through this process, we can identify the most appropriate intervention strategy that targets the problem and offers parents the guidance they need to help themselves and their children.
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