According to a coalition of adoption advocates, broader acceptance of an emerging mental health diagnosis has the potential to help traumatized children access the help they need.
That’s the goal of the End Childhood Trauma Tour, which stops in five cities this week in the name of promoting awareness of the disruptive effects of trauma on children.
The tour started in Minneapolis on Friday before stopping in Chicago. It heads to Boston tonight before moving on to Philadelphia and Washington, D.C. on Tuesday and Wednesday.
Organized by a group of nonprofit organizations — Calo Programs, Attachment and Trauma Network, American Adoption Congress and the Association for Training on Trauma and Attachment in Children (ATTACh) — the tour calls attention to the potential for the Developmental Trauma Disorder (DTD) diagnosis, which organizers believe can help caregivers and clinicians address the needs of children who struggle with trauma and attachment issues.
Developmental Trauma Disorder has been used for at least the past 15 years to describe the impact of traumatic experiences that occur to children from ages 0 to 6. Understanding the impact of this type of complex trauma is often complicated, experts say, by the fact that young children often lack the ability to understand or communicate the damaging effects of trauma
But despite research tying the impact of adverse childhood experiences (ACEs) to health outcomes among adults later in life, DTD has not achieved mainstream acceptance. The disorder is not included in the current version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).
That is a significant barrier to helping adoptees and other foster children gain better therapeutic interventions, said Thomas Ahern, senior vice president with Calo Programs and an adoptee himself.
“Clinicians have to put this hodge-podge group of diagnoses together to create something that represents a treatment for the symptoms because that’s what they have to do to get reimbursed by insurance companies,” said Ahern, who helped organize the tour.
Developmental trauma is prevalent among adoptive children and those in foster care, nearly all of whom have experienced some form of out-of-home placement. A recent study by David Brodzinsky found that although adoptees make up about 2 percent of the children in the nation, they represent up to 30 percent of youth placed in residential treatment centers.
Advocates say that no DSM-recognized diagnosis properly acknowledges the struggles of these children, which often manifests as self-destructive behaviors, difficulty with self-regulation and acting out.
“We’ve been doing therapy on these kids for decades,” said Ahern. “But they’re not getting any better because no one knows the right kind of therapy to get them.”
Advocates are hoping that greater awareness of DTD can help adoptive parents like Mary McGowan, who is the executive director of ATTACh and the adoptive mother of five who has seen the impact of early childhood trauma up close with her own children.
She adopted all of her kids at age 18 months or younger, but all have struggled with emotional and physical outbursts that have sometimes wrecked her house and tested her patience.
“When I watch them destroy the house and smash all these things, sometimes I just want to go ‘You know what, I have had enough,’” McGowan said. “But I have to understand what is behind this behavior. It helps me understand they’re not deliberately doing these things to me. This is about their trauma, their pain and them not knowing how to say ‘help me.’”
These traumatic experiences early in life can cause changes in the chemistry of the brain, especially in the frontal lobe of the brain where emotional regulation and cognition occurs.
It’s not enough, McGowan says, just to expect that a loving home will solve all these issues in children who have experienced loss or separation at a young age. If adoptive and foster parents have a better idea of the trauma experienced by the children in their care, they will be better equipped to lead them along the road to support and healing.
“Love is important, extremely important, but it is not enough,” McGowan said. “We are putting these children with the most complex emotional behavioral issues due to trauma and attachment into homes that have little or no training on how to deal with them.
“But we have this knowledge that can change the way they’re parenting and change the course of thousands and thousands of children’s lives.”