2011 Children’s Roundtable Summit
Seven Springs, PA
Marty Beyer, Ph.D.
Trauma can interfere with
all aspects of a child's
functioning, especially
when he/she
experiences repeated or
multiple losses,
maltreatment, exposure
to frightening situations
or other trauma.
While other children are
growing emotionally, a
child coping with
trauma is distracted
from normal
developmental tasks.
Children who experience loss,
maltreatment, or other trauma may:
• be delayed
• be depressed
• have problems with regulating
• be fearful
• have trouble concentrating in school
• be sensitive to unfairness
• be tentative in trusting others
• show aggression
• blame themselves for their
Especially during their first three years,
children who receive consistent,
responsive caregiving develop trust
which research has shown is linked to
brain development and the ability have
secure attachments and manage their
emotions in the future.
Loss of or rejection by a caregiver, or
multiple caregivers, can damage a child
and lead to insecure attachments These
children become easily distressed, are
difficult to soothe, and both want comfort
and are angry with their caregiver.
"The experience of trauma
represents for children a loss of
the developmentally appropriate
expectation that their parents will
protect them from harm. Young
children rely on their parents for
the consolidation of their sense of
self, which is established through
modulation of emotion...[and]
relationships...[which are]
disrupted when a child lives in
chronic circumstances of
traumatic stress."
(Osofsky, Young Children and Trauma, 2004)
Legacies of Biological Disruption from Adversity
• Cognitive, emotional and social capacities are
intertwined in the architecture of the
developing brain
• Toxic stress disrupts brain circuits and
overloads the child’s stress response system
(including immune system, heart rate and
stress hormones)
• Children who have experienced significant
adversity require early specialized intervention:
> stable and supportive relationships
> language-rich environment
> mutually responsive “SERVE & RETURN”
There’s Good News from Brain Science
for Children in Foster Care
• Using brain science, the
needs of children in foster
care can be understood in
ways never before possible
• Identifying which children in
foster care are at greatest
risk and how to help them
can be done with
increasing precision
• Preventing toxic stress and
mitigating its effects in
young children in foster
care is possible
Preventive intervention for maltreated pre-school children
Neglected children, perhaps due to fewer “serve and return” experiences, may have blunted
stress hormone levels and diminished brain activity in response to corrective feedback.
With 4-6 months of intervention, they return to normal cortisol and brain activity, and
greatly reduced behavior problems
Attachment Biobehavioral Catchup
Teaching parents and foster parents “relentless parenting,” caring in a highly
responsive “serve and return” way to children who push caregivers away
and/or have behavior problems that do not invite nurturing
Family Check Up
Early support for positive parenting practices that prevent the development of
children’s problem behaviors, particularly reducing coercive interactions
Safe Care
Parent training in parent-child interaction and problem-solving
Parent Child Therapy
Interactive therapy between parents and young children experiencing interpersonal
violence and traumatic loss, including children in foster care
Incredible Years
Parent training focused on enhancing parenting skills, knowledge of child
development and positive child behavior. Caregivers reported lower levels of
parenting stress and increased empathy toward their children.
Hector's foster parents are having trouble with his temper
tantrums which happen a lot, disturbing meals, bedtime, and
the other children in their home. Their assumptions about his
temper tantrums are:
His mother was not attuned to his distress
He has an insecure attachment to his mother
His mother modeled poor emotion regulation
His mother did not have a consistent bedtime routine
If we look behind Hector’s temper tantrums we see
overwhelming feelings that he cannot express.
His feelings of loss are too much for him to
soothe himself. He is protesting that
everything is out of control.
A child's unique temperament frames
his/her response to trauma:
"...reserved children may tend to
respond to the trauma with
internalizing behaviors such as
affective numbing, social withdrawal,
constricted exploration, separation
anxiety and new fears. In contrast,
active and outgoing children may be
more prone to respond with
externalizing behaviors such as
recklessness, temper tantrums,
defiance and aggression."
(Osofsky, Young Children and Trauma, 2004)
The younger the child, the
less they are able to
communicate about their
distress. Many children
who enter care are under 3
years old, and their
parents, relatives, foster
parents and others have
trouble deciphering what
they need.
Depression is common
but often not diagnosed in
traumatized children.
Their behavioral problems
become the focus rather
than their underlying
sadness, isolation, selfdislike and feeling
Children with untreated
trauma adjust poorly in
middle school because
their delayed
development, problems
with regulating emotions
and relationship
difficulties are so
Trauma exposure plays a key role in
the development of behavior
problems in adolescents-the effects
of trauma contribute to the
impulsivity and anger associated with
school difficulties, substance abuse
and gang involvement. "We are
beginning to move from the mere
recognition that juvenile delinquents
have often faced extreme adversity
in their childhood, to the
understanding that such adversity
has had specific effects which
contribute to delinquency."
(Greenwald, Trauma and Juvenile Delinquency, 2002)
"At times she is so overwhelmed and exhausted by worries and troubles that
she feels hopeless and depleted. She cares for her family but is acutely aware
of the pervasiveness of their problems which weigh heavily on her. Caring for
others in the family sometimes keeps her from caring for herself. Tiffany sees
the world as a hazardous place, where she must confront dangers without help
from others."
• Girls experience more negative life events than boys
• Girls are more upset by stress, are prone to see themselves as
helpless, fear abandonment by others, and express a greater need for
closeness and nurturing than boys do
• Girls report significantly lower levels of self-worth and satisfaction
with their social and academic achievement than boys.
• Many girls who previously seem resilient appear to lose self-confidence
around age 11 or 12.
• Connection with others is the central organizing feature of
development in girls, and their focus on relationships creates a
concern over loss of closeness that can dominate girls' thinking
from elementary through high school.
Traumatized youth tend to
misinterpret and be offended by
relatively benign things that others
say and do. They have often had
difficulty since childhood
modulating their reactions and
putting their feelings into words
instead of aggression.
Traumatized youth can be
surprised by and unable to control
their angry outbursts when they feel
threatened if memories of their past
victimization are triggered.
This reflexive reaction to provocation may not be
understood as an effect of trauma. Foster parents,
group home staff and school staff may not have
training in managing a traumatized child, which
would emphasize that:
these children overreact to threat, reflexively,
without thinking
praise is much more effective than punishment in
changing their behavior
adult actions can prevent most of their behavior
crucial skills for caring for a traumatized child are:
avoiding power struggles
de-escalation before they get out of control
teaching children not to be so rejection-sensitive
and what to do with their angry feelings
Removal and placement are
always traumatic for
children, no matter what the
Even in abusive situations,
there is a loss of everything
familiar to the child and the
attachment between the
child and parent is affected
The child's first
placement in foster care
should be the child's
only placement. Children
need consistent
caregivers and multiple
moves disrupt their
attachments and can
damage a child's trust
and ability to build
Training for foster parents
should include information
about attachment,
including: how foster
parents can support the
child's attachment to his/
her parent and help the
child have multiple
attachments. Foster
parents also need
information about children's
possible visit reactions,
especially to separating
again from family.
Parents and foster parents should
have support for finding common
ground in meeting the child's
When foster parents and parents
have a positive relationship
children feel reassured, safer, and
happier; they are not torn between
the caregivers in their lives and
their multiple attachments are
Parent-foster parent
communication promotes
reunification or another
permanency plan, and makes it
more likely that attachments can
continue no matter what the
permanency outcome.
Visits are the primary way that
the attachment between
parents and their children is
maintained and strengthened
while they are separated.
Visits must be frequent and
arranged in a way that
supports the parent to parent
their children during their
family time.
Throughout the time the case is open, parents' concepts of their children's needs
may remain different from the worker, foster parent, parenting teacher, or therapist.
The parent's grief, anger, and preoccupation with complying with court-ordered
services may obscure their child's needs.
Parents may act out their anger about the child's removal during visits.
Their child's reactions to separation and the conditions that brought them into care
may be challenging for the parent to manage in visits.
Parents report that being watched by someone taking notes during visits makes
them uncomfortable and less likely to do anything with their children for fear of
making a mistake.
Children's behavior reflects their feelings about being separated from family
members, about maltreatment that preceded placement, and their confusion about
living with a new family.
Many parents of children in foster care experienced trauma as
they were growing up. Some were in foster care themselves.
The loss of their children and the resulting instability and sense
of guilt take a toll on parents.
• They feel helpless and hopeless.
• They get frustrated that "the system" is so slow.
• They are emotionally fragile as they "start their lives over" in
alcohol/drug treatment and domestic violence programs.
• They feel guilty for having been inattentive to their children’s
needs in the past.
• Those who have not fully grieved the death of a loved one
have even more trouble with the separation from their children.
When they visit their children, parents
are overwhelmed by their mixed feelings
of pleasure, sadness, awkwardness
and defensiveness.
They envy the foster parent.
Separating from their child in visit
after visit is so painful it is hard
for them to return.
Even though they enjoy their children,
visits make most parents feel
inadequate and miserable.
Visit Coaching is
fundamentally different from
supervised visits.
Instead of watching the
family, the Visit Coach is
actively involved in
supporting them to meet
their children's needs.
Visit Coaching includes:
• Helping parents articulate their children's needs to
be met in visits
• Preparing parents for their children's reactions
• Helping parents plan to give their children their full
attention at each visit
• Appreciating the parent's strengths in responding to
each child and coaching them to enhance their
• Supportively reminding the parent immediately
before and during the visit of how they planned to
meet each child's needs
• Helping parents visit consistently and keep their
anger and depression out of the visit

Children in Foster Care Coping with Loss