Stopping trauma in its tracks

For the last two weeks we've posted the simplified version of the ACE Study (the CDC's Adverse Childhood Experiences Study) questionnaire one question at a time in a daily poll. They're aggregated here. Each daily poll is accompanied by information about child trauma. Those are aggregated here, on the ACEs group page. This is the last in this series, and accompanies this last poll.

Thank you to everyone who participated and shared these difficult parts of your lives. We'll leave the polls open for a while longer. A follow-up post about all the polls will appear on Monday.

One of the ways to reduce the long-term effects of childhood trauma is to intervene immediately after a traumatic event occurs, otherwise post-traumatic stress disorder can develop and the physiology of a growing brain can be altered. A promising intervention called the Child and Family Traumatic Stress Intervention was tested on half of 106 children between the ages of 7 and 17 who had experienced a traumatic event. The other half had traditional support counseling. The children and their caregivers were recruited through emergency rooms, police, and child welfare and social services departments.

Most children experience at least one traumatic event while they're growing up, including abuse, witnessing violence, experiencing a serious illness or accident; one in five end up with post-traumatic stress disorder, according to this review of the project on

"This is the first preventative intervention to improve outcomes in children who have experienced a potentially traumatic event, and the first to reduce the onset of PTSD in kids," said lead study author Steven Berkowitz, MD, associate professor of Clinical Psychiatry at the University of Pennsylvania School of Medicine and director of the Penn Center for Youth and Family Trauma Response and Recovery. "If this study is replicated and validated in future studies, this intervention could be used nationally to help children successfully recover from a traumatic event without progressing to PTSD."

The four-part intervention occurs within 30 days of the traumatic event. In the first 90-minute session, the caregiver works with a counselor to fill out a long questionnaire about the trauma. In the second session, the child works with the counselor to do the same, according to this review of the project on The counselor then helps the caregiver choose a strategy to improve communication between the child and caregiver, and the third and fourth sessions review progress and tweak the strategy. The strategies include recognizing and managing trauma symptoms and teaching coping skills.

After three months, the intervention was able to prevent chronic PTSD in 73 percent of the children. That's remarkable. But there's a catch, noted the researchers.

However, while CFTSI [the intervention] proved effective at treating those who received the intervention, the greatest challenge was getting needy families through the clinician’s door in the first place. Less than one in four of eligible and needy families actually agreed to participate and stay the course. According to Berkowitz and colleagues, this is because “caregivers are notoriously poor at recognizing acute post-traumatic stress symptoms in their children”. They argue that “it is incumbent upon child-serving systems such as pediatric emergency departments and child welfare agencies to facilitate the identification of exposed children in need of early intervention.”

It's not just needy families that can't or don't want to recognize traumatic symptoms in their children. As the ACE Study shows, it's also middle-class and upper-middle class families.

The research appears in June issue of The Journal of Child Psychology and Psychiatry.

Tagged: child trauma, ACE Study, intervention


Marilyn Hull 7 years, 2 months ago

Caregivers who inflict or contribute to trauma wouldn't want to bring attention to anything that incriminates or reflects negaitvely on them. This is the real tragedy.

jestevens 7 years, 2 months ago

You've got that right, Marilyn. More than likely, the caregivers themselves have been victims of abuse, too, and are passing it on. Our system doesn't do a good job of helping them. We let abuse go on too long, then intervene when it's at a level that's already caused trauma. And then we cause further trauma. There's gotta be a better way. I'll be reporting on those that are trying new, unconventional methods that are showing very positive results.

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