Objective: Developmental trauma or chronic early childhood exposure to abuse and neglect by caregivers has been shown to have a long-lasting pervasive impact on mental and neural development, including problems with attention, impulse control, self-regulation, and executive functioning. Its long-term effects are arguably the costliest public health challenge in the United States. Children with developmental trauma rarely have a satisfactory response to currently available evidence-based psychotherapeutic and pharmacological treatments. Neurofeedback training (NFT) is a clinical application of brain computer interface technology, aiming to alter electrical brain activity associated with various mental dysfunctions. NFT has shown promise to improve posttraumatic stress disorder (PTSD) symptoms. Method: This randomized controlled study examined the effects of NFT on 37 children, aged 6 -13 years with developmental trauma. Participants were randomly divided into active NFT (n ϭ 20) or treatment-asusual control (n ϭ 17). Both groups underwent 4 assessments during equivalent timelines. The active group received 24 NFT sessions twice a week. Results: This pilot study demonstrated that 24 sessions of NFT significantly decreased PTSD symptoms, internalizing, externalizing, other behavioral and emotional symptoms, and significantly improved the executive functioning of children aged 6 -13 years with severe histories of abuse and neglect who had not significantly benefited from any previous therapy. Conclusions: NFT offers the possibility to improve learning, enhance self-efficacy, and develop better social relationships in this hitherto largely treatment-resistant population. Clinical Impact StatementAbuse and neglect of children by caregivers often have long-lasting and pervasive effects on mental and neural development, including problems with attention, impulse control, self-regulation, and executive functioning. Impairment of affect regulation is thought to be the largest obstacle to effective intervention. In this pilot study of neurofeedback for polysymptomatic children with such histories, we found a significant improvement on affect regulation and executive functioning after 24 sessions of neurofeedback treatment. This offers the possibility of being able to improve learning, enhance self-efficacy, and develop better social relationships in this hitherto largely treatment resistant population.

Much progress has been made toward determining "what works" to support the well-being of trauma-exposed young children through mental health interventions. However, compared to the number of young children who have access to mental health services, many more young children have access to preschool. Estimates suggest that one in four (Briggs-Gowan, Ford, Fraleigh, McCarthy, & Carter, 2010) to one in two preschool children have experienced a potentially traumatic event (Jimenez, Wade, Lin, Morrow, & Reichman, 2016) and may be in need of trauma-informed supports. However, only 2.5% of preschool-aged children received mental health services in the last year (Child and Adolescent Health Measurement Initiative, 2016), indicating a large gap between exposure to trauma and receipt of services for young children. Comparatively, approximately 48% of children aged 3 and 4 years, almost four million children, are enrolled in preschool annually (U.S. Census Bureau, 2016). In some states, upward of 80% of children will have spent at least some time in a preschool setting by the time they reach kindergarten (Updegrove, Long, & Ruth, 2017). Preschools are potential natural systems of care that can be leveraged to support children who have experienced trauma. However, there is little research to suggest best practices for trauma-informed preschools, this despite the fact that young children are exposed to trauma at disproportionate rates compared with older children (Fantuzzo & Fusco, 2007; Lieberman, Chu, Van Horn, & Harris, 2011), the negative effects of which are well-established. This conceptual article details the need for and highlights recommendations to guide the development of trauma-informed preschool models for young children. This article does so by discussing the known prevalence and impact of early trauma, exploring evidence related to early childhood trauma interventions and trauma-informed education for older children, and outlining recommendations for key components of trauma-informed preschool models. Recommendations for policies to support trauma-informed preschool models and for future research are also discussed. Early Adversity Young children experience particularly high rates of adversity and trauma. By age 4, 25% to 50% of preschool-aged 789254T ECXXX10.

Studies of relatively recently resettled refugees have noted social disconnection, linked to various physical and mental health outcomes, as a concern. Limited studies have examined whether social disconnection and its effects persists within refugee populations resettled more than 3 decades prior. The relationship between social disconnection and self-reported health was explored in a secondary analysis of a cross-sectional needs assessment survey with a snowball sample of 100 Cambodian refugees residing in Connecticut. Social disconnectedness and comorbid health conditions were prevalent. Lack of religious and community engagement were associated with poor health outcomes, while individuals with a lack of ethnic engagement reported better overall health. This study underscores the importance of understanding the specific risks that social disconnection poses to refugees who have resettled many years before and their offspring that may assist in better serving currently settling refugees within the United States.