Care When It Counts: Establishing Trauma-Sensitive Care as a Preventative Approach for 0–3-Year-Old Children Suffering from Trauma and Chronic Stress

Abstract

Adverse childhood experiences are an important societal concern. Children aged 0–3 are particularly vulnerable to unpredictable chronic stress due to the critical period for brain development and attachment. Trauma-sensitive care is a preventative approach to reduce the burden of stressful experiences by committing to positive relationships. Professional caregivers are ideally placed to offer trauma-sensitive care; however, earlier research reveals that the tools they need to consciously apply trauma-sensitive care principles are missing. The current study organized living labs (co-creative research method) to present trauma-sensitive care as a preventative approach aimed at children aged 0–3. Two living labs were organized in Belgium and Hungary, where professional caregivers collaborated to create a protocol that offers guidelines on how to implement trauma-sensitive care. The resulting protocol included a theoretical foundation on trauma as well as a translation of these guidelines into practical recommendations. The protocol was evaluated by incorporating it into a training intervention delivered to 100 professional caregivers from childcare organizations across four European countries. The protocol received positive feedback from participants, with results indicating a self-reported increase in knowledge, attitude and practice of trauma-sensitive care principles. We conclude that this trauma-sensitive care protocol is a promising answer to the needs of professional caregivers working with children aged 0–3.

Narrative Review of the Complex Interaction between Pain and Trauma in Children: A Focus on Biological Memory, Preclinical Data, and Epigenetic Processes

“…Physical pain can trigger traumatic memories or emotions, leading to re-traumatization and a worsening of psychological distress [55,58]. Similarly, trauma-related stress and psychological factors can amplify the experience of physical pain.…”

“…Also, trauma can disrupt a child's ability to effectively cope with pain [59]. They may develop maladaptive coping strategies or engage in avoidance behaviors to deal with the pain, further perpetuating their distress and hindering their recovery [55,58]. Finally, unresolved trauma in childhood may have long-lasting effects on pain perception and pain management and contribute to the development of chronic pain conditions, such as fibromyalgia or complex regional pain syndrome, but also increase the risk of post-traumatic stress and enhance the risk of experiencing pain-related disabilities later in life [60].…”

“…The three areas we will explore are the impact of biological memory, the critical role of the environment, and the use of models to improve our neurobiological and molecular insight [59,64,65]. A comprehensive approach that integrates trauma-informed care [58], appropriate psychological support, and pain management strategies will alleviate the impact of trauma on pain experiences and promote the child's overall well-being.…”