Comunicar el Trauma – JUST PUBLISHED!

Breaking News!

I am delighted to share that my book, “Communicating Trauma” has just been published in Spanish! Yay Hurray!

CT spanish NaamaYehuda

Comunicar el Trauma – Na’ama Yehuda

 

Comunicar el trauma:Criterios clínicos e intervenciones con niños traumatizados

 

From the publisher:

Comunicar el trauma explora diferentes aspectos del lenguaje y la comunicación y cómo su desarrollo se ve afectado por el trauma y el desbordamiento emocional de los niños. A lo largo del texto, múltiples estudios de caso describen de qué modo los distintos tipos de trauma infantil afectan a la capacidad de los niños para relacionarse, atender, aprender y comunicarse. Estos ejemplos nos brindan diferentes maneras de entender, responder y apoyar a los niños que tratan de comunicar que se sienten desbordados. Psicoterapeutas, patólogos del habla y del lenguaje, trabajadores sociales, educadores, terapeutas ocupacionales y físicos, personal médico, padres de acogida, agencias de adopción y otros cuidadores y profesionales de la infancia encontrarán, en este libro, información y consejos prácticos para mejorar la conexión y el comportamiento, paliar la falta de comunicación y conseguir que los niños más problemáticos sean escuchados.

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“Un libro fascinante sobre el trauma infantil y el modo en que los niños expresan su sufrimiento y que, más importante aún, constituye un mapa para la curación. Escrito con gran sensibilidad, cariño, comprensión y sabiduría clínica, este libro es una joya diáfana y accesible, que incluye conmovedores e instructivos ejemplos de casos. Tanto los padres como los profesionales encontrarán en sus páginas una valiosa ayuda.”

–Ono Van der Hart, PhD, Universidad de Utrecht, Holanda 

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For more information about the English edition go to “Communicating Trauma” (or look under the — soon to be updated… — Books and Publications tab at the top of the page).

 

Blue Belle

Blue Belle NaamaYehuda

Photo: Na’ama Yehuda

 

She hangs out next to the couch, wrapped around the floor lamp like a hand in a hand. She’s been there a long time. She lived on other floor lamps before this one, till their time had come and she welcomed a new one. She makes friends with them all, says goodbye to those who lost their spark. Perhaps she thinks of them, sometimes.

She hangs out next to the couch, wrapped around the floor lamp like a protective palm over a young hand. She watches little fingers wrestling beads onto threads, listens as small mouths make words out of thoughts, witnesses big hearts in tiny chests writing grand ideas into evolving minds – theirs and mine.

She hangs out next to the blue couch. She hears the unasked questions that stay behind worried parents’ lips. The questions children ask, sometimes for the first time. She understands. She does not prod. She just knows. They look for her, especially after a long break, reassured to find her there, still wrapped around the floor lamp like a comfy hug.

She’s been there long enough to find the right time to catch their eye.

With a quiet smile.

Blue Belle on her perch by the couch. Patience in her heart, twinkle in her eye.

 

 

 

For Linda Hill’s SoCS prompt: Blue (first blue object you see)

 

 

What PTSD teaches us about human frailty and resilience

The link below will lead you to one of the best interviews about PTSD I have ever seen, hands down.

The fact that Rachel Yehuda is my cousin is an added bonus–I am ever so proud of her: for the person she is, for the work she does, for the wisdom and empathy she imparts, for how she has literally changed the field of PTSD in the last 25 years.

(I recommend reading the transcript, not just viewing the snippet of video on the site)

Take a look. Take a read. You will be glad to have taken the time:

Ingenius: Rachel Yehuda

http://nautil.us/issue/31/stress/ingenious-rachel-Yehuda

 

experience

ADHD or Trauma?–The Likelihood for Mistaken Diagnosis

trauma brain

A new study shows that a child with an ADHD diagnosis is more likely to have also experienced stress and trauma early in life.

Clinicians working with traumatized children and adolescents have long noticed–and noted–that it was not unusual for children with trauma histories to be diagnosed (and possibly all too often misdiagnosed) with ADHD. 

What complicates the clinical picture is that a child can have ADHD and trauma history (or Autism and trauma history). In fact, children with ADHD and children with communication disorders are more likely to be maltreated than children without these issues.

As the article below states, and what is very important to take into account, is the need to rule out trauma as the cause–or contributor–to the child’s clinical presentation, rather than simply assume that a distracted, inattentive child has ADHD. Assessment needs to address the possibility of trauma, and intervention approaches must be adjusted accordingly. For example, medication for ADHD may not be appropriate for a child whose inattentiveness is due to hypervigilance. It is crucial to ensure that past trauma be treated and ongoing trauma be addressed, so that the child can let go of the coping skills adopted to manage overwhelm.

 

The article is copied below. You can also read it on the original webpage by clicking on the title below. For more information about trauma and development, click here.

 

News Analysis: Are We Misdiagnosing Childhood Traumas as ADHD?

Children with attention deficit hyperactivity disorder (ADHD) receive a diagnosis based on their behavior: age-inappropriate fidgeting, inattentiveness, hyperactivity, and trouble sitting still and concentrating. However, according to new research presented today at the Pediatric Academic Societies annual meeting in Vancouver, Canada, these behaviors may also be linked to childhood trauma.

A research team analyzed data about 65,680 children ages 6 to 17. (The data was taken from the 2011-2o12 National Survey of Children’s Health.) The children’s parents answered questions about whether their kids had been diagnosed with ADHD, how severe their symptoms were, and whether they were taking any ADHD medications. The parents also reported on whether the children had had any of nine adverse childhood experiences (ACEs): poverty, divorce, the death of a parent or guardian, domestic violence, neighborhood violence, substance abuse, incarceration, familial mental illness, or discrimination.

“Diagnoses of ADHD have increased over the last decade, and there has been a concomitant rise in stimulant medication use,” said Nicole Brown, an assistant professor of pediatrics at the Children’s Hospital at Montefiore and lead author of the study, in an interview with Healthline. “Many of my patients also experience trauma during childhood, which often exacerbates ADHD symptoms and poses diagnostic challenges with respect to teasing out whether their symptoms directly result from the trauma they experience.”

About 12 percent of the children who participated in the survey had been diagnosed with ADHD. Parents reported that these children had also experienced higher rates of all of types of ACEs than children without ADHD.

The children with ADHD were also more likely to have experienced a greater number of adverse events. Seventeen percent of children with ADHD had experienced four or more ACEs, as opposed to 6 percent of children without ADHD. The children who had dealt with four or more ACEs were almost three times are likely to be using an ADHD medication as children with three or fewer ACEs, and their parents rated their ADHD as being more severe.

ADHD and Trauma: The Chicken and the Egg

How is ADHD connected to stress and trauma? There could be a number of explanations.

First, it’s possible that doctors are simply mistaking the signs of trauma in children for ADHD. “What we find is that there is often an overlap in the symptoms of children who have ADHD and children who have experienced trauma, particularly small children,” said Alicia Lieberman, professor and vice chair for academic affairs at the University of California, San Francisco, Department of Psychiatry and the director of the Child Trauma Research Program at San Francisco General Hospital, in an interview with Healthline. “The inability to concentrate, the fidgetiness, the inability to pay attention, the distractibility, the restlessness, and the irritability are often behaviors that trigger a diagnosis of ADHD. And often, the people making the diagnosis do not ask what happened to the child, what kind of experiences the child has had.”

Brown agrees that this may explain her findings. “Studies have also shown that symptoms of post-traumatic stress disorder (PTSD) or acute stress disorder resulting from adverse life events closely resemble ADHD symptoms, so there is a high likelihood for clinicians to diagnose ADHD and overlook a possible trauma history,” she said.

Another explanation is that children with ADHD may be more likely to get into trouble and to experience traumatic events as a result. “Children with ADHD can become more impulsive, can be more annoying to parents that might be depleted, so children with ADHD might be at greater risk for being maltreated or getting into accidents, which might in turn trigger PTSD,” explained Lieberman.

Finally, researchers know that stress in the early life environment might affect the development of the brain. “It’s also possible that being exposed to a traumatic event increases the likelihood of developing psychiatric disorders that have a range of manifestations, including anxiety, post-traumatic stress disorder, and ADHD,” Lieberman said.

“When a child is presenting difficult behavior, the first thing to ask is ‘What happened to the child?’ rather than ‘What is wrong with the child?’”

Under this lens, ADHD is only one of many possible outcomes that can result from early-life trauma. And even then, ADHD might just be a sign of what’s to come. “We know that early life adversity produces developmental changes consistent with ADHD, but it produces many other effects as well,” explained Regina Sullivan, a professor of child and adolescent psychiatry at the New York University School of Medicine. “As a child is developing, and there’s a neurobehavioral deficit, how that is expressed changes during development. ADHD can sometimes be symptoms of neurobehavioral problems that will emerge later in development.”

Sullivan added, “Early life trauma and stress can interact with genetics to produce different disorders based on the age the trauma was experienced and the particular type of stress or trauma. Different-aged children, and children with different genetics, and children with different personalities, will respond differently to a given stress.”

Are We Medicalizing Stress?

Rising rates of ADHD diagnosis and medication use raise the question: are we turning normal levels of life stress into a medical condition? Lieberman points out that more than 60 percent of children report that they have been exposed to some kind of victimization in the previous year, and more than 10 percent have had five or more exposures. For many children, ACEs aren’t rare, they’re the norm.

And when kids are under stress, they’re more likely to act out. “When a child is presenting difficult behavior, the first thing to ask is ‘What happened to the child?’ rather than ‘What is wrong with the child?’” said Lieberman. “The recommendation that the authors of the study make about the importance of screening for trauma exposure in every child that is showing symptoms that can be associated with ADHD is extraordinarily important and timely.”

In these circumstances, medications probably aren’t the answer. “While stimulant medications may prove beneficial for some children, they may not be the most effective management strategy for all children,” said Brown. “Children with ADHD diagnoses who have experienced trauma may additionally benefit from specific behavioral interventions that are tailored to addressing their underlying trauma histories.”

However, Sullivan cautions against drawing too many conclusions about a child’s past from his or her diagnosis of ADHD. “Not all children with ADHD have had early life adversity,” she said. ADHD also isn’t necessarily a sign of other disorders to come. “Sometimes, when someone has ADHD, they maintain those ADHD symptoms throughout life, changing somewhat, but they still have the diagnosis of ADHD.”

It will be many years before the root causes of ADHD are fully understood. Until then, doctors must try to figure out which symptoms are caused by trauma, while also ensuring that children with ADHD get proper treatment for the disorder itself.

adhd