U.S. Department of Health and Human Services

Administration for Children and Families

Administration on Children, Youth and Families

Children’s Bureau

Child Welfare Information Gateway

Children’s Bureau/ACYF

1250 Maryland Avenue, SW

Eighth Floor

Washington, DC 20024

703.385.7565 or 800.394.3366

Email: info@childwelfare.gov

http://www.childwelfare.gov

BULLETIN FOR 

PROFESSIONALS

August 2011

Use your smartphone to 

access this bulletin online.

Supporting Brain 

Development 

in Traumatized 

Children and Youth

What’s Inside:

• Understanding trauma and 

brain development

• Identification and 

assessment

• Ages and stages

• Helping caregivers 

promote healthy brain 

development

• Working with other service 

providers

• Creating a trauma-informed 

child welfare system

• References

As a child welfare professional, you may have 

concerns about the impact of maltreatment on 

a child’s growth and development, and for good 

reason: A growing body of evidence indicates 

maltreatment can alter brain functioning and 

consequently affect mental, emotional, and 

behavioral development (often called socioemotional development). You and the families you 

serve can benefit from knowledge of children’s 

developmental stages and the signs and symptoms 

of developmental delays. This bulletin summarizes 

what you can do to support the identification and 
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

2 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

assessment of the impact of maltreatment and 

trauma on brain development; how to work 

effectively with children, youth, and families 

to support healthy brain development; and 

how to improve services through cross-system 

collaboration and trauma-informed practice.

This bulletin is a companion piece 

to Information Gateway’s issue 

brief Understanding the Effects of 

Maltreatment on Brain Development

(http://www.childwelfare.gov/pubs/issue_

briefs/brain_development). The issue 

brief provides basic information on brain 

development and helps professionals 

understand the emotional, mental, and 

behavioral impact of early abuse and 

neglect in children who come to the 

attention of the child welfare system.

Understanding Trauma 

and Brain Development 

Research indicates that newborns’ brains have 

developed enough to interact with the world 

around them, even in the earliest days of 

life. They can recognize their mother’s voice 

and smell, and they have some capacity to 

self-regulate and self-soothe. As amazing 

as these early abilities are, the majority of 

brain development occurs during the child’s 

early months and years, and higher functions 

continue to develop throughout adolescence 

into early adulthood. The brain develops 

in response to experiences with caregivers, 

family, and the community, and the quality of 

those experiences affects whether the child 

will develop a strong or weak foundation 

for all future learning, behavior, and health 

(Center on the Developing Child at Harvard 

University, 2007).

A traumatic experience such as abuse or 

neglect can profoundly impact a child’s brain 

development. Trauma may occur when a 

child feels intensely threatened by an event in 

which he or she is involved or witnesses, and 

it is often followed by serious injury or harm 

(National Child Traumatic Stress Network, 

2005). A child may experience a single 

traumatic event or chronic trauma (occurring 

repeatedly over time). Other types of 

traumatic events include witnessing domestic 

or community violence; surviving a serious 

illness, war, or terrorism; or grieving the death 

of a loved one. A growing body of evidence 

documents that brain functioning is affected 

when a child experiences trauma and that 

cognitive, physical, emotional, social, health, 

and developmental problems can result.

Research overwhelmingly points to the 

benefits of supporting children and families 

at an early age to prevent maltreatment and 

its negative effects on brain development 

before they occur. In addition, cost-benefit 

analyses demonstrate the stronger return on 

investments that result from strengthening 

families, supporting development, and 

preventing maltreatment during childhood 

and adolescence rather than funding 

treatment programs later in life (Center on the 

Developing Child at Harvard University, 2007).
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

3 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

Identification 

and Assessment 

As a child welfare professional, you are 

in a unique position to identify children’s 

developmental concerns early and help 

families receive the support they need to 

reduce any long-term effects. In working with 

at-risk children and families, you may assess 

risk factors and indications of developmental 

delays resulting from maltreatment or trauma 

as well as protective factors and indicators of 

resiliency that may help reduce the stressors.

Risk Factors

Research indicates that the following child, 

parent, and family factors may increase a 

child’s risk for developmental delay. While the 

presence of one risk factor does not mean the 

child will have a developmental delay, multiple 

risk factors should increase the cause for 

concern:

• Biomedical risk conditions in a child (such 

as low birthweight, physical deformities, or 

chronic heart or respiratory problems)

• Child maltreatment, particularly before

age 3

• Parental substance use or mental health 

problem

• Single and/or teenage parent

• Low educational attainment of parent

• Four or more children in the home

• Family poverty or domestic violence

• Involvement with the child welfare system 

(Barth et al., 2007; Administration for 

Children and Families, 2007)

Throughout this bulletin, the vignettes tell 

the story of Billy’s traumatic experiences 

in early childhood and the efforts of his 

family, child welfare services, and related 

professionals to address the effects on his 

behavior and development.

Billy is a 6-year-old boy placed with 

his maternal grandmother by the child 

welfare system. Although his mother 

stated that she never used drugs 

while she was pregnant, Billy was born 

prematurely. His mother did not have a 

home or regular income, and they moved 

from place to place for several years. 

Billy slept wherever he could find a spot, 

and he ate only sporadically. Billy did not 

cause much trouble because he rarely 

spoke.

BILLY’S STORY: INTRODUCTION

Indications of Delay

During your interactions with families, observe 

the behaviors of children and youth for any 

indications of developmental delay. (See the 

Ages and Stages section later in this bulletin.) 

Because parents know their children best, ask 

them if they have concerns about their child’s 

behavior so they can help identify issues. If 

there are causes for concern, refer the family 

to early intervention services or to a healthcare provider or youth specialist so the child 

can be fully assessed by a trained professional.

The Keeping Children and Families Safe Act 

of 2003 (P.L. 108-36) required State child 

welfare agencies to develop “provisions and 
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

4 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

procedures for referral of a child under age 

3 who is involved in a substantiated case of 

child abuse or neglect to early intervention 

services funded under Part C of the Individuals 

with Disabilities Education Improvement Act” 

(§ 106(b)(2)(A)(xxi)). Doing so helps ensure 

that the developmental needs of children 

who are abused or neglected are addressed 

and families receive the support they need 

to promote optimal child development. For 

more information, see Information Gateway’s 

Addressing the Needs of Young Children in 

Child Welfare: Part C — Early Intervention 

Services (http://www.childwelfare.gov/pubs/

partc).

After Billy was removed from his mother’s 

care due to abandonment, he was placed 

in foster care until his grandmother could 

be located. Billy’s grandmother became 

concerned about his behavior and 

development while caring for him over the 

last 6 months. Billy hid food in his pockets 

and in his room, and his teacher reported 

he was stealing food at school. Billy also 

slept on the floor. Because he was so 

quiet, it took some time for Billy’s teacher 

to notice he had difficulty speaking and 

interacting in school.

BILLY’S STORY: PART 2

ASSESSMENT TOOLS FOR CHILD 

AND YOUTH DEVELOPMENT 

Measures Review Database

National Child Traumatic Stress Network

http://www.nctsnet.org/resources/onlineresearch/measures-review

Presents a database of tools measuring 

children’s experiences of trauma and other 

mental health-related issues.

Trauma Assessment Pathway (TAP) 

Model

Chadwick Center for Children and 

Families, Rady Children’s Hospital, San 

Diego

http://www.taptraining.net

Offers a framework to build and sustain 

an assessment-based treatment program 

and provides a guide for individualized 

treatment for children who suffer complex 

trauma.

Early Childhood Measures Profiles

Child Trends

http://aspe.hhs.gov/hsp/ECMeasures04

Compiles assessment tools measuring 

language and literacy, cognition, 

mathematics, social-emotional 

competency, and approaches to learning.

Screening, Evaluation, and Assessment

National Early Childhood Technical 

Assistance Center

http://nectac.org/topics/earlyid/

screeneval.asp

References numerous publications and 

organizations professionals may consult 

regarding developmental assessments.
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

5 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

Ages and Stages 

There are sensitive periods for developing 

certain abilities (such as when infants form 

attachments with their parents) that, if 

unachieved, could impair later development. 

Every child grows at his or her own pace, 

but most children achieve developmental 

milestones within the same general timeline. 

Keep in mind that the impact of abuse or 

neglect may cause children to develop at a 

slower rate (Perry, 2006) and that children born 

prematurely may also achieve milestones at 

different times, depending on the degree of 

prematurity.

The chart on the next page provides general 

guidance on developmentally appropriate 

behavior in children, behaviors of the child or 

parent that may be a cause for concern, and 

positive parenting strategies. You may want 

to adjust your expectations according to the 

child’s needs and the parent’s situation. In 

addition, the presence of a cause for concern 

does not always mean the child is at risk for 

developmental delay; however, the presence 

of multiple concerns increases that risk.

Note: This chart should not replace a 

more thorough screening or assessment 

by a qualified professional. Child welfare 

professionals may use this information 

to observe the behaviors of children and 

youth and refer families to a developmental 

professional when appropriate.
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

6 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

Child Development, Parenting Strategies, and Causes for Concern, 0–18 years1

1	 Adapted from: Chamberlain, 2009; Gabriel, n.d.; Mayer, Anastasi, & Clark, 2006; National Center on Birth Defects and Developmental

Disabilities, 2010; National Research Council and Institute of Medicine, 2009; New York City Administration for Children’s Services, 2005;

ParentFurther, 2010; ZERO TO THREE, 2007.

Child Parent

Age

Developmentally 

appropriate 

behavior

Causes 

for concern

Parenting 

strategies

Causes 

for concern

0–3 

months

• Reacts and turns 

toward sound

• Watches faces and 

follows objects

• Coos and babbles

• Becomes more 

expressive and 

develops a social 

smile

• Develops a general 

routine of sleep/

wake times

• Is unable to 

move each limb 

separately from the 

others

• Has difficulty 

tracking light or 

faces

• Regularly cries for 

hours at a time and 

is very hard to calm

• Don’t be afraid of 

“spoiling” your 

baby; hold, cuddle, 

and comfort him 

often

• Respond to your 

baby’s cries and 

provide the comfort 

he needs (rocking, 

feeding, diaper 

changing)

• Give the baby lots 

of attention (talk, 

sing, read, play), 

and read the cues 

to recognize when 

he needs a break

• Have conversations 

with your baby 

acting as if you 

understand each 

other

• Allow the baby to 

explore through 

movement, taste, 

and touch, but set 

safe limits

• Provide time on 

the floor for sitting, 

rolling, and crawling

• Does not know 

when to feed or 

tries to keep the 

baby on a rigid 

schedule

• Feels too much 

attention or holding 

will spoil the baby

• Has trouble 

knowing when the 

baby is hungry, 

needs attention, or 

needs quiet time

• Gets upset every 

time the baby cries

• Allows the baby to 

cry for a long time 

without trying to 

comfort

• Doesn’t enjoy time 

with the baby or 

feel the baby’s 

personality “fits in” 

with family

4–7 

months

• Babbles chains of 

sounds

• Responds to others’ 

expressions of 

emotions

• Grasps and holds 

objects 

• Regards own 

hand and explores 

objects with hand 

and mouth

• Sits with, and then 

without, support on 

hands

• Cannot hold head 

up or roll over

• Does not make 

sounds in response 

to attention

• Consistently resists 

all efforts to hold or 

comfort

• Shows little interest 

in exploration

• Strongly resists a 

routine of sleep and 

awake time
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

7 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

Child Parent

Age

Developmentally 

appropriate 

behavior

Causes 

for concern

Parenting 

strategies

Causes 

for concern

8–12 

months

• Changes tone when 

babbling

• Says “dada” and 

“mama” and uses 

exclamations

• Imitates sounds and 

gestures

• Explores in many 

ways (shaking, 

dropping, banging, 

poking)

• Pulls self up to 

stand and may walk 

briefly without help

• Is not able to calm 

himself sometimes

• Does not babble 

or make simple 

gestures

• Fails to respond 

to name or simple 

verbal requests

• Does not crawl or 

explore the area

• Has little or no 

reaction when 

parent(s) leave the 

room or return

Continued from 

previous page

Continued from 

previous page

2 years • Says several single 

words and two- or 

three-word phrases

• Follows simple 

instructions

• Points to things 

when named

• Finds hidden 

objects

• Scribbles

• Stands alone and 

walks well

• Knows no single 

words

• Does not walk 

easily

• Does not seem to 

know or respond to 

family members

• Does not amuse 

himself for short 

periods of time

• Offer a variety of 

sensory experiences 

and follow the 

toddler’s lead in 

play

• Encourage, but 

don’t rush, motor 

development—

provide plenty of 

safe, low places to 

walk and climb

• Create predictable 

routines and rituals

• Is cold and 

unresponsive 

toward the child

• Rarely praises the 

child or shows 

affection

• Has trouble dealing 

with own or the 

child’s anger

• Focuses more on 

the child’s negative 

behaviors

Child Development, Parenting Strategies, and Causes for Concern, 0–18 years (Continued)
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

8 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

Child Parent

Age

Developmentally 

appropriate 

behavior

Causes 

for concern

Parenting 

strategies

Causes 

for concern

3 years • Uses four- to fiveword sentences

• Follows twoor three-part 

instructions

• Recognizes and 

identifies most 

common objects

• Draws simple 

straight or circular 

lines

• Climbs well, walks 

up and down stairs, 

runs

• No two-word 

spontaneous 

phrases

• Has trouble 

expressing 

emotions

• Often refuses to do 

simple tasks

• Seems overly 

fearful, even in safe 

situations

Continued from 

previous page

• Be a safe, reliable 

base as the child 

explores the world 

around him

• Tell stories and talk 

with the child about 

what they see, hear, 

and do

• Listen and try to 

understand what 

the child is saying

• Take the child’s 

emotions seriously 

and help him make 

sense of them

• Support interaction 

with peers; provide 

structure but 

otherwise let him 

negotiate playtime 

on his own

Continued from 

previous page

• Frequently yells 

at the child or 

punishes accidents 

harshly

• Describes the child 

as having hostile 

intentions, i.e., “He 

doesn’t like me” or 

“He knows better”

• Pushes the child 

too hard to do too 

many activities and/

or finds it hard to 

let the child try 

things by himself

• Has trouble setting 

consistent rules and 

safe limits

4 years • Uses five- to sixword sentences, 

tells stories

• Understands 

counting and 

may know some 

numbers

• Identifies four or 

more colors

• Copies or draws 

simple shapes

• Walks/runs forward 

and backward with 

balance

• Is unable to run, 

jump, or climb 

easily

• Is extremely 

aggressive and 

hostile toward 

peers

• Clings and gets 

very upset when 

parent leaves

Child Development, Parenting Strategies, and Causes for Concern, 0–18 years (Continued)
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

9 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

Child Parent

Age

Developmentally 

appropriate 

behavior

Causes 

for concern

Parenting 

strategies

Causes 

for concern

5 years • Speaks in full 

sentences, tells 

longer stories

• Draws circles and 

squares, begins to 

copy letters

• Climbs, hops, 

swings, and may 

skip

• Tries to solve 

problems from 

a single point of 

view and identify 

solutions to 

conflicts

• More likely to agree 

to rules

• Does not speak full 

sentences or speak 

clearly enough 

for strangers to 

understand

• Seems shy and very 

fearful with other 

children

• Never shares or 

takes turns

• Regularly has 

difficulty caring for 

own toilet needs

• Help child take on 

new responsibilities

• Teach reasonable 

risks and safe limits

• Handle anger 

constructively

• Create a safe 

environment where 

your child can feel 

comfortable talking 

about a wide 

range of issues and 

emotions

• Share feelings 

and stories about 

how to deal with 

problems and face 

fears

• Support healthy 

friendships 

and encourage 

appropriate social 

activities

• Regularly finds the 

child’s behavior 

unmanageable

• Does not see the 

need for the child 

to socialize with 

others

• Thinks the child is 

too aggressive or 

too dependent

• Often criticizes or 

blames the child

• Seems excessively 

anxious about the 

responsibilities of 

being a parent

• Leaves the child 

alone for extended 

periods of time

• Is not involved with 

school or with other 

parents of children 

the same age

6–7 

years

• Reads short words 

and sentences

• Draws person or 

animal

• Takes pride 

and pleasure in 

mastering new skills

• Has more internal 

control over 

emotions and 

behaviors

• Shows growing 

awareness of good 

and bad

• Is frequently sad, 

worried, afraid, or 

withdrawn

• Is easily hurt by 

peers

• Bullies other 

children

• Develops unrealistic 

fears (phobias)

Child Development, Parenting Strategies, and Causes for Concern, 0–18 years (Continued)
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

10 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

Child Development, Parenting Strategies, and Causes for Concern, 0–18 years (Continued)

Child Parent

Age

Developmentally 

appropriate 

behavior

Causes 

for concern

Parenting 

strategies

Causes 

for concern

8–10 

years

• Reads well

• Multiplies numbers

• Expresses a unique 

personality when 

relating to others

• Solves conflicts by 

talking, not fighting

• Is able to “bounce 

back” from most 

disappointments

• Returns to baby-like 

or silly behaviors

• Is preoccupied with 

violent movies, TV, 

video games

• Is fearful with 

familiar adults, or 

too friendly with 

strangers

Continued from 

previous page

Continued from 

previous page

11–14 

years

• May have frequent 

mood swings or 

changes in feelings

• Gradually develops 

own taste, sense of 

style, and identity

• Has a hobby, sport, 

or activity

• Learns to accept 

disappointments 

and overcome 

failures

• Has one or more 

“best” friends and 

positive relationships 

with others the same 

age

• Eats or sleeps less 

(or more) than 

before

• Has strong negative 

thoughts or opinions 

of himself

• Has an extreme 

need for approval 

and social support

• Has highly conflicted 

relationships or 

regularly causes 

family conflicts

• Is alone most of 

the time and seems 

happier alone than 

with others

• Establish fair and 

consistent rules

• Provide 

opportunities for 

new, challenging 

experiences

• Address the 

potential 

consequences of 

risky behaviors

• Help teens 

resolve conflicts, 

solve problems, 

and understand 

changing emotions

• Encourage goals 

for the future and 

help create systems 

for time and task 

management

• Discuss the physical 

changes in puberty 

that affect height, 

weight, and body 

shape

• Worries that the 

child is maturing 

very early or very 

late

• Doesn’t set 

reasonable limits for 

the child’s behavior

• Is uninterested 

in helping the 

child address 

overwhelming 

emotions or 

situations

• Expects the child 

to adhere to strict 

rules and severely 

punishes mistakes

• Often has conflicts 

and loses temper 

with the child

• Frequently criticizes, 

nags, or judges the 

child
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

11 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

Child Development, Parenting Strategies, and Causes for Concern, 0–18 years (Continued)

Child Parent

Age

Developmentally 

appropriate 

behavior

Causes 

for concern

Parenting 

strategies

Causes 

for concern

15–18 

years

• Begins to develop 

an identity and selfworth beyond body 

image and physical 

appearance

• Is able to calm down 

and handle anger

• Sets goals and works 

toward achieving 

them

• Accepts family 

rules, completes 

chores and other 

responsibilities

• Needs time for 

emotions and 

reasoning skills to 

catch up with rapid 

physical changes

• Feels hopeless, 

unable to make 

things better

• Withdraws from 

family or friends

• Often gives in 

to negative peer 

pressure

• Becomes violent or 

abusive

• Drives aggressively, 

speeds, drinks and 

drives

• Has a favorable 

attitude toward drug 

use

• Diets excessively, 

even when not 

overweight

Continued from 

previous page

• Be available for help 

and advice when 

needed

• Tolerate (within 

reason) teen’s 

developing likes and 

dislikes in clothes, 

hairstyles, and music

Continued from 

previous page

• Doesn’t provide the 

child any privacy 

and finds it overly 

difficult to “let go” 

as he becomes more 

independent
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

12 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

Helping Caregivers 

Promote Healthy 

Brain Development 

Most scientists agree that children need 

positive relationships, rich learning 

opportunities, and safe environments to 

support their healthy brain development 

(Center on the Developing Child at 

Harvard University, 2007). As a professional 

working with children and youth affected 

by maltreatment and with their parents or 

caregivers, you can help to improve children’s 

chances for these positive experiences. Those 

opportunities exist at many points in the child 

welfare continuum, including prevention, 

family strengthening, and treatment.

Preventing Trauma

Professionals who work with families can help 

parents create safe and loving environments 

for their children to prevent abuse or neglect 

before it occurs. Efforts to support optimal 

brain development should start as early as 

pregnancy, when mother and child form 

their first attachments. The baby’s prenatal 

development is more than simple maturation; 

it involves complex interactions among the 

mother, baby, prenatal environment, and early 

experiences. Because babies begin to develop 

all five senses before birth, even experiences 

in the womb can affect their development 

(Klein, Gilkerson, & Davis, 2008). You can help 

parents focus on their child’s development 

before birth by teaching the mother to be 

aware of baby’s movements and to embrace 

a positive lifestyle by avoiding alcohol, drugs, 

or cigarettes, eating nutritious meals, and 

practicing good hygiene. You may also want 

to link families to services such as home 

visiting or Early Head Start programs designed 

for at-risk expectant families.2

After the baby is born, parents can continue 

to receive help as needed through family 

support programs such as parent education 

and home visiting. Recent prevention resource 

guides from the U.S. Department of Health 

and Human Services Children’s Bureau (Child 

Welfare Information Gateway et al., 2011) 

encourage professionals to promote five 

protective factors that strengthen families and 

help prevent abuse and neglect, which serve 

to promote healthy brain development:

• Nurturing and attachment 

• Knowledge of parenting and of child and 

youth development 

• Parental resilience 

• Social connections 

• Concrete supports for parents

Parents can also support their baby’s brain 

development by understanding and practicing 

the strategies to promote healthy brain 

development described below.

Building Relationships

One of the most important factors in a child’s 

development is the support of a parent or 

caregiver who gives consistent love and 

support. This importance is underscored 

by the Centers for Disease Control and 

Prevention’s (CDC’s) effort to promote safe, 

stable, and nurturing relationships between 

2	 Read about Early Head Start services and locate programs on

the Early Childhood Learning and Knowledge Center website:

http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/ehsnrc/Early%20

Head%20Start.
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

13 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

children and parents. Because young 

children experience the world through their 

relationships with parents and caregivers, 

those relationships are fundamental to the 

healthy development of the brain and of 

physical, emotional, social, behavioral, and 

intellectual capabilities (National Center for 

Injury Prevention and Control, 2009).

Researchers use the idea of “serve and 

return,” as in a game of tennis, to describe 

parent-child interactions. If a child attempts 

to interact with a parent (for instance, by 

babbling or making faces), but the parent 

does not respond appropriately, then 

the child’s learning process is incomplete 

(FrameWorks Institute, 2009). You can help 

the parent or caregiver recognize cues 

when the child wants to eat, sleep, play, or 

engage in other activities. Over time, the 

caregiver’s awareness of and response to the 

child’s needs will lead to easier interactions 

between the two and, ultimately, a stronger 

relationship.

Whether a child is at home or has been placed 

with a relative caregiver or foster parent, 

you should focus on ensuring the child has a 

secure relationship with at least one important 

person in his or her life. Training relative 

caregivers and foster parents on meeting the 

child’s emotional and behavioral needs can 

help them form a healthy relationship that 

supports the child’s growth. If the child must 

be placed in out-of-home care, strive to make 

the first placement the last. The importance 

of stable attachment relationships for young 

children’s healthy development cannot be 

overstated. In addition, if the child has been 

placed in out-of-home care, you can support 

parent-child attachment, when appropriate, 

by coordinating a visit soon after placement 

and helping the parent maintain a schedule of 

frequent and extensive visits (Dicker, 2009).

Child Welfare Information Gateway 

partnered with the National Resource 

Center for Permanency and Family 

Connections, a service of the Children’s 

Bureau, to develop an online training 

on parent-child visits that may help 

workers enhance efforts toward family 

reunification. View the free training on the 

Information Gateway website: 

http://training.childwelfare.gov

Establishing Nurturing Routines 

The predictability of a daily routine helps 

children understand the world is a safe place 

where they can learn and grow without fear. 

Routines also help establish and maintain an 

attachment between the child and caregiver 

(Hammond, 2010). You can help caregivers 

understand the importance of routines and 

create a plan that meets the child’s needs.

Children need to feel that their caregiver is 

in control. The caregiver should discuss any 

changes to the routine with the child before 

they occur and give the child age-appropriate 

opportunities to make decisions about daily 

activities (Perry, 2002). Routines can also 

help the caregiver establish clear and logical 

limits for inappropriate behavior and develop 

disciplinary strategies that take the child’s past 

experiences into consideration. When caring 

for a traumatized child, these rules should be 

applied consistently but fairly (National Child 

Traumatic Stress Network Schools Committee, 

2008).
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

14 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

Enhancing Parent-Child Interactions 

Research shows that babies prefer human 

interaction more than anything else (ZERO TO 

THREE, 2008). The connections babies form 

with their caregivers and the experiences they 

share are essential to promoting healthy brain 

development. Because many parents worry 

that they don’t know how to support their 

baby’s development, you can teach them basic 

parenting skills (touching, holding, comforting, 

rocking, singing, and talking to) and explain 

that these simple interactions are some of the 

best stimulation a baby can receive (ZERO TO 

THREE, 2008).

Prepare caregivers to support child 

development and provide appropriate 

learning opportunities by describing the 

stages of child development and the timeline 

for milestones they can expect their children 

to achieve. Children build upon skills over 

time as they accomplish increasingly difficult 

and varied tasks (National Scientific Council 

on the Developing Child, 2007). Caregivers 

should understand that children do not learn 

faster if they are forced to attempt activities 

they are not developmentally ready for yet. In 

addition, explain to caregivers of maltreated 

children the negative developmental 

outcomes that may result from maltreatment. 

Because the child’s “developmental age” may 

be younger than his or her chronological age, 

the caregiver should adjust expectations and 

modify learning activities to meet the child’s 

developmental needs (Perry, 2006).

Use the parent section of the chart beginning 

on page 6 to guide a discussion of parenting 

strategies with caregivers, or locate resources 

for caregivers about Understanding 

Developmental Stages on the Child Welfare 

Information Gateway website: http://www.

childwelfare.gov/preventing/promoting/

parenting/understanding.cfm

Billy’s grandmother asked for help from 

his caseworker, who referred him to a 

mental health therapist for evaluation. 

After letting Billy speak openly about 

his past experiences, the therapist 

determined Billy’s tendencies to steal 

food and sleep on the floor were adaptive 

behaviors he developed while living 

with his mother—skills that helped him 

survive but are no longer appropriate 

given his current, more stable situation. 

Building on the therapist’s advice and 

taking Billy’s unique situation into 

consideration, the caseworker helped his 

grandmother establish regular routines, 

such as mealtimes and bedtimes, and 

gave her ideas for activities Billy and his 

grandmother could share to enhance the 

bond between them. The caseworker also 

connected the grandmother to a support 

group where she could meet other 

grandparents raising their grandchildren.

BILLY’S STORY: PART 3

Supporting Teenage 

Brain Development 

Trauma and its effects are not limited to young 

children. Although the first few years of life 

are critical to supporting brain development, 

it is important to remember that our brains 

continue growing into young adulthood. 

Right before puberty, the adolescent brain 

experiences a growth spurt in the areas that 

affect planning, reasoning, impulse control, 

and emotions.

You can help caregivers and other important 

adults in a teen’s life understand how the 

teenage brain develops and equip them with 
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

15 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

strategies to optimize that development. 

Teens benefit from quality time with their 

caregivers and adult mentors who help them:

• Organize tasks and set priorities

• Practice making decisions

• Master new skills

• Seek healthy adventures and take positive 

risks

• Minimize stress

• Adopt healthy lifestyles and allow time for 

plenty of sleep (Chamberlain, 2009)

While all teens need adults in their lives who 

can help them gain new experiences and 

support them through adolescence, teens who 

have suffered from trauma caused by abuse or 

neglect can benefit especially from caregivers 

who encourage their growing independence 

while also offering a safety net when they 

need help. 

Read more about adolescent and teen brain 

development, as well as the impact of trauma, 

in “The Amazing Brain” series on the Institute 

for Safe Families website, which provides 

information for parents and caregivers: 

http://www.instituteforsafefamilies.org/the_

amazing_brain_materials.php

Addressing the Effects of Trauma 

No two children are affected by trauma in 

the same way. Depending on the age at 

which a child experienced a traumatic event 

or ongoing trauma, the initial response may 

range from hyperarousal (fight or flight) to 

dissociation (freeze and surrender), or a 

combination of the two (Perry, 2002). It is 

normal for children to process their feelings 

after a traumatic event. Common emotional 

responses include:

• Making sense of the event

• Creating memories

• Re-experiencing the trauma

• Avoiding reminders of the event

• Experiencing anxiety or sleep problems

• Acting impulsively (Perry, 2002)

Caregivers should not pressure the child to 

talk about the traumatic event but should 

be prepared to discuss it when the child is 

ready. Children who sense their caregiver is 

uncomfortable with or upset about the event 

may avoid talking about it. When the child 

begins talking, the caregiver should listen, 

avoid overreacting, answer questions, and 

provide comfort and support (Perry, 2002).

Children who continue to experience 

heightened emotional responses for 

longer than 1 month may be experiencing 

posttraumatic stress disorder (PTSD) (Perry, 

2002).

The next section discusses different types of 

services and how to access them for children 

suffering from trauma caused by maltreatment.
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

16 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

Surviving Childhood: An Introduction to 

the Impact of Trauma

Child Trauma Academy 

http://www.childtraumaacademy.com/

surviving_childhood

Discusses the impact of negative 

experiences on the developing brain and 

reviews public policy and preventative 

approaches to address children’s health 

and development.

PTSD in Children and Adolescents

National Center for PTSD 

http://www.ptsd.va.gov/professional/

pages/ptsd_in_children_and_adolescents_

overview_for_professionals.asp

Provides information on events that may 

cause PTSD, how many children are 

affected, risk factors, symptoms, and 

treatment.

PTSD IN CHILDREN AND YOUTH

Working With Other 

Service Providers 

Because no single system can address all the 

issues a child and family may experience, 

child welfare professionals should strive to 

form collaborative relationships with other 

service providers to improve access to and 

coordination of services. Key services for 

children affected by trauma and their families 

are summarized below. 

Early Intervention

Each State has an early intervention program 

(EIP) that provides specialized health, 

educational, and therapeutic services to 

infants and toddlers who have an identified 

developmental delay or disability and their 

families. Some States may also serve children 

who are considered to be at risk of developing 

substantial delays (National Dissemination 

Center for Children With Disabilities, 2010). 

EIPs are administered by lead agencies in 

each State (including departments of health, 

developmental disability, social services, 

children and families, or education). As 

described earlier, State child welfare agencies 

are required to refer a child under age 3 who 

is involved in a substantiated case of abuse or 

neglect to the EIP.

Early intervention programs can serve as a 

source of support to help families address 

their children’s development and, when 

necessary, provide services to minimize or 

eliminate developmental delays. In addition, 

EIPs may provide a variety of services 

to caregivers to help them support their 

children’s development, such as parent 

training, home visitation, or respite care. 

Once a family is referred to the EIP, an EIP 

service coordinator will work with the family 

to develop an Individual Family Services Plan 

(IFPS) and coordinate with the child welfare 

system to ensure the child and family’s needs 

are being met. For more information, see 

Information Gateway’s Addressing the Needs 

of Young Children in Child Welfare: Part C — 

Early Intervention Services

(http://www.childwelfare.gov/pubs/partc).
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

17 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

Early Care and Education

Because children often spend time away 

from home in early care and education (ECE) 

settings, professionals serving very young 

children are critical partners in supporting 

healthy development. ECE programs that 

provide rich learning environments for 

children and work to strengthen families 

can reduce the effects of an unfavorable 

home environment (Stepleton, Mcintosh, & 

Corrington, 2010). ECE professionals also 

observe the child’s behavior in a variety of 

social and educational situations and may 

be among the first to recognize the signs 

of developmental delay. ECE programs 

that encourage regular communication with 

families allow professionals to address any 

concerns as they arise and help connect 

families to needed services.

When child welfare and ECE professionals 

maintain open communication with the 

families they serve, everyone can contribute 

to the decision-making process to determine 

what actions are in the best interests of 

the child. This collaboration also facilitates 

the family’s ability to access services and 

allows limited resources to be used more 

efficiently and effectively (Stepleton et al., 

2010). For more information, read the tutorial 

“Recognizing and Addressing Trauma in 

Infants, Young Children, and Their Families” 

from the Center for Early Childhood Mental 

Health Consultation: http://www.ecmhc.org/

tutorials/trauma

Health and Nutrition

A mother’s nutrition during pregnancy affects 

her baby’s birth weight and brain size, and 

the quality of a child’s nutrition continues 

to affect brain development, especially 

during the first 2 years of life (ZERO TO 

THREE, 2008). Helping a family gain access 

to quality, affordable health care and make 

healthy decisions regarding diet and nutrition 

are important for supporting a child’s brain 

development both before and after birth. In 

addition, when children regularly attend wellchild visits, their primary care provider is better 

able to assess growth over time, identify 

delays early, and make referrals for treatment 

or services (Center on the Developing Child at 

Harvard University, 2007). You should ensure 

families follow the recommended schedule for 

well-child visits and have the means to attend 

those visits.

The Federal Early and Periodic Screening, 

Diagnostic, and Treatment (EPSDT) program 

provides comprehensive health services for 

individuals under age 21 enrolled in Medicaid. 

Among other requirements, EPSDT programs 

must provide services to children such as 

comprehensive health and developmental 

assessments, physical examinations, vision, 

hearing, and dental services, and diagnosis 

and treatment. A health-care provider can 

assess the family’s eligibility and help them 

access these services. For more information, 

visit the EPSDT Services in Medicaid 

Knowledge Path from the Maternal and Child 

Health Library: http://www.mchlibrary.info/

knowledgepaths/kp_epsdt.html

Mental Health

When children are affected by a traumatic 

event, they may experience a variety of 

emotions or display behavioral problems 

that indicate the attention of a mental health 

professional is needed. The nature of the 

event, factors such as the age or sex of the 

child, and the child’s previous experiences can 

all affect how he or she responds to trauma 
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

18 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

(Perry, 2002). An assessment by a trained 

professional can help determine if individual 

or group therapy would be beneficial for the 

child to address the impact of the trauma. 

There are a number of points to consider 

when working with older youth who may 

benefit from mental health services:

• Youth should be involved in decisions about 

their mental health care whenever possible.

• It is critical to keep the option open for 

youth to request mental health services 

because they may be resistant initially but 

change their mind later.

• Workers should strive to reduce any stigma 

attached to mental health services.

• As with all clients, workers must respect and 

protect the privacy of youth who may or 

may not choose mental health services.

Keep in mind that parental stress and 

unresolved trauma from the parent’s childhood 

may lead to intergenerational trauma 

impacting both the parent and child’s mental 

health. In such cases, services for both the 

parent and child may be necessary to fully 

address the effects of trauma.

You can help families receive appropriate 

mental health services by explaining the 

benefits to caregivers, connecting them with 

service providers that match their needs, and 

ensuring they follow through with treatment 

recommendations. Visit the Mental Health 

section of the Child Welfare Information 

Gateway website for more information on 

mental health services for children, youth, and 

families involved with the child welfare system: 

http://www.childwelfare.gov/systemwide/

mentalhealth

To address Billy’s problems in school, 

his caseworker sought the help of the 

school’s psychologist as well as a speech 

pathologist. Initial tests indicated Billy 

had attention-deficit/hyperactivity 

disorder (ADHD); with parental consent, 

Billy was prescribed medicine to address 

the issue. The speech pathologist also 

began working with Billy and gave his 

grandmother exercises to do with him 

at home. Several months later, when 

Billy’s grandmother and teacher felt 

the medicine was not “working,” Billy’s 

mental health therapist was consulted 

again. The therapist advised that Billy’s 

problems are more likely caused by 

symptoms of posttraumatic stress disorder 

(PTSD) resulting from his earlier traumatic 

experiences. Under the therapist’s 

supervision, Billy stopped taking the 

medicine, and his treatment plan was 

revised to include more trauma-focused 

therapies, such as play and art therapy, to 

help Billy work through his feelings.

BILLY’S STORY: PART 4

Schools and Communities

The physical and emotional distress that 

traumatized children experience may lead 

to behavioral problems in school and 

poor academic performance. Potential 

developmental delays may worsen the 

situation as children fall behind their peers 

academically and have difficulty making 

social connections. You can reach out to the 

educators of the children you serve to inform 

them of each child’s unique needs and support 
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

19 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

any accommodations necessary to ensure 

the child’s educational success. In particular, 

school professionals may benefit from special 

training on the impact of trauma and how to 

work with traumatized children and youth. 

The larger community and the opportunities 

it provides for social connections can also 

impact the child’s ability to recover from 

trauma.

The status of the child’s emotional or physical 

health may require the school to develop 

an Individualized Education Program (IEP) 

in collaboration with the child’s family and 

other professionals involved in the child’s life. 

The IEP should describe the specific services 

and support the child’s needs to meet his or 

her educational goals. For more information 

on the role of educators in supporting 

traumatized children and youth, visit the 

National Child Traumatic Stress Network’s 

Child Trauma Toolkit for Educators: 

http://www.nctsnet.org/resources/audiences/

school-personnel/trauma-toolkit

Collaborating With Service Providers

Strategies to improve collaboration among 

these systems include:

• Establish cross-training opportunities for 

professionals to understand the basic 

principles of other systems

• Ensure adequate mechanisms for referrals 

to other systems and follow up on those 

referrals

• Invite all providers serving the child 

or family to regularly scheduled team 

meetings

• Engage community-based services and 

formal and informal community networks as 

part of the support system for families

• Involve related service systems during 

systemic performance reviews or quality 

improvement efforts (Stepleton et al., 2010)

The Child Welfare Information Gateway 

website offers resources for Collaboration for 

Service Delivery at http://www.childwelfare.

gov/management/practice_improvement/

collaboration/service.cfm

Creating a TraumaInformed Child 

Welfare System 

For children and youth involved with 

child welfare, especially those who have 

been placed in out-of-home care, some 

experiences with the child welfare system may 

unintentionally cause additional trauma. Being 

interviewed as part of a child abuse or neglect 

investigation, separated from family members, 

or moved among multiple placements can 

contribute to the trauma the child may have 

already experienced. The key to making 

child- and youth-serving systems more traumainformed is professionals who understand 

the impact of trauma on child development 

and can address trauma and minimize any 

additional negative effects.

According to the National Child Traumatic 

Stress Network (2008b), essential activities of 

child welfare trauma-informed practice are:

• Maximize the child’s sense of safety

• Assist children in reducing overwhelming 

emotion

• Help children make new meaning of their 

trauma history and current experiences
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

20 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

• Address the impact of trauma and 

subsequent changes in the child’s behavior, 

development, and relationships

• Coordinate services with other agencies

• Use comprehensive assessment of the 

child’s trauma experiences and their impact 

on the child’s development and behavior to 

guide services

• Support and promote positive and stable 

relationships in the life of the child

• Provide support and guidance to the child’s 

family and caregivers

• Manage professional and personal stress, 

often called vicarious or secondary trauma

Child welfare agencies across the country 

are realizing the benefits of trauma-informed 

practice for children, families, and their 

workforce, and are building upon existing 

policies and practices to make their services 

more trauma-informed. For example, since its 

launch in 2007, the Multiplying Connections 

initiative in Philadelphia has taken great strides 

to improve public child and family service 

systems in ways that will promote higher 

quality connections between children and 

caring adults that in turn lay the foundation for 

optimal brain development. The following are 

some strategies used by the initiative to create 

more trauma-informed services:

• Revise mission statements, policies and 

protocols, and core competencies to 

include trauma-informed practices and 

values

• Implement professional development 

activities and create training cohorts among 

staff to promote collaboration and shared 

learning opportunities

• Strengthen organizational partnerships by 

holding joint meetings and sharing funding 

when possible

• Incorporate trauma-informed practice goals 

into evaluation activities (Lieberman & 

Cairns, 2009)

For more information on trauma-informed 

practice, access the National Child Traumatic 

Stress Network’s Child Welfare Trauma Training 

Toolkit: http://www.nctsnet.org/products/

child-welfare-trauma-training-toolkit-2008, or 

visit the website of Philadelphia’s Multiplying 

Connections initiative: 

http://www.multiplyingconnections.org

Conclusion

To create an effective trauma-informed 

child welfare system, it is critical that the 

professionals who regularly interact with 

families are familiar with and can respond to 

the issues surrounding trauma and its effect 

on brain development. Efforts should begin 

with prevention, when families can learn 

parenting strategies to promote healthy brain 

development and prevent abuse or neglect. 

Many of the same preventive strategies can 

also be taught to parents involved with child 

welfare, foster parents, relative caregivers, 

and other out-of-home care providers to 

support the development of a traumatized 

child or youth and minimize the effects of 

trauma. Professionals who know the stages 

of development and the warning signs for 

developmental delays can work with families 

to identify concerns and connect them to 

needed services. Ultimately, coordinated childand youth-serving systems that are rooted in 

trauma-informed practices can have a positive 

impact on outcomes for children, youth, and 

families involved in the child welfare system.
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

21 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

BILLY’S STORY: CONCLUSION

In order to improve communication 

and avoid overlapping efforts, Billy’s 

caseworker scheduled a multidisciplinary 

team meeting for the adults in Billy’s life. 

The long-term plan that resulted from 

the meeting included a number of action 

items:

• Billy’s therapy sessions will continue; his 

grandmother will attend on occasion 

to support his progress and learn new 

activities and exercises to do with him 

at home.

• At school, Billy’s teacher will follow the 

newly created individual education plan 

(IEP) to help him succeed academically 

and will create a weekly progress report. 

Billy’s speech pathologist scheduled 

several more sessions to track his 

improvements.

• Billy’s grandmother will continue to 

attend monthly grandparent support 

meetings to make connections and 

receive support from other community 

members.

• Billy’s caseworker will help his 

grandmother become a foster parent 

and seek financial support while she 

cares for Billy. If Billy’s father or mother 

is unwilling or unable to care for 

him, the grandmother will apply for 

subsidized guardianship to give Billy a 

more permanent home.

Suggested Citation:

Child Welfare Information Gateway 

(2011). Supporting brain development 

in traumatized children and youth. 

Washington, DC: U.S. Department of 

Health and Human Services, Children’s 

Bureau.
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

22 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

References

Administration for Children and Families, Office of Planning, Research and Evaluation. (2007). 

Special health care needs among children in child welfare. NSCAW Research Brief No. 7. 

Washington, DC: Author. Retrieved January 2011 from http://www.acf.hhs.gov/programs/opre/

abuse_neglect/nscaw/reports/special_health/special_health.html

Barth, R. P., Scarborough, A., Lloyd, E. C., Losby, J., Casanueva, C., & Mann, T. (2007). 

Developmental status and early intervention service needs of maltreated children. Washington, 

DC: U.S. Department of Health and Human Services, Office of the Assistant Secretary for 

Planning and Evaluation. Retrieved January 2011 from http://aspe.hhs.gov/hsp/08/devneeds

Center on the Developing Child at Harvard University. (2007). A science-based framework for early 

childhood policy: Using evidence to improve outcomes in learning, behavior, and health for 

vulnerable children. Retrieved September 2010 from http://developingchild.harvard.edu/library/

reports_and_working_papers/policy_framework

Chamberlain, L. B. (2009). The amazing adolescent brain: What every educator, youth serving 

professional, and healthcare provider needs to know. Institute for Safe Families, Multiplying 

Connections, and Advocates for Youth. Retrieved September 2010 from http://www.

multiplyingconnections.org/sites/default/files/Teen%20Provider%20article%20(2)_0.pdf

Child Welfare Information Gateway, Children’s Bureau, FRIENDS National Resource Center for 

Community-Based Child Abuse Prevention, and the Center for the Study of Social PolicyStrengthening Families. (2011). Strengthening families and communities: 2011 resource guide. 

Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau. Retrieved 

April 2011 from http://www.childwelfare.gov/preventing/preventionmonth/guide2011

Dicker, S. (2009). Reversing the odds: Improving outcomes for babies in the child welfare system. 

Baltimore: Brookes Publishing Co.

FrameWorks Institute. (2009). Child abuse prevention toolkit: Elements of the core story.

Retrieved September 2010 from the Prevent Child Abuse America website at http://www.

preventchildabuse.org/canp/resources/pdf/Child_Abuse_Toolkit_Core_Story.pdf

Gabriel, G. (n.d.). Child and brain: The stages of development. BrainConnection.com. Retrieved 

September 2010 from http://brainconnection.positscience.com/topics/?main=fa/child-brain
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

23 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

Hammond, R. A. (2010). ‘Round the clock routines. In Respecting babies: A new look at Magda 

Gerber’s RIE approach. Washington, DC: ZERO TO THREE. Retrieved September 2010 from 

http://main.zerotothree.org/site/DocServer/Hammond_2.pdf?docID=11381

Klein, R., Gilkerson, L., & Davis, E. (2008). Prenatal development. In L. Gilkerson & R. Klein (Eds.), 

Early development and the brain: Teaching resources for educators. Washington, DC: ZERO TO 

THREE. Retrieved September 2010 from http://main.zerotothree.org/site/DocServer/EarlyBrain_

Unit2.pdf?docID=4461

Lieberman, L. & Cairns, J. (2009). Addressing the impact of childhood trauma on brain 

development. Retrieved September 2010 from the Multiplying Connections website at 

http://www.multiplyingconnections.org/sites/default/files/Addressing%20the%20Impact%20

of%20Childhood%20Trauma%20on%20Brain%20Development.pdf

Mayer, R., Anastasi, J. M., & Clark, E. M. (2006). What to expect and when to seek help: A bright 

futures tool for families and providers. Washington, DC: National Technical Assistance Center 

for Children’s Mental Health, Georgetown University Center for Child and Human Development, 

in collaboration with the National Center for Education in Maternal and Child Health. Retrieved 

September 2010 from http://www.brightfutures.org/tools

National Center for Injury Prevention and Control. (2009). Strategic direction for child maltreatment 

prevention: Preventing child maltreatment through the promotion of safe, stable, and nurturing 

relationships between children and caregivers. Washington, DC: Centers for Disease Control 

and Prevention, U.S. Department of Health and Human Services. Retrieved September 2010 

from http://www.cdc.gov/ViolencePrevention/pdf/CM_Strategic_Direction--Long-a.pdf

National Center on Birth Defects and Developmental Disabilities. (2010). Developmental 

milestones. Centers for Disease Control and Prevention. Retrieved September 2010 from 

http://www.cdc.gov/ncbddd/actearly/milestones

National Child Traumatic Stress Network. (2005). Understanding child traumatic stress. Retrieved 

January 2011 from http://www.nctsn.org/nctsn_assets/pdfs/edu_materials/Understanding_

Child_Traumatic_Stress_Brochure_9-29-05.pdf

National Child Traumatic Stress Network. (2008). The essential elements of trauma-informed child 

welfare practice. In Child welfare trauma training toolkit. Retrieved May 2011 from 

http://www.nctsnet.org/sites/default/files/assets/pdfs/cwt3_SHO_EEs.pdf

National Child Traumatic Stress Network Schools Committee. (2008). Child trauma toolkit for 

educators. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress. 

Retrieved May 2011 from http://www.nctsnet.org/resources/audiences/school-personnel/

trauma-toolkit
Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov

24 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at http://www.childwelfare.gov/pubs/braindevtrauma.cfm

National Dissemination Center for Children With Disabilities. (2010). Overview of early intervention. 

Retrieved September 2010 from http://www.nichcy.org/babies/overview

National Research Council and Institute of Medicine. (2009). Preventing mental, emotional, and 

behavioral disorders among young people: Progress and possibilities. Washington, DC: The 

National Academies Press. Retrieved January 2011 from http://clientportal.omni.org/d/dbh/

Lists/SAP%20Block%20Grant/Attachments/17/IOM_Matrix_8%205x11_FINAL.pdf

National Scientific Council on the Developing Child. (2007). The timing and quality of early 

experiences combine to shape brain architecture: Working paper #5. Retrieved September 2010 

from http://developingchild.harvard.edu/library/reports_and_working_papers/working_papers/

wp5/

New York City Administration for Children’s Services. (2005). Handbook for healthy development 

of children and youth (3rd ed.). New York City Administration for Children’s Services, Office of 

Child and Family Health and Graphics. Retrieved September 2010 from http://home2.nyc.gov/

html/acs/downloads/pdf/Handbook%20for%20Healthy%20ENG.pdf

ParentFurther. (2010). Ages and stages. Search Institute. Retrieved September 2010 from 

http://www.parentfurther.com/ages-stages

Perry, B. D. (2002). Surviving childhood: An introduction to the impact of trauma. Child 

Trauma Academy. Retrieved September 2010 from http://www.childtraumaacademy.com/

surviving_childhood

Perry, B. D. (2006). Applying principles of neurodevelopment to clinical work with maltreated and 

traumatized children: The neurosequential model of therapeutics. In N. B. Webb (Ed.), Working 

with traumatized youth in child welfare (pp. 27-52). New York: The Guilford Press. Retrieved 

September 2010 from the Child Trauma Academy website at http://childtraumaacademy.org/

Documents/NeurosequentialModel_06.pdf

Stepleton, K., Mcintosh, J., & Corrington, B. (2010). Allied for better outcomes: Child welfare and 

early childhood. Center for the Study of Social Policy. Retrieved September 2010 from 

http://www.strengtheningfamilies.net/images/uploads/images/(1.1)_Allied_for_Better_

Outcomes_(draft)_.pdf

ZERO TO THREE. (2007). Baby brain map. Retrieved September 2010 from http://www.

zerotothree.org/baby-brain-map.html

ZERO TO THREE. (2008). Frequently asked questions: Brain development. Retrieved September 

2010 from http://main.zerotothree.org/site/DocServer/Brain_FAQ.pdf?docID=11561