Children’s Bureau/ACYF/ACF/HHS

800.394.3366 | Email: info@childwelfare.gov | https://www.childwelfare.gov

WHAT’S INSIDE

Understanding trauma 

and brain development

Encouraging healthy 

brain development

Screening children for 

services and working 

with other providers

Treatment for traumaaffected children and 

youth

Conclusion

References

BULLETIN FOR 

PROFESSIONALS

September 2017

Supporting Brain 

Development in Traumatized 

Children and Youth

Healthy brain development is essential for 

realizing one’s full potential and for overall wellbeing. For children and youth who experience 

child abuse or neglect and associated trauma, 

brain development may be interrupted, leading to 

functional impairments. Ongoing maltreatment 

can alter a child’s brain development and 

affect mental, emotional, and behavioral 

health into adulthood. Frontline child welfare 

professionals are in a unique position to 

recognize developmental delays in children and 

youth and provide appropriate support services. 

This bulletin summarizes what you can do to 

promote healthy brain development for this 

vulnerable group of children and youth and put 

families and service providers in touch with the 

most effective, evidence-based interventions.
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This bulletin is a companion piece to Child 

Welfare Information Gateway’s issue brief 

Understanding the Effects of Maltreatment on 

Brain Development (https://www.childwelfare.gov/

pubs/issue-briefs/brain-development/), which 

helps professionals understand the behavioral, 

emotional, and mental impacts of early abuse and 

neglect in children who come to the attention of 

the child welfare system.

Understanding Trauma and Brain 

Development

Early life experiences shape the development of brain 

circuitry and help to determine the makeup of a person’s 

intelligence, emotions, and personality. Positive 

experiences with caregivers, family members, and the 

broader community strongly influence whether an infant 

or child develops a strong or weak foundation for future 

social-emotional health and help the child’s developing 

brain offset the potentially negative consequences of 

abuse or neglect (Chen, Miller, Kobor, & Cole, 2011).

When infants and young children are exposed to chronic 

or acute maltreatment within the caregiving context, brain 

development may be compromised and emotional, 

behavioral, or learning challenges may persist, especially 

in the absence of targeted and trauma-informed 

interventions. 

When primary caregivers make infants and children feel 

safe and nurtured, their developing brains are able to 

spend more time learning and building essential 

connections. When children feel unsafe or threatened, 

however, their brains shift into survival mode, making 

learning particularly difficult. 

Brain imaging studies of children with documented cases 

of maltreatment reveal distinct changes in both the brain’s 

structure and functioning (Delima & Vimpani, 2011). Such 

studies show that abuse, neglect, and other exposure to 

trauma can result in long-lasting negative changes to the 

brain. Victims of child maltreatment frequently suffer from 

delayed speech, reading ability, and school readiness 

(Chamberlain, 2016). Although these results could be 

related to other variables as well, the correlation between 

childhood abuse and neglect and altered brain 

functioning appears significant in brain imaging studies 

(Nemeroff, 2016): 

 The area of the brain associated with executive 

functioning and planning, the prefrontal cortex, shows 

correspondingly smaller amounts of gray and white 

matter in youth who were studied for their reported 

experiences with childhood trauma compared with 

those who did not report such experiences. 

 The region of the brain associated with learning, the 

hippocampus region, is smaller in individuals reporting 

early exposure to trauma. 

 The brain’s emotional reaction center associated with 

behavioral functioning and survival instincts, the 

amygdala, shows correspondingly increased reactivity 

with higher reported exposure to trauma during 

infancy and early childhood.

Trauma-induced changes to the brain can result in varying 

degrees of cognitive impairment and emotional 

dysregulation that can lead to a host of problems, 

including difficulty with attention and focus, learning 

disabilities, low self-esteem, impaired social skills, and 

sleep disturbances (Nemeroff, 2016). Since trauma 

exposure has been linked to a significantly increased risk 

of developing several mental and behavioral health 

issues—including posttraumatic stress disorder, 

depression, anxiety, bipolar disorder, and substance use 

disorders—it is important for practitioners to be aware of 

steps they can take to help minimize the neurological 

effects of child abuse and neglect and promote healthy 

brain development (Shonkoff, 2011).
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Abusive Head Trauma 

Abusive head trauma (AHT)—forceful blows to the 

head or the shaking of an infant’s head (“shaken 

baby syndrome”)—creates a distinct set of 

problems for the developing brain. AHT is a leading 

cause of severe brain injury and death in infants and 

children in child abuse cases. Annually, it affects 30 

in 100,000 children under age 1 (American 

Academy of Pediatrics, 2015). The Centers for 

Disease Control and Prevention (CDC) within the 

U.S. Department of Health and Human Services 

(HHS) identified AHT as a serious public health 

issue that can result in potential brain damage and 

related hearing loss, developmental delays, and 

physical disabilities (HHS, 2016). 

Children who sustain serious AHT at a young age 

may suffer greater deficits in cognitive and 

behavioral development than those experiencing 

head trauma later in childhood (McKinlay & 

Anderson, 2013). AHT can harm the brain’s frontal 

lobes and future capacity for executive functioning 

skills, such as goal setting, planning, problemsolving, mental flexibility, and abstract thought. The 

extent of AHT damage may not be fully understood 

until a child matures, as potential deficits may 

present during development (Savage, 2012). 

Neuroscience is rapidly developing potential new 

therapeutic opportunities for traumatic brain 

injuries, including gene expression, immune system 

treatment, stem-cell use, and drug protocols (Su, 

Veeravagu, & Grant, 2016). A range of interventions 

can be pursued after a child’s brain injuries have 

been medically stabilized, depending on the child’s 

age and the type and extent of damage. 

Interventions may assist children to varying 

degrees—from achieving very basic skills (e.g., 

feeding, chewing, and swallowing) to more 

advanced capabilities (e.g., speech and higher 

cognitive functions) (Castelli, 2012). For more 

information, consult the International Brain Injury 

Association website at www.internationalbrain.org. 

Encouraging Healthy Brain 

Development

As a child welfare professional, you can help support 

healthy brain development by promoting safe and 

nurturing environments for children and families and 

by encouraging both the prevention and treatment of 

trauma.

Preventing Trauma

Efforts to support healthy brain development ideally 

should start before and continue through pregnancy, 

when maternal health can influence the developing 

brain and the mother-child attachment begins. Maternal 

stress can affect the developing brain and create longterm issues for the unborn child (Brohl, 2016). You can 

help parents and caregivers focus on optimal fetal, 

newborn, and child development by linking families to 

services designed for at-risk expectant families, such as 

home visiting programs. Home visiting programs teach 

caregivers specific parenting skills—techniques for coping 

with a baby’s crying or other behavioral challenges, for 

example—and have been linked with reduced stress 

in the family environment (Garner, 2013). For more 

information, visit Information Gateway’s webpage on child 

maltreatment prevention and home visiting programs 

at https://www.childwelfare.gov/topics/preventing/

prevention-programs/homevisit/homevisitprog/. 

Healthy brain development can be encouraged after birth 

through supportive services such as continued home 

visits and other parent education programs. Information 

Gateway’s website features extensive resources on 

protective factors that professionals can use to strengthen 

families and help prevent trauma, including the following:

 Nurturing and attachment 

 Parental education regarding child and youth 

development

 Parental resilience

 Social connections

 Concrete supports for parents

 Social and emotional competence for children
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The webpage on protective factors, which also includes 

the most current Children’s Bureau resource guide, can 

be accessed at https://www.childwelfare.gov/topics/

preventing/promoting/protectfactors/.

For more information about protective factors, 

refer to Child Welfare Information Gateway’s 

issue brief Protective Factors Approaches in Child 

Welfare at https://www.childwelfare.gov/pubs/

issue-briefs/protective-factors/ and the National 

Child Abuse and Neglect Technical Assistance 

and Strategic Dissemination Center (CANTASD) 

website at http://www.cantasd.org/. CANTASD 

is a service of the Children’s Bureau’s Office on 

Child Abuse and Neglect.

Enhancing Caregiver Interactions and 

Building Relationships

You can help parents and caregivers by talking with 

them about child development, including important 

developmental milestones, how each child has a different 

timetable for reaching those milestones, and how 

quality interaction with the child can enhance his or her 

development. Helping parents and caregivers increase 

their sensitivity and responsiveness to their child’s needs 

can make a tremendous difference in that child’s future 

mental health and well-being. Child welfare professionals 

can help ensure that a child has a positive, enduring 

relationship with at least one important person in his or 

her life. For instance, training relative caregivers or foster 

parents to meet the child’s emotional and behavioral 

needs can help promote healthy bonds that support the 

child’s development. If the child has been placed in outof-home care, you can facilitate quality visits between the 

birth parent and the child. You can also ensure that the 

birth family, resource family, and any other caregivers are 

all receiving the same advice regarding parenting and 

attachment techniques. 

The predictability of a routine gives a child the sense 

that the world is a safe place for exploring, learning, 

and growing. This is important to the developing brain 

because it lowers stress and reinforces a sense of wellbeing. You can help parents and caregivers understand 

the importance of consistency for children and suggest an 

age-appropriate plan. A routine also allows caregivers to 

establish limits for challenging behavior and disciplinary 

strategies, which should be applied consistently and 

fairly. Consistency is very important to the developing 

infant and child, and caregivers should be very clear with 

children if, and when, there will be changes to routines. 

To help strengthen the bond between caregiver and 

child and create safe environments for the families in 

your care, see Gateway’s Parent Education to Strengthen 

Families and Reduce the Risk of Maltreatment at https://

www.childwelfare.gov/pubs/issue-briefs/parented/ and 

the CDC guide, Essentials for Childhood Framework: 

Steps to Create Safe, Stable, Nurturing Relationships and 

Environments for All Children, at http://www.cdc.gov/

ViolencePrevention/childmaltreatment/essentials/index.

html. You can also consult the Triple P Positive Parenting 

Program, an evidence-based program shown to improve 

parent-child interactions, at http://www.ct.gov/triplep/lib/

triplep/pdfs/triplepoverview.pdf.

Supporting Brain Development in Older 

Children

Another critical phase of human brain development 

occurs during adolescence, offering youth the potential 

to recover from earlier trauma and set a new foundation 

for the years ahead (Jim Casey Youth Opportunities 

Initiative, 2011). Positive experiences during this pivotal 

phase can strengthen healthy neural connections and 

promote learning. Child welfare staff, and others working 

with young people, can create opportunities to engage 

in trauma-informed practice and provide supports that 

may help reverse the harmful impacts of prior trauma. 

According to the Jim Casey Youth Opportunities Initiative 

(2011), they can do this in the following ways:

 Develop an understanding of trauma and its impact on 

child and youth development 

 Recognize that youth can be traumatized by systems 

and services designed to help them 
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 Create safe and welcome spaces for young people 

 Share information about trauma, complex trauma, 

ambiguous loss, neuroplasticity, and resilience to 

increase their understanding of the developmental 

needs of older youth 

Trusted adults can provide a needed safety net at this 

vulnerable time and offer youth advice and support 

regarding their growing independence.

You can help the important adults in a preteen’s life 

understand how the brain develops and educate them 

about strategies that will help youth with the following:

 Organizational and goal-setting skills

 Decision-making skills

 Stress management techniques

 Wellness practices (e.g., balanced diet, ample sleep, 

avoidance of risky behaviors)

The Jim Casey Youth Opportunities Initiative 

features comprehensive information on strategies for 

promoting adolescent brain development at http://

www.jimcaseyyouth.org/areas-of-expertise/160/

adolescent-brain-development.

Screening Children for Services and 

Working With Other Providers

It is important for children who have experienced trauma 

to receive screening as soon as possible to check for 

potential developmental delays. Determining whether 

the children and youth in your care require services can 

make a substantial difference in their future health and 

well-being, as early treatment may prevent additional 

developmental delays or deficits and increase the 

likelihood of favorable outcomes (Brohl, 2016; Levitt, 

2014). 

The CDC lists the following as risk factors for 

developmental delays (HHS, 2015):

 Medical factors such as low birthweight, premature or 

multiples birth, or brain damage experienced in utero 

or later

 Genetic factors or maternal or paternal mental health 

issues

 Unhealthy parental behaviors during pregnancy, such 

as drinking or smoking

 Exposure of mother or child to high levels of 

environmental toxins

For a comprehensive list of screening instruments 

to assess a child’s potential developmental delays, 

see Early Childhood Developmental Screening: A 

Compendium of Measures for Children Ages Birth to 

Five at http://www.acf.hhs.gov/sites/default/files/opre/

compendium_2013_508_compliant_final_2_5_2014.

pdf. Information Gateway features extensive resources 

on developmental stages on its website at https://www.

childwelfare.gov/topics/preventing/promoting/parenting/

understanding/. 

Collaborating with multiple providers across varied 

service sectors may help improve outcomes for children 

and youth since no single system can address all the 

issues a child and family may experience. The following 

sections provide a summary of key services for children 

and families affected by trauma.

Early Intervention

Each State has an early intervention program (EIP) that 

provides specialized health, education, and therapeutic 

services to infants and toddlers who have an identified 

developmental delay or disability. EIPs can support 

families in addressing children’s developmental delays 

through parenting training, home visitations, respite 

care, or other supports. When a family is referred to 

an EIP, the EIP service coordinator will work with the 

family to develop an individual family service plan and 

coordinate with the child welfare system to make sure 

the child’s needs are being met. According to the Early 

Childhood Technical Assistance Center (ECTAC), early 

intervention services result in greater developmental 

progress for between 67 and 75 percent of participating 

children across three outcomes—social relationships, the 

use of knowledge and skills, and taking action to meet 

needs—and most children receiving such services leave 

the program functioning within age-level expectations 

(ECTAC, 2016). 
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For more information on early intervention services 

for young children in child welfare, see Addressing the 

Needs of Young Children in Child Welfare: Part C—Early 

Intervention Services at https://www.childwelfare.gov/

pubs/partc/. 

Quality Early Care and Education

Early care and education (ECE) professionals can be 

critical partners in supporting healthy brain development 

and in helping to overcome the effects of an unhealthy 

home environment. Young children often spend a 

substantial amount of time in ECE settings, and ECE 

professionals may be among the first to observe 

signs of developmental delays. ECE programs that 

encourage regular communication with families can help 

professionals to flag developmental concerns, connect 

families to needed services, reduce stress, and improve 

outcomes (National Scientific Council on the Developing 

Child, 2013). Children’s stress responses have been shown 

to return to normal through relationships with supportive 

and responsive caregivers and high-quality early 

education services (Levitt, 2014). 

Many States have instituted a quality rating 

system for ECE. The National Association for the 

Education of Young Children has set 10 standards 

for early childhood programs. To earn accreditation, 

programs must meet all 10 standards. For more 

information, see https://families.naeyc.org/

accredited-article/10-naeyc-program-standards. 

For information about Head Start, the HHS program that 

promotes school readiness for young children from lowincome families, visit http://www.acf.hhs.gov/programs/

ohs.

To learn more about developing responsive relationships 

with ECE providers, visit the ZERO TO THREE website at 

https://www.zerotothree.org/early-learning/child-care.

Schools and Communities

Children whose brain development has been 

compromised by trauma may face significant problems 

in their schools and communities, including absenteeism, 

poor academic performance, and behavioral issues. 

These problems are often compounded when children 

fall behind their peers in school and have difficulty 

making and maintaining social connections. You can reach 

out to school staff regarding the children you serve to 

inform them of each child’s individual needs and to seek 

accommodations to ensure their educational success. 

School officials may benefit in particular from special 

training on the impact of trauma and from guidance on 

how to work with traumatized children and youth. 

The National Child Traumatic Stress Network has 

developed tools and materials to help educators 

understand and respond to the specific needs of 

traumatized children. For more information on the role 

of educators in helping children overcome the effects of 

trauma at different developmental stages, refer to the 

National Child Traumatic Stress Network’s Child Trauma 

Toolkit for Educators at http://www.nctsnet.org/sites/

default/files/assets/pdfs/Child_Trauma_Toolkit_Final.pdf.

Child Welfare and Education 

Collaboration

The Connecticut Department of Children and 

Families was 1 of 10 Children’s Bureau grantees 

chosen to promote collaboration between child 

welfare and education systems in order to increase 

educational stability for children. Connecticut’s 

Waterbury Educational Stability Initiative provided 

training on child traumatic stress to education and 

child welfare stakeholders, including child welfare 

professionals, school counselors, parent liaisons, and 

foster parents. The project also sought to bridge 

the gap between the schools and law enforcement 

by training municipal police officers assigned to the 

schools. The site visit report is available at https://

www.childwelfare.gov/pubpdfs/waterbury.pdf.
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Mental Health

Children and youth affected neurologically by trauma 

may experience a variety of emotional regulation and/

or behavioral challenges that require attention by a 

mental health professional. An assessment by a trained 

professional can help determine if the child or youth 

would be best served by individual or group therapy 

and which type of therapy would be most appropriate. 

When parental or primary caregiver stress and unresolved 

trauma from the parent’s childhood are a factor in parent 

(or caregiver) and child well-being, treatment may be 

necessary for both children and guardians. 

For more information, see the Information Gateway web 

section on working with children, youth, parents, and 

caregivers affected by mental health concerns at https://

www.childwelfare.gov/topics/systemwide/bhw/casework/

families-mh/ and Information Gateway’s Intergenerational 

Patterns of Child Maltreatment: What the Evidence Shows 

at https://www.childwelfare.gov/pubs/issue-briefs/

intergenerational/.

Treatment for Trauma-Affected 

Children and Youth

There are several promising evidence-based intervention 

models for helping to restore social, emotional, and 

cognitive health in infants, children, and youth who have 

experienced developmental deficits from traumatic stress. 

These treatments aim to reduce the harmful effects 

of toxic stress by restoring the balance between the 

emotional and cognitive systems of the brain. Treatment 

may include teaching children how to self-calm and 

regulate emotions; how to process their experience 

through images, thoughts, emotions, and movement 

to engage all parts of the brain and encourage positive 

emotions and initiative; and a family component to 

address communication patterns, conflict, and hierarchy 

(Stien & Kendall, 2004).The type and length of intervention 

will depend on the degree of impairment and the services 

that are available in your area. The following are examples 

of interventions that can help support brain health.

Attachment and Biobehavioral Catchup

Attachment and biobehavioral catchup (ABC) 

interventions are designed for caregivers of infants 

and very young children up to age 2 who have suffered 

from neglect. ABC takes place in the caregiver’s home 

and includes both the caregiver and affected child over 

a 10-session treatment sequence. The sessions are 

designed to instruct the caregiver on how to best nurture 

the child and how routine interactions can optimize the 

child’s healthy development. Studies of ABC interventions 

have shown them to be successful in reducing a child’s 

stress hormones (Dozier & Fisher, 2014), which improves a 

child’s overall well-being.

For more information on ABC therapeutic interventions, 

see the Infant Caregiver Project’s webpage at http://www.

infantcaregiverproject.com/.

Child-Parent Psychotherapy

Child-parent psychotherapy (CPP) is a flexible two-way 

model targeted to young children from infancy through 

age 6 with attachment, behavioral, or mental health 

problems from exposure to maltreatment, domestic 

violence, or other trauma. CPP can be used with birth 

parents, foster parents, or kinship parents and can also be 

adjusted for transitions among caregivers.

Therapy is designed to repair trust in the relationship 

between the child and primary caregiver through 

restoring the child’s sense of safety and building the 

primary caregiver’s sense of competence in parenting 

skills. CPP also considers current socioeconomic 

stressors and cultural values, such as those experienced 

in immigrant families, and it creates an opportunity for 

caregivers to understand their own emotions surrounding 

unresolved losses or traumas from earlier experiences 

(Zindler, Hogan, & Graham, 2010). CPP is conducted in 

weekly sessions with the parent or primary caregiver and 

child over the course of a year. 

For more information on CPP, see the National Child 

Traumatic Stress Network factsheet at http://www.nctsn.

org/sites/default/files/assets/pdfs/cpp_general.pdf.
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New York City Child Welfare 

Program Addresses Trauma

In New York City, the Administration for Children’s 

Services (ACS) launched a program in 2013 that 

offers 11 evidence-based treatment models for 

working with at-risk families, several of which 

are directly aimed at improving the neurological 

outcomes of trauma exposure. The ACS program 

has had substantial success in reducing the 

number of children in care, including a 14 percent 

reduction in teenage foster care placements 

between fiscal years 2013 and 2014 (Metz & 

Collins, 2016).

ACS has also launched a new initiative, Strong 

Families NYC, which includes comprehensive 

trauma screening for children and youth entering 

foster care. Since July 2014, provider agencies 

have completed more than 14,000 screenings 

using the Child and Adolescent Needs and 

Strength – NY tool (https://www.omh.ny.gov/

omhweb/resources/publications/cans/cans_

manual.pdf). This measures a child and his or 

her caregiver in multiple areas, such as trauma 

exposure, school performance, medical concerns, 

and cultural identity, to allow caseworkers to 

identify appropriate interventions.

Parent-Child Interaction Therapy

Parent-child interaction therapy (PCIT) is designed for 

children ages 2–12 and is used to address interpersonal 

trauma and repair the caregiver-child relationship by 

building responsive parenting skills. PCIT takes place 

through the active coaching of primary caregivers during 

caregiver-child play sessions. Coaching takes place in real 

time behind a one-way mirror during a caregiver-child 

play session—with a hearing device in the caregiver’s 

ear—so that coaching is concealed from the child. The 

goal of PCIT is to build responsive parenting skills and a 

secure parent-child relationship based on nurturing care, 

firm control, and effective communication where clear 

limit setting results in consistent discipline and positive 

behavior. 

For more information, visit PCIT International at www.pcit.

org. Also see the Information Gateway issue brief ParentChild Interaction Therapy With At-Risk Families at https://

www.childwelfare.gov/pubs/f-interactbulletin/.

Eye Movement Desensitization and 

Reprocessing

Eye movement desensitization and reprocessing (EMDR) 

is a clinical psychotherapy technique used with all age 

groups—from very young children to adults—where 

the emotional or behavioral problems associated with 

past trauma exposure are alleviated by the active 

“reprocessing” of traumatic memories. This reprocessing 

allows the individual to establish a healthier frame of 

mind. The length of treatment will depend on many 

factors, including whether single-episode or chronic and 

complex trauma exposure is involved. In general, the 

treatment must progress through eight distinct phases 

that incorporate past memories, current triggers, and 

positive responses for the future (Wesselmann & Shapiro, 

2013).

For more information, visit the EMDR Institute website at 

www.emdr.com.

Integrative Treatment of Complex Trauma

Integrative treatment of complex trauma (ITCT) is 

designed for children and youth who have experienced 

complex psychological trauma. These children frequently 

present with parental attachment issues (e.g., parental 

abandonment, multiple foster placements). ITCT 

employs multiple treatment modalities, including 

relational treatment in individual and group therapy 

and cognitive, exposure, and play therapies. There are 

separate programs for children (ITCT-C for ages 8–12) 

and adolescents (ICTC-A for ages 13–21). For more 

information on the children’s version of ICTC, see http://

www.nctsnet.org/nctsn_assets/pdfs/Slides_Lanktree.

pdf. More information on the adolescent version of ITCT 

is available through the University of Southern California 

Adolescent Trauma Training Center at http://keck.usc.

edu/adolescent-trauma-training-center/about-itct-a.
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Trauma-Focused Cognitive Behavioral 

Therapy

Trauma-focused cognitive behavioral therapy (TF-CBT) 

is targeted to children ages 3–18 and their families 

to address significant trauma-induced emotional or 

behavioral difficulties. At its core, CBT is based on the 

premise that individuals’ thoughts, perceptions, and 

attitudes about themselves and others affect their 

interpretation of external events and related emotions 

and behaviors. CBT seeks to inform individuals’ awareness 

of their cognitive distortions and the behavior patterns 

that reinforce such thinking (Chard & Buckley, 2010). 

TF-CBT is a structured child and parent model that 

combines elements of cognitive therapy, behavioral 

therapy, and family therapy to eliminate a child’s negative 

emotional and behavioral responses to trauma and 

provides primary caregivers with the tools to address 

the child’s emotional distress. When possible, TF-CBT 

is conducted with children and primary caregivers in 

separate, parallel sessions.

For more information, refer to the TF-CBT National 

Therapist Certification Program at https://tfcbt.org/

and Information Gateway’s Trauma-Focused Cognitive 

Behavioral Therapy for Children Affected by Sexual Abuse 

or Trauma at https://www.childwelfare.gov/pubs/trauma/.

Trauma Systems Therapy

Trauma systems therapy (TST) is both a clinical and an 

organizational model designed for children and youth 

ages 6 through 19 affected by trauma to coordinate a 

broad-based approach to trauma care. TST enlists the 

family, neighborhood, school, and community in meeting 

a child’s needs and recognizing his or her strengths 

and weaknesses. It relies on a two-pronged approach 

that builds the child’s capacity to self-regulate powerful 

emotions and equips the child’s social environment 

to help the child manage these emotions and protect 

against threats. 

For more information, refer to the National Child 

Traumatic Stress Network’s factsheet on the topic at 

http://www.nctsn.org/sites/default/files/assets/pdfs/

tst_general.pdf. 

Mindfulness Meditation

Mindfulness meditation has shown promise for improving 

mental, behavioral, and physical outcomes in youth 

who have experienced trauma (Ortiz & Sibinga, 2017). 

Mindfulness therapy is similar to CBT and involves 

retraining an individual’s attention on the present 

moment. Brain imaging studies with combat veterans 

demonstrate that mindfulness-based exposure therapy 

can alleviate posttraumatic stress disorder symptoms 

by redirecting attention from disturbing flashbacks to 

a focus on the present (King et al., 2016). Mindfulnessbased meditation practice has also been shown to 

increase attention and working memory in patients with 

mild traumatic brain injury or postconcussion syndrome 

(Jackson, 2014) and to strengthen the brain’s ability to 

control emotions and reduce mood swings and anxiety 

(Wolkin, 2016).

Coping With Trauma

There are several resources for addressing 

the needs of children and youth who have 

experienced trauma, including the following:

 ChildTrauma Academy (http://childtrauma.

org/), a not-for-profit organization dedicated to 

helping high-risk children in therapeutic, child 

protection, and educational settings through 

direct service, research, and education

 National Child Traumatic Stress Network 

(http://www.nctsnet.org), a database of 

empirically supported treatments and 

promising practices for responding to trauma 

and tools for assessing children’s exposure to 

trauma and related mental health issues

See also Information Gateway’s Developing 

a Trauma-Informed Child Welfare System at 

https://www.childwelfare.gov/pubs/issue-briefs/

trauma-informed/.
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This publication is available online at https://www.childwelfare.gov/pubs/braindevtrauma/.

Conclusion

Research demonstrating the brain’s remarkable ability 

to overcome adversity offers promise for neurological 

recovery from child maltreatment with the appropriate 

interventions. Positive attachment relationships are 

essential in helping to heal trauma and buffer its negative 

effects. Building the capacity of birth, foster, kin, and 

adoptive parents to provide responsive caregiving to the 

children in their care (National Scientific Council on the 

Developing Child, 2016)—as well as ensuring access to 

early intervention and trauma-informed practices—can 

help promote healthier brain development and improve 

outcomes for children, youth, and families involved in the 

child welfare system.

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Child Welfare Information Gateway. (2017). Supporting 

brain development in traumatized children and youth. 

Washington, DC: U.S. Department of Health and Human 

Services, Children’s Bureau.