Expert: The Experience of the Pandemic May Have a Compounding Effect on Children With Complex Development Trauma

Contemporary Clinic® interviewed Bethany Hall, MSN, the owner of Healing Connection, on the role nurse practitioners have in understanding and approaching care for children with complex developmental trauma (CDT).

In this discussion, Hall explains how the COVID-19 pandemic has impact the occurrence of CDT among children during quarantine, and the need for greater awareness of this issue in light of the potential increase in need for care in this area.

Alana Hippensteele: Do you think the COVID-19 pandemic has affected the occurrence of CDT or the need for greater attention to this issue?

Bethany Hall: So, I think we're all going through acute trauma, and something I talk a lot about with my colleagues and with my patients is this idea of the window of tolerance.

So, imagine on the table in front of you, you have 3 glasses of water. One glass of water is just barely full, another one is about halfway full, and the next one is full almost to the tippy top. So, if I shake that table in front of you, very different things are going to happen to each glass. The one with very little water probably will spill nothing, the one with the middle amount of water may spill a little bit, but likely would still contain most of that water. The cup that's full almost to the tippy top when you shake that table, water is going to go everywhere. So, the proverbial water is going everywhere right now.

These kids that have a small window of tolerance that already, because of the way their brains and their bodies have been affected by trauma, a new onset of acute trauma really just causes them to react in a much larger way on a much grander scale than a person that did not undergo significant childhood trauma.

So, 100%, yes. I think the acute impact on chronic trauma is a real issue. Then we've seen in cities—like where you're based in Philadelphia—some of these very large cities went to all virtual, so then you have all these children in already poverty-stricken areas who have parents with low resources, many of them who've also experienced trauma that are now stuck in a home 24/7 with very little resources.

So, if you think even just about the effect on the parents’ ability to parent, you have parents who already have a small window of tolerance who may have experienced abuse and neglect in their own lives that now are under an extreme amount of stress. So, I believe that we already have some data, but I believe we will see even more that childhood abuse and neglect go up significantly because of these parents’ inability to have the resources that they need, to have the break that they need, the mental health care and self-care that they need to parent well.

But also, we do see the compounded effect on children that already have a small window of tolerance. This acute trauma on them is also really wreaking havoc, and it's really imperative during this time that we understand how to increase their resiliency, increase their window of tolerance, increase the abilities that we're giving to these parents as far as tools to help promote mental flexibility, resilience, all of those things.

Again, I think, in the future, we're going to, as they say, reap the whirlwind in these coming years as these children grow into adulthood if we are not making a concerted effort to help them process traumatic events so that they do not become traumatic and cause a negative impact on that child.