A mother brings her 8-year-old son to the pediatrician after his teacher repeatedly asks her to have him evaluated for ADHD. The trauma-informed pediatrician knows that childhood trauma exposure can resemble hyperactivity associated with ADHD.
The pediatrician asks the mother to privately complete an adverse childhood experiences (ACEs) questionnaire and asks to do one with the son as well. The questionnaire reveals that the son had witnessed his mom being physically abused by her last two boyfriends; and the mom noted that her father was abusive to her and her mother when she was a child.
This is just one story of intergenerational trauma. The groundbreaking study on ACEs showed the impact of childhood trauma on long-range adult outcomes (Felitti et al., 1998). Since that study, evidence has increasingly shown that the effects of trauma can be experienced intergenerationally. For example, a recent study found parents’ ACE exposure was related to their children having worse overall health status, higher odds of asthma and watching excessive amounts of television (Le-Scherban, Wang, & Boyle-Steed, et al., 2018).
Though the “how” is not yet fully understood, the impact may be related to parents using the same parenting behaviors as those practiced by their own parents or the ongoing impact of significant environmental stressors like poverty, unsafe living conditions, or racial inequity across generations.
Trauma-related patterns within families can be interrupted in the presence of nurturing relationships, enriching activities, and a safe environment. Addressing trauma when it occurs in childhood can also help those children develop into more well and resilient parents themselves.
Some things to consider:
- Take a trauma-informed approach with the whole family. When caregivers are stressed or overwhelmed, shift the question from “what is wrong with you?” to “what happened to you?”
- Consider using the 10-item ACEs questionnaire to screen family members for exposure to trauma. The questionnaire, which can be used with almost any population, is helpful in starting a conversation about intergenerational trauma and other adverse experiences. The American Academy of Pediatrics has shared multiple versions of the questionnaire.
- Infuse early intervention and wellness approaches at the family level. Encourage exercise, and teach parenting skills, mindfulness, yoga and self-care—and do so early, before significant challenging behaviors or family discord can develop.
- When needed, use evidence-based treatments for trauma such as Trauma-Focused Cognitive Behavioral Therapy, which can enhance an entire family’s understanding of the effects of trauma on their relationships and behaviors.
- Check out the Centers for Disease Control and SAMHSA for additional resources in addition to the ones on this site.
References:
Felitti, V., J., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the adverse childhood experiences and child health outcomes. Pediatrics; 141(6).
Le-Scherban F., Wang X., Boyle-Steed, K.H., et al. (2018). Intergenerational associations of parent leading causes of death in adults. American Journal of Preventive Medicine, 14, 245-258.
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