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Review
. 2023 Dec;70(6):1183-1200.
doi: 10.1016/j.pcl.2023.06.010. Epub 2023 Aug 12.

Violence Exposure and Trauma-Informed Care

Michael Arenson  1 , Heather Forkey  2
Affiliations
Review

Violence Exposure and Trauma-Informed Care

Michael Arenson et al. Pediatr Clin North Am. 2023 Dec.

Abstract

Addressing violence in pediatrics requires a working knowledge of trauma-informed care (TIC). TIC weaves together our current understanding of evolution, child development, and human physiology and how these explain common childhood responses to traumatic events. In this article, we describe our current approach to treating childhood trauma in the context of violence. Ultimately, TIC relies on the pediatrician's ability to keep trauma high on their differential diagnosis. TIC leverages a child's natural strengths and biologic processes by (1) scaffolding the patient's relationships to safe, stable, and nurturing adults and (2) strengthening core resilience skills while addressing trauma symptoms when necessary.

Keywords: Adverse childhood experiences; Child development; Human stress response; Positive childhood experiences; Relational health; Toxic stress; Trauma-informed care.

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Figures

Fig. 1.
Fig. 1.
The 4 major behavioral responses to a threat. (Adapted from Garner AS, Saul RA. Defining adversity and toxic stress. In: Thinking Developmentally: Nurturing Wellness in Childhood to Promote Lifelong Health. American Academy of Pediatrics. 2018:13–24; with permission.)
See this image and copyright information in PMC

References

    1. Harvard Center for Developing Child. Three Early Childhood Development Principles to Improve Child Outcomes. https://developingchild.harvard.edu/resources/three-early-childhood-deve.... Accessed March 6, 2023.
    1. Taylor SE. Tend and Befriend: Biobehavioral Bases of Affiliation Under Stress. Curr Dir Psychol Sci 2006;15(6):273–7.
    1. Garner AS. Thinking Developmentally: Nurturing Wellness in Childhood to Promote Lifelong Health. 10.1542/9781610021531. - DOI
    1. Tronick E, Beeghly M. Infants’ meaning-making and the development of mental health problems. Am Psychol 2011;66(2):107–19. - PMC - PubMed
    1. Shonkoff JP, Garner AS. Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption and DC, Section on Developmental and Behavioral Pediatrics. The lifelong effects of early childhood adversity and toxic stress. Pediatrics 2012;129(1):e232–46. - PubMed

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