An overview of childhood traumatic exposures and their impact for health care providers - child and adolescent psychiatrists, general psychiatrists, other pediatric behavioral health providers and primary care clinicians - is presented. Most clinicians are unaware that children in the United States are exposed to trauma frequently, either as a single occurrence, or through repeated events. These exposures result in neurobiological, developmental and clinical sequelae that can undermine children's health and well-being. This issue describes the multiple types of traumatic exposures and their sequelae, methods of screening and assessment, and principles of effective prevention and clinical treatment. The volume highlights areas of particular relevance to children, such as natural disasters, war, domestic violence, school and community violence, sexual victimization, and complex trauma. Each is differentiated as a unique trauma, requiring trauma-informed systems of care to effectively meet the needs of the exposed population. Since traumatic exposure results in added risk to child well-being, the third section of the volume describes strategies for primary prevention (e.g. violence prevention) and risk mitigation (e.g. skill and resilience building strategies), as well as reviews evidence based treatments for trauma-induced clinical disorders.
By Stephen J Cozza , MD, Uniformed Services University of the Health Sciences