Developmental Trauma in Children and Young People: Understanding the Impact of Early Experience

The word trauma is now used frequently when talking about children’s and young people’s mental health, but it can mean quite different things. Trauma is not simply another word for something upsetting, nor can we decide whether an experience was traumatic by looking only at what happened.

At its heart, trauma involves an experience that overwhelms our capacity to manage what is happening to us. This can involve too much: fear, violence, unpredictability or intrusion. But trauma can also involve a lack of something that was needed. For a developing child, the absence of safety, attention, affection, protection or emotional responsiveness can be as significant as something frightening that happened.

Trauma is a subjective response. What is traumatic for one person may not be traumatic for another. Imagine one hundred soldiers returning from the same war. Although they may have been exposed to similar events, their responses will not be the same. Some may suffer lasting effects of trauma while others do not. This is not a question of one person being stronger or weaker. We each encounter experience through our own history, relationships and ways of making sense of the world.

For children, this individual response is developing at the same time as the mind and body themselves are developing.

What is developmental trauma?

Sometimes trauma follows a single overwhelming event, such as a serious car accident or assault. This is sometimes described as acute trauma or single-incident trauma.

Developmental trauma is different. It describes the impact that repeated or prolonged traumatic experiences can have when they occur during a child’s development, often over months or years. This may involve abuse or neglect, living with violence, frightening or unpredictable care, repeated separations, or growing up without a reliable sense of physical and emotional safety.

Developmental trauma is not, in itself, a formal psychiatric diagnosis. It is a descriptive term that helps us think about the complex mental health and developmental difficulties that can emerge when traumatic experience becomes entangled with the process of growing up.

This distinction matters. An adult involved in a car accident may experience something terrifying that interrupts an established sense of themselves and the world. When trauma begins in infancy or early childhood, that sense of safety may not yet have had the opportunity to develop. The child is not returning to an earlier experience of security because their development has been taking place within an environment where security itself has been uncertain.

Early relationships and the developing mind

A baby is dependent upon other people not only for physical survival but also for the beginnings of emotional regulation. Hunger, fear, discomfort and distress cannot initially be understood or managed alone. Through being fed, held, comforted and responded to, difficult states become more manageable. Over time, something that originally had to be provided through a relationship can gradually become an internal capacity.

When early care is neglectful, frightening, intrusive or unpredictable, this process can be disrupted. The developing child has to adapt to an environment that does not reliably help them manage what they are experiencing.

Early experience also takes place during a period of rapid brain development. Research into early adversity has shown that prolonged exposure to stress can influence developing systems involved in emotional regulation, attention and responses to threat. The first months and years of life are important because development is occurring quickly and because the infant has so little ability to change their own circumstances.

This should not be understood to mean that early trauma permanently “damages the brain” or fixes a child’s future. Development continues, the brain remains capable of change, and later relationships matter. Early experiences can leave a developmental imprint without becoming a destiny.

When survival strategies outlive the danger

A child growing up in frightening or unpredictable circumstances has to find ways of living within them. What later appears to be a difficulty may have begun as a solution.

Being alert to small changes in another person’s mood may be useful when an adult can become frightening without warning. Avoiding dependence can offer protection when people cannot be relied upon. Keeping feelings hidden can make sense when expressing distress brings no comfort or makes a situation worse. Taking control can feel safer than waiting to discover what somebody else will do.

These ways of coping do not automatically disappear when circumstances change. The child will continue to anticipate danger even when the immediate threat has passed. An adult who offers help can still be difficult to trust. An ordinary disagreement can carry the expectation of rejection or abandonment. Closeness can be wanted and feared at the same time.This is one of the difficulties at the heart of developmental trauma. A way of relating that once helped a child survive can later make relationships harder to manage.

Trauma, helplessness and control

An important part of traumatic experience is the loss of control.

For a small child this can be stark. They have little control over whether they are fed, comforted, touched, left alone, shouted at, protected or frightened. They cannot leave an unsafe home or choose another adult to care for them. When experiences of helplessness are repeated, finding ways to regain control can become important.

This can help us understand behaviour that otherwise looks simply oppositional. Refusing food, school, help or an adult’s request may sometimes provide something that has been missing: the experience of deciding what happens to me. Withdrawal and shutting down can serve a similar purpose by making the person less reachable when interaction itself feels threatening.

Refusal has many possible meanings and should never automatically be interpreted as evidence of trauma. But when trauma is part of a child’s history, the need to retain control deserves thought.

This helps explain why increasing pressure can make matters worse. If an adult responds to refusal by becoming more forceful, the child may experience the situation not as reassurance but as another encounter in which somebody else has control over them.

Understanding this does not mean abandoning boundaries or expectations. It means recognising that behaviour has meaning, and that responding effectively may depend upon understanding what the behaviour is protecting the child from.

Why difficulties can become visible at school

School places complex demands upon children. It involves separation from home, relationships with adults and peers, expectations, rules, transitions, uncertainty, learning, frustration and a degree of dependence upon people the child has not chosen.

For a child whose early relationships have made other people difficult to trust, school can bring many of these difficulties together in one place.

A correction from a teacher can carry meanings that go far beyond what was intended. A change of classroom can disturb a fragile sense of predictability. Attention that should be available for learning may instead be occupied with monitoring what is happening around them. Friendship can bring the wish to belong into contact with fears of rejection, humiliation or abandonment.

Behaviour that appears disruptive, avoidant or puzzling can begin to make more sense when considered in this context. School refusal, difficulties concentrating, emotional outbursts, withdrawal and problems with relationships may be expressions of distress rather than separate problems to be solved one by one.

The behaviour we see is often only the visible part of a more complicated internal experience.

Developmental trauma, ADHD and autism

The relationship between developmental trauma, autism and ADHD requires care because there can be overlap in the difficulties we observe.

Attention, emotional regulation, sleep, sensory experience, relationships and responses to change can all be affected by trauma. Difficulties in these areas can also be associated with ADHD or autism. Looking only at the visible symptom can therefore be misleading.

A child who appears unable to concentrate may be struggling with attention in the context of ADHD, but attention can also be disrupted by an expectation of danger. If part of the mind is continually monitoring the environment, there is less attention available for a maths lesson. Equally, distress caused by sensory overload, uncertainty or social demands in an autistic child should not automatically be interpreted through the language of trauma.

These explanations are not mutually exclusive. An autistic child or a child with ADHD can also have experienced trauma. Diagnosis therefore needs to sit alongside a careful understanding of developmental history, relationships and the circumstances in which difficulties arise.

The question is not always “Which condition explains this behaviour?” It can be more useful to ask “What is happening for this particular young person, and how did we arrive here?”

Adolescence and young adulthood

Developmental trauma does not necessarily disappear when childhood ends. Adolescence and young adulthood bring changes that can expose earlier difficulties in new forms.

Becoming more independent requires a young person to negotiate separation and dependence. Friendships become more complicated and intimate relationships begin to carry greater emotional weight. Questions of identity, sexuality, work, university and leaving home can place pressure on an existing sense of self.

Earlier expectations about relationships can become especially important during this period. The wish to be close to another person may exist alongside a fear of what closeness makes possible. Dependence can feel dangerous. Rejection can feel catastrophic. A young person may find themselves repeating patterns they understand intellectually but cannot simply decide to stop.

Seen only in the present, these patterns can appear confusing or self-defeating. Understanding how they developed can change the question from “Why do you keep doing this?” to “Why has this become necessary?”

Psychoanalytic psychotherapy and developmental trauma

Psychoanalytic psychotherapy has a long history of working with children and young people who have experienced trauma, neglect and complex early relationships. Child and adolescent psychotherapists undertake extensive specialist training in emotional development, unconscious processes, relationships and the ways early experience can continue to shape a person’s present life. This expertise has an established place within CAMHS and specialist NHS services working with children and young people with complex mental health needs.

The aim of psychotherapy is not simply to remove troublesome behaviour.

Symptoms matter, especially when they interfere with education, relationships or everyday life. But stopping a symptom does not necessarily address why it developed. If a behaviour has an important psychological function, suppressing it may leave the underlying difficulty unchanged. Psychoanalytic psychotherapy therefore tries to understand why this particular response has developed in this particular young person. What does it protect them from? What happens when they feel dependent upon another person? What does anger mean within their relationships? What happens when they experience rejection, uncertainty or a loss of control?

With children, this work may take place through play and behaviour as well as words. With adolescents and young adults, it may involve thinking together about relationships, feelings, recurring situations and aspects of experience that have previously been difficult to put into words.

A relationship in which something different can happen

This is important because developmental trauma so often has its roots in relationships.

A young person does not leave their expectations about other people at the consulting-room door. If experience has taught them that adults disappear, cannot be trusted, become intrusive or reject them when things become difficult, there is every reason to expect some of these fears to emerge within psychotherapy too.

Psychoanalytic psychotherapy does not regard this as an obstacle to treatment. The therapeutic relationship becomes one of the places where these expectations can gradually be understood.

A consistent relationship with a psychotherapist can make it possible for experiences that previously had to be avoided, controlled or acted out to become thinkable. Feelings can begin to acquire words. Reactions that once seemed inexplicable can be connected with experience. The distinction between what happened then and what is happening now can become clearer.

The aim is not to erase the past. It is to reduce the extent to which the past has to keep organising the present. This is what is meant by seeking long-lasting change rather than simply symptom control. The work is concerned with a young person’s capacity to understand themselves, tolerate emotional experience and enter relationships without relying so heavily upon ways of surviving that may no longer be necessary.

Trauma does not have to define the future

Developmental trauma can shape a child’s development, but it should not become another fixed identity through which everything about them is understood. Children and young people continue to develop. New relationships can matter. Families can change. A school can become safer and more understanding. Experiences that could not be understood at one point in life may become possible to think about later. Nor should every difficulty be explained through trauma. The same behaviour can have very different meanings in different children. Understanding developmental trauma requires us to remain curious about the individual rather than fitting them into another category.

For parents and professionals, one of the most useful shifts may be from asking only “How do we stop this behaviour?” towards asking “What might this behaviour be doing for this young person, and why might they have needed it?”

That question does not offer an instant solution. It does something more important: it allows us to begin with the child rather than the symptom.

Developmental trauma in children and young people:

Written by Ben French BSc, C-Psych, C-Obs, MA Psych. Ben French is a Child and Adolescent Psychotherapist and Psychoanalyst working with children, teenagers and young adults aged 2 to 25. He has over 15 years’ experience supporting young people’s mental health, including senior roles in CAMHS and education.