In 2022, the World Health Organization estimated that millions of children were mistreated each year around the world. Mistreatment such as neglect and abuse are types of adverse childhood experiences, or ACEs. But they often say little about how children respond, which can either be traumatic or resilient. Now, revolutionary new findings in the sciences help us understand how different dimensions of adversity can leave different signatures of trauma and how we can use this knowledge to help children recover and build resilience against future harms.
Consider Ethan and Kevin (their names are pseudonyms to protect their privacy), two children that I worked with as an educator and researcher of trauma in schools. Ethan was abandoned by his mother at birth and placed in an orphanage in Eastern Europe, his home for the next six years. He was deprived of the fundamental needs of safety, nutrition, and human contact. He had books, but there was no one to read to him. He had caretakers, but they rarely comforted him when he was upset.
Kevin, on the other hand, witnessed his father physically and emotionally abusing his mother for the first ten years of his life. Around his sixth birthday, Kevin directly experienced his father’s abuse. For entertainment, and to teach him that life is tough, Dad put Kevin and his older sister Joani into the outdoor dog cage, threw food in, and forced them to compete for their nightly dinner. If they refused, he beat them until they entered the dinner arena.
Ethan and Kevin were both traumatized by their mistreatment, but that doesn’t capture what was happening inside of them. Ethan had no motivation, was numb to rewards, struggled with school and couldn’t maintain social relationships. Kevin was an emotional maelstrom, frightened, hypervigilant, running away from unfamiliar men and hurting himself when he heard noises. Ethan and Kevin presented different traumatic responses or “signatures”—unique identifiers of the mental distortions created by their adverse experiences. Identifying these traumatic signatures enables caretakers, teachers, doctors, and counselors to sculpt a path to resilience that is specific to the child’s harms and needs and gives them the best hope for recovery, whether in childhood or later in life.
The idea of traumatic signatures is only a few years old, but the scientific evidence leading to it is not. We have known for decades that different environmental experiences influence development, including how and when our emotions, thoughts, and actions mature. When the environment is harsh and unpredictable, threatening survival, the timing of development tends to speed up, leading to individuals who mature quickly—recognizing and responding appropriately to danger as youngsters. In contrast, when the environment is impoverished, with individuals deprived of essential experiences and resources, development tends to slow down, resulting in delays in the attainment of independence, dedicated social roles, and sexual behavior.
Ethan and Kevin, like millions of other children, experienced two of the core types of adversity — deprivation and abuse, respectively — during different periods of development. These differences in experience shaped their traumatic signatures.
Deprivation is typified by a delay in the development of the brain’s executive functions—attention, short-term working memory, self-regulation, and planning. The executive functions form the bedrock to all learning and decision-making, but they are also essential in supporting more specialized cognitive functions such as language, social thinking, math, music, and morality. Children with weak executive functions struggle in school, and are socially and physically unhealthy. Such was Ethan’s traumatic response.
Abuse is characterized by warp speed development of a nervous system that detects threats, accompanied by hypervigilance, emotional turbulence, and out of control behavior. The root cause is a hyperactive amygdala, a brain region that plays an essential role in emotional processing, and its connection to a frontal lobe region that controls our feelings, thoughts, and actions. This constellation of changes to the nervous system leaves the child in a heightened state of fear, either fleeing or fighting to cope with an unpredictable environment. Such was Kevin’s traumatic response.
The signatures penned by these types of adversity are further modified by their timing. In studies of orphans living in austere, institutionalized settings — such as the orphanage that Ethan grew up in—those deprived of essential experiences for more than the first few years of life showed deficits in executive functioning, social relationships, and attachment. In contrast, orphans who were placed in foster care by their second birthday, largely recovered from their deprivation in the years that followed. Children who are abused earlier, typically before puberty—such as Kevin—show greater emotional dysregulation, weaker control over their thoughts and actions, and more rapid biological aging.
Different types of adversity, including different combinations, pen different signatures. But ultimately, they also define how we help children recover and sculpt their resilience. Each child’s genetic architecture positions them somewhere on a spectrum of responses to adversity that runs from vulnerable to resilient. Those who land on the resilient end are handed greater immunity to adversity because of stronger regulatory systems that tamp down emotions and maintain focused attention. Those who land on the vulnerable end are handed greater sensitivity to adversity, dominated by emotional turbulence and inflamed autoimmune systems that overreact. Environmental experiences can displace individuals onto different sections of this spectrum, either enhancing their resilience or magnifying their vulnerability.
At age six, Ethan’s tenure of deprivation ended and a rich life of loving care started with Julie, his adoring adoptive mother. At age 10, Kevin’s father was incarcerated and his parents divorced, thereby ending his tenure of exposure to abuse and starting a more promising life with his mother Kate who desperately tried to provide for him despite her own struggles with mental health. Ethan and Kevin were both on Individualized Education Plans (IEPs) that documented their disabilities and guided the work carried out in their schools. Both of their schools were trauma-informed, meaning that they adhered to the four Rs: realizing that traumatic experiences are common, recognizing that traumatic experiences are associated with specific symptoms or signatures, responding to a child’s trauma by integrating knowledge of what happened with what can be done to help, and resisting re-traumatizing both students and staff. Both schools were also aware of Ethan’s and Kevin’s life experiences and recognized that they would require different approaches for aiding recovery and building resilience.
Ethan, like other children who have been deprived of essential experiences in the early years of their lives, required an approach that reassured him of receiving unwavering, predictable care while providing strategies to enhance his ability to learn and develop healthy relationships. His care included access to a visual schedule that showed the timing of activities, including when meals and snacks were provided. Predictable access to meals and snacks, both at home and in school, rapidly helped reduce his obsession and hoarding of food. The unwavering support provided by Julie as well as the school staff, eventually melted away Ethan’s distrust of others, enabling healthy relationships to grow. The visual schedule helped reduce the load on his short- term working memory, while helping him prepare and plan for transitions between activities. Stubbornly resistant to change, however, was Ethan’s capacity to associate or link actions with consequences. For Ethan, as for other children who have been severely deprived of experiences early in life, associative learning was heavily compromised, awaiting the addition of new tools to the trauma-informed toolkit.
Kevin’s signature of abuse was initially treated by a psychiatrist with Tenex—a medication for aggression, impulsivity, and hyperactivity—along with cognitive behavioral therapy techniques to help him manage his emotions and control impulses. Kate also worked tirelessly with Kevin to build a sense of safety and predictability at home.
