Health

Understanding Developmental Trauma

Every child comes into adoption with their own unique story.

For some children, early experiences may have included loss, uncertainty, neglect or trauma. These experiences can shape how a child feels, learns, behaves and builds relationships. Understanding the difference between developmental trauma and mental health difficulties can help parents respond with greater confidence, compassion and hope.

Developmental trauma describes ongoing stress or disruption during the earliest stages of life, including before birth, that affects healthy development. It can happen when a child has not consistently experienced safety, comfort and nurturing relationships – the very experiences that help an infant feel secure.

A child’s developing brain is highly sensitive to its environment. When early life feels frightening or unpredictable, the brain adapts for survival. These adaptations can influence:

• how safe a child feels in the world
• how they respond to stress or threat
• how they trust other people
• how they process emotions
• how they pay attention and learn
• how their sensory system develops

A child who has experienced developmental trauma may sometimes appear:

• controlling
• withdrawn
• angry
• unusually independent
• emotionally younger than their age

These behaviours are often not “bad behaviour.” They are understandable ways a child has learned to protect themselves in a world that has not always felt safe.

At the heart of understanding developmental trauma is the knowledge that the positive relationships a child builds are the key to recovery.

Looking Beneath Behaviour

Children often communicate through behaviour long before they can explain their feelings in words.

Sometimes a child may consciously know they are safe, but their body and emotions still react as though danger is present. Behaviour can reflect fear, stress or unmet developmental needs rather than deliberate defiance.

Instead of asking:

“What is wrong with this child?”

it can be more helpful to ask:

“What has happened to this child?”
and
“How can I help them feel safe enough to heal?”

When adults respond with curiosity rather than correction, children can begin to build trust and develop new ways of coping.

Children who have experienced developmental trauma can be at greater risk of mental health difficulties. However, developmental trauma is different because healing usually happens through long-term safe relationships, not short-term interventions.

While some children may need specialist mental health services, many benefit most from adults around them who can:

• validate their feelings
• provide safety
• remain calm and predictable
• help them make sense of their experiences

Children need support with regulation and relationships before they can successfully use reasoning skills. Many traditional parenting approaches focus first on reasoning, but children affected by trauma often need a different sequence – it may be helpful to look at the Neurosequential Model and the BUSS Model when considering this, and referring back to the notes on Therapeutic Parenting.

Therapeutic Parenting Hope for the Future

• Children can recover from early trauma.
• With safe relationships, consistent care and developmentally informed support, children can build resilience, connection and a stronger sense of belonging.
• Healing takes time, but change is possible.

A Key Message for Parents

You do not need to have all the answers.

The most powerful foundation for healing is a relationship that is:

• safe
• consistent
• nurturing

Because for many children:

Connection comes before correction, and safety comes before learning.

Mental health refers to a child’s emotional well-being; how they think, feel and manage everyday life.

Some children may experience difficulties such as:

• anxiety
• low mood
• sleep difficulties
• persistent worries or fears

Children who have experienced developmental trauma can be at greater risk of mental health difficulties. However, developmental trauma is different because healing usually happens through long-term safe relationships, not short-term intervention.

While some children may need specialist mental health services, many benefit most from adults around them who can:

• validate their feelings
• provide safety
• remain calm and predictable
• help them make sense of their experiences

If you think your child would benefit from further mental health support, the best first point of contact is your family GP, who may refer you to the Local CAMHS Teams

Child and Adolescent Mental Health Services (CAMHS) is an NHS service that supports children and young people under the age of 18. In some areas, this service is referred to as CYPS.

CAMHS Teams offer support for children or young people struggling with moderate to severe emotional, behavioural and mental health difficulties.

These difficulties may include:

• disordered eating
• low mood or depression
• feelings of worry or anxiety
• hearing voices or seeing things
• self-harm and/or suicidal thoughts
• experience of trauma or abuse
• emotional and behavioural difficulties

BATHNES CAMHS

Bristol, North Somerset and South Gloucestershire CAMHS

There are five locality CAMHS teams based across Bristol, North Somerset and South Gloucestershire. You will see the team that is affiliated to your GP surgery.  For children under five years of age, please visit the Primary Infant Mental Health Specialists (PIMHS) page for further advice.

Gloucestershire CAMHS

Wiltshire CAMHS

Further Mental Health Support

Online support and counselling (available universally)

Youth Wellbeing Directory
Lists local services where you can find support for young people’s mental health and wellbeing.
Webpage: https://www.annafreud.org/on-my-mind/youth-wellbeing/

The Mix:  https://www.sane.org.uk/who-we-are 

Tellmi (formerly MeeToo) Age Range: 11+  https://www.tellmi.help/ 

Calm Mindfulness and meditation for older adolescents and young adults  https://www.calm.com/

Kooth: https://www.kooth.com/

Samaritans: Call 116 123 https://www.samaritans.org/about-samaritans/

Childline: Call free on 0800 1111 https://www.childline.org.uk/

Shout: 24/7 text service, free on all major mobile networks, for anyone in crisis, anytime, anywhere. It’s a place to go if you’re struggling to cope and need immediate help. Text 85258. https://giveusashout.org/

Only available in mainland UK

Mental health for people aged over 18 years

If you are still receiving support from the Child and Adolescent Mental Health Services (CAHMS), you will need to transition to adult mental health care. Mind has set out some guidance on how this works.

You can also get support from Health in Mind.

Foetal Alcohol Spectrum Disorder (FASD) and Adoption

What Is FASD?

Foetal Alcohol Spectrum Disorder (FASD) is a lifelong condition caused by prenatal alcohol exposure (PAE). This can occur at any point during pregnancy—even before a pregnancy is confirmed. Alcohol is a teratogen (a substance that can interfere with the development of a fetus), meaning it can cause lasting harm to the unborn child at any stage of pregnancy.

Important: There is no known safe amount or time to drink alcohol during pregnancy. The UK Chief Medical Officer advises that people who are pregnant or planning to become pregnant should avoid alcohol completely.

How Common Is FASD?

In the UK, around 3.2% of babies are estimated to be born with FASD. This is three to four times more common than autism.

However, certain populations—especially children in the care-experienced and adoption communities—are more significantly affected. A study in Peterborough (Gregory et al., 2015) found that 75% of children referred for an adoption medical had been exposed to alcohol in the womb.

Do People With FASD Look Different?

FASD is often called a “hidden disability” because it’s not always visible. Only about 10% of individuals with FASD show physical traits associated with the condition, which may include:

• A thin upper lip

• A smooth philtrum (the groove between the nose and upper lip)

• Narrow eye openings

Because these physical features are rare, many individuals and their families face challenges in getting the condition properly recognised by professionals.

Common Symptoms and Characteristics

People with FASD often experience a range of challenges, which may vary from person to person. Common characteristics include:

• Impulsivity

• Cognitive difficulties

• Memory challenges

• Sensory processing issues

• Motor skill delays

• Executive functioning problems

• Difficulty with social interactions

• Emotional dysregulation

These can present as developmental dysmaturity, inconsistent performance, or “spiky profiles” of ability; where a child may appear to have mastered a skill one day and struggle with it the next.

Useful Resources and Publications

Here are some sites to learn more about FASD:

• National FASD – Publications & Preferred Language Guide

• Me & My FASD – Youth-friendly site with comics, games & resources

• FASD Hub – Support, resources & updates via Adoption UK

ADHD and Autism in Children and Young People

Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder are both neurodevelopmental conditions that can be seen more frequently in adopted children and young people than in the wider population. This may reflect a combination of genetic factors, prenatal influences and early life experiences. While they are separate conditions, some children may show features of both, and there can sometimes be overlap in how difficulties appear.

ADHD

ADHD mainly affects a child’s ability to regulate attention, activity levels and impulses.

A child with ADHD may:

• find it hard to concentrate or stay focused
• seem constantly on the go
• act before thinking
• struggle to wait
• become easily distracted
• find routines difficult to maintain

In adopted children, these difficulties can sometimes be harder to recognise because early trauma or chronic stress may also affect attention, behaviour and emotional regulation. The difference is that ADHD is primarily linked to how the brain develops and manages self-control, rather than being solely a response to past experiences.

Autism

Autism affects how a child experiences communication, relationships and the world around them.

A child who is autistic may:

• find social communication difficult
• prefer predictability and routine
• experience sensory sensitivities
• develop very focused interests
• find change overwhelming
• communicate emotions in different ways

For some adopted children, autistic traits can be misunderstood because trauma can also affect trust, communication and emotional expression. This means autism may sometimes be overlooked, or trauma-related difficulties may be mistaken for autism.

Where They Can Overlap

Although ADHD and autism are different, some children may experience both. Areas of overlap can include:

• difficulties with emotional regulation
• sensory sensitivities
• social challenges
• sleep difficulties
• struggles in school

Because trauma can also affect these same areas, it can take time to understand what is causing a child’s difficulties. A careful assessment that considers the child’s full developmental history is often important.

Understanding the Difference

The key difference is often the underlying cause:

• ADHD primarily affects attention, impulsivity and activity levels
• Autism primarily affects communication, social understanding and sensory processing
• Trauma often reflects a child’s adaptations to feeling unsafe

Sometimes these experiences can exist alongside one another, which is why each child needs to be understood as an individual.

Supporting Children Well

Whether a child has ADHD, autism, or both, the most helpful support usually includes:

• understanding the child’s individual needs
• creating predictable routines
• reducing stress where possible
• working closely with school
• offering calm, consistent relationships

Early understanding can make a significant difference in helping children feel safe, understood and able to thrive.

For more information about symptoms and routes to diagnosis, the NHS website can be a helpful starting point, alongside organisations such as the National Autistic Society and ADHD UK.

Supporting Parents’ Wellbeing

Parenting always comes with ups and downs, but parenting a child who has experienced trauma or neglect can bring unique emotional challenges.

Children affected by trauma may struggle with anxiety, emotional regulation, and forming secure attachments. As a parent, this can be exhausting and isolating. You might feel overwhelmed, rejected, or even experience secondary trauma. It’s easy to lose sight of the joys of parenting when you’re in survival mode.

Breaking the Cycle: Self-Care for Parents

To best care for a child, you must also care for yourself. Taking time to rest, connect, and recharge helps reduce stress, process emotions, and rebuild your resilience. It also gives you the emotional space to respond more calmly and compassionately to your child’s needs.

Remember: You don’t have to do this alone. Building your support network is just as important as supporting your child.

Fundamentals of Self-Care

• Keep connected with your people
  Spend time with friends and family who lift you and make you feel safe.

• Find your tribe

• Remember ITAV is available to all our adopters (and prospective adopters at Stage Two), ITAV is an organisation run by adopters for adopters, offering support and connections.

  Join a support group with other adopters or foster carers. The National Association of Therapeutic Parents is a great place to start.

• Health for the body – exercise
  Regular exercise helps burn off stress hormones and boost your mood.

• Health for the mind
  As hard as it can be, try to build in some quiet space, even five or ten minutes a day. Try journaling,  yoga, meditation, or mindfulness to slow down and reflect.

You’re Not Alone

Parenting a traumatised child is a powerful act of love, but it doesn’t have to come at the cost of your wellbeing. Prioritising your health and happiness is not selfish, it’s essential.

Understanding Blocked Care

When a child’s behaviours are consistently challenging or rejecting, parents can begin to feel emotionally shut down, which is known as Blocked Care. It’s a natural, neurological response to chronic stress, where a parent’s ability to feel empathy and connection becomes blunted. This doesn’t mean you don’t love your child, it means your nervous system is trying to protect you. The good news is that with the right support, self-compassion, and therapeutic strategies, blocked care can be reversed. Recognising the signs early is a vital step toward rebuilding connection and restoring joy in your relationship.

If you feel that you are in Blocked Care, please get in touch with our Support Helpdesk.

Read more about Blocked Care in Adoption Here