Trauma & Children with LDs - #2 How to Help

About this episode

BLOG PODS #43 - Trauma & Children with Learning Disabilities - #2 How to Help

INTRODUCTION

Working with troubled kids has all kinds of complexities attached to it - none more so than when the child has a learning disability. Over the years I’ve come across this a lot but it still amazes me how complex it can be, especially when layered up with other factors - like trauma.

In the last post we looked a bit at how kids with LDs can be effected by trauma and some of the differences to bear in mind if we’re going to avoid applying the same approaches we might use for normally developing children.

In this post, we’ll look at how we can approach our work of supporting traumatised kids with LDs and some practical ways we can orientate our practice to try and optimise our impact.

Given the breadth of the subject, what follows is necessarily cursory, but please contribute your own thoughts by leaving a comment.

How to Support Traumatised Children with Learning Disabilities

The issues facing kids with LDs, who also endure trauma, are legion and so are the challenges for those trying to help.

Given the summary ideas listed in the previous post, here are a few thoughts on how we might approach our work in supporting these kids in a way that takes account of all this (as always, this is very much a list of things that strike me as I write and is therefore far from exhaustive).

4 things to get us started…

1. Understand this Child’s Unique Needs

Every child with LDs has a unique combination of strengths and challenges. So, practitioners should:

Understand the child’s specific LDs and how it might be affecting their ability to process trauma.

Speaking with parents, carers, educationalists and other colleagues who know the child well can really help here.

Focusing on the child’s functioning before the trauma (if possible) can help us highlight the before/after affects of what happened.

Observe how the child expresses stress or fear, negative moods, disappointments, how they regulate affect, etc. as this may differ from typical trauma responses.

Remember, nothing is perfectly generalisable; every child is different-before the trauma-so, equally, every child’s post-traumatic presentation is layered on top of that distinctiveness, and is therefore unique in itself.

2. Use Trauma-Informed Practices

Trauma-informed care ensures that children feel safe, understood and supported.

Key principles include:

- Developmental focus: Taking account of how old the child is is important; how mature they are even more so. Make sure to distinguish between the two; in the intervention planning phase, maturity is the thing that matters most.

- Safety: Create predictable routines, boundaries and environments to help children feel secure. Your own consistency of presentation and approach is central to this - keep change to a minimum and you’re well on your way!

- Trustworthiness: Be respectful, consistent and transparent in your actions and communication. Follow through on what you say - always. If in doubt, listen; then listen some more, reflect back…and listen again. It’s their party, remember, so keeping that in mind will help put the brakes on any tendency to rush in.

- Empowerment: Give children choices and involve them in decisions whenever possible. If in doubt, ask them what they’d prefer, what they think, etc. Coupled with the kind of active listening mentioned just now, this gives kids their voice - particularly crucial when children with LDs may struggle with communication anyway.

3. Adapt Therapeutic Approaches

Standard trauma interventions will almost certainly need to be chosen and adapted to best fit children with LDs:

- Art or play therapy can help non-verbal children express their emotions. Using non-directed approaches allows the therapist to learn from the child and avoids things like confirmation bias and the misreading of intentions and meanings. When it comes to ‘interpretation of meaning,’ again, let kids do this for us as much as possible - jumping to conclusions is the enemy!

- Sensory integration techniques may help children with sensory processing challenges to self-regulate. Information from parents and carers can really help here, too; always ask, ‘what’s worked previously in this situation?’ Then integrate and develop these into your work. Tactile techniques, movement, music/rhythm, breath work, etc. can all work with LDs, too, so don’t right these off; but don’t rush in thoughtlessly, either. Keeping the child’s interoceptive ‘inner world’ in mind will help.

- Social stories or visual aids can be used to explain therapy concepts and process/es, present ideas, posit responses and/or provoke conversation. This is a real skill; suffice to say that some kids need a more tangential and/or creative approach to explaining things… But this is worth the time and effort involved as it feeds into safety, helps with engagement and builds trust, as well as ensuring the ways we communicate ‘fit’ the needs of each child.

4. Collaborate with Schools/Education

Trauma often affects children’s ability to learn (see last week’s post), so collaboration with teachers and other educational staff is critical.

Strategies include:

- Recognise that help here is two-way traffic - we can all learn from each other in our joint mission to help kids. Asking for help may also give us an ‘in’ to offer help back.

- How kids with LDs interact with peers can provide valuable insights for the helping process - teachers and school staff have unique insights into this. Smoothing the therapeutic process by introducing consistencies that dovetail with school, for example, is a great way of helping kids feel safe and at ease.

- Providing a safe space at school where kids can go to self-regulate can really help. Lots of special schools and schools with well-being units/areas will have these, but the child may not know about them or have used them before. Tap into every resource available.

- Training educationalists to recognise trauma responses in children with LDs. In my experience, some LDs teaching staff can (understandably) tend to assign behavioural and emotional responses to the LDs. While this may well be true, there may be trauma-genic influences in play, too. Raising awareness of this in school settings is a good place to start.

- Adjusting academic expectations to accommodate the child’s emotional state. We encounter this a lot in our work using the trauma recovery model (TRM). Often a child’s presentation will regress as they start to deal with hard stuff (processing trauma). When this happens, the key is that our help must also also adapt so our expectations of the child match their current capacity - none more so than school performance. Dialling up the pressure in school is that last thing a child needs if they’re just beginning, or in the throes of, processing trauma.

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Practical Implications for Practitioners

1. Holistic Assessments

Social workers and other helping professions should assess both trauma history and LDs when working with children; looking at either in isolation is a waste of time.

This dual lens helps practitioners:

Understand the child’s unique needs and challenges.

Identify gaps in support, such as unmet educational or therapeutic needs.

Whenever possible-i.e. when there’s been an episodic (one-off) trauma, rather than a developmental one-we need to examine the before and after aspects of it; how did this traumatic event change the child’s presentation?

This approach will help avert the risk of the trauma defining the child in the adults’ minds. To help them recover to how they were, we need to understand the impact of what happened.

This is more complex, of course, if the adults aren’t aware of their having been a traumatic event. Then we’re reliant on noticing changes, sometimes over time, between the child’s previous presentation and the changes induced by what happened to them.

In either event-known/unknown trauma-assessing the whole child as broadly as possible, is critical

2. Advocate for Multidisciplinary Support

Children with LDs often require coordinated care across multiple systems. Blockers within and between different parts of the system make things worse for the child and harder for those trying to support them.

Practitioners can:

Advocate for even more individualised plans (IEPs and EHCPs; or 504 Plans in the U.S.) in education and healthcare settings.

- Temporary adjustment of plans and approaches may be necessary during a child’s recovery process.

- Reviewing plans in light of a changed presentation will help keep things up to date and relevant.

- Adding the views of new disciplines to existing plans may yield a more rounded picture of the child, leading to a clearer view of what’s going on and how to help.

Collaborate with therapists, teachers, healthcare colleagues and caregivers to create a cohesive care plan. Tailoring everyone’s expectations to the current needs of child will ensure a smoother approach to the work.

Ensure access to services like speech therapy, occupational therapy or other specific and/or targeted help. More than most client groups, kids with LDs need robust and persistent advocacy to ensure they get the help they need. Fighting on their behalf and giving their voice a boost can be hard work, but it’s tremendously satisfying, too.

Having as many relevant disciplines involved in the helping task, ensures thoroughness and increases the likelihood of a successful outcome.

3. Educate Parents and Caregivers

Parents and caregivers may need guidance on how to support their child at home as things unfold.

Practitioners can:

- Teach caregivers about trauma responses and how they may differ in children with LDs - helping parents to adjust their understanding of their own child is a key part of aiding recovery. The child will need to be ‘held’ safely at home during the treatment phase; parents and carers are absolutely central to this - any time educating, supporting and helping them is time well spent.

- Learning together, working together - Parents spend significantly more time with their kids than we do, obviously. So, for example, providing strategies for calming and supporting the child during meltdowns or distress can really help soothe the home environment and ‘hold’ the child more effectively as they recover. Any insights gained by practitioners that may help in the home-and vice versa-should be shared freely and form part of an ongoing, regular, two-way conversation where key adults are constantly learning from each other in the trial and error nature of the process.

- Connect families with support groups or community resources. Peer support during tough times can be a massive help. Parents/carers may not be aware of local opportunities to plug into the support other individuals and families can provide. Whether these be in-person groups, WhatsApp groups or online resources of some kind, cutting through the isolation is a good thing. Doing some of the work for parents and carers and making them aware of what’s ‘out there’ can be a big help.

4. Promote Resilience

Building resilience is a key goal for all traumatised children.

Resilience is a multi-dimensional concept which, in simple terms, is defined as positive adaptation and competence while facing adversity. (Goddard, 2020:7)

Often, children with LDs-especially those exposed to developmental trauma-will not have experienced the ‘ordinary magic’ of being held within a loving family, where adults are attentive, affectionate and alive to their problems and needs. So they haven’t learned how to ride over and learn from the inevitable bumps in the road that come along from time to time.

Practitioners can help ameliorate this by:

- Encouraging caregivers to focus on the child’s strengths and achievements. Balancing the problem focus with strengths, achievements and positives is powerful and can lend real hope and encouragement to what can feel like an arduous and slow process at times.

- Facilitating positive peer relationships through group activities, playdates or involvement in settings where kids with LDs can get together. Aside of the obvious benefits to the child and their parent/s, being present at such times can provide professionals with valuable insights into the child and their current functioning; all this feeds back into the assessment and intervention planning to best meet needs and tailor support more effectively.

- Teaching coping skills, such as deep breathing, mindfulness and tactile expression in ways the child can understand. Somatic (body-based) approaches like these can be really helpful in slowing down the physiological aspects of trauma activation, helping the child to be calmer in the moment and take fuller advantage of the opportunities afforded them. N.B. Work within your skillset and don’t over-reach, of course - this work is not the place for experimentation…

FINAL THOUGHTS

When trauma and learning disabilities meet inside the unique personality of a child, it presents challenges for those of us trying to help. But with the right input and help, children can be supported very successfully to overcome these barriers and fulfil more of their potential than they would otherwise.

Most of us have accumulated a range of skills, techniques and knowledge during our careers; the challenge here is how to apply all that to the needs of this particular child. Keeping this perspective front and central is, perhaps, the key principle of all this.

By understanding the unique needs of traumatised children with LDs, practitioners can advocate with confidence - and hang in there when the going (and the funding) gets tough - to ensure they receive the care and compassion they need.

With patience, creativity, collaboration and a truly trauma-informed approach, we can help children move beyond their challenges and build brighter futures.

See you in the next one!

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More information:

See Jonny’s temporary website - here

WEBSITE: ACEs Hub Wales (link) has loads of resources available

WEBSITE: Traumatic Stress Wales (link) also has a resources section as well as links to various events, a treatment and recovery section as well as information on prevention

BOOK: Navigating Autism: 9 Mindsets For Helping Kids on the Spectrum (link)

BOOK: Ordinary Magic: Resilience in Development by Ann Masten (link)

PAPER (2025): Trauma-Informed Practice for Children and Young People with Intellectual Disabilities - A Scoping Review (link)

PAPER (2020): Adverse Childhood Experiences and Trauma-Informed Care by Anna Goddard (link)

PAPER (2009): Assessment of PTSD in Individuals with Intellectual Difficulties (link)

PAPER (2008): Responding to the Mental Health Needs of Young People with Profound and Multiple Learning Disabilities and Autistic Spectrum Disorders: Issues & Challenges (link)

For colleagues in the U.S. (though information is useful regardless):

WEBSITE: Child Mind Institute

WEBSITE: National Child Traumatic Stress Network.

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