March 13, 2023

Trauma-informed care is a system of care that provides safe spaces for people who have experienced trauma while reducing the likelihood of re-traumatization. The trauma-informed care approach entails realizing, recognizing, and responding to the effects of trauma on the populations you serve. It also redefines trauma reactions as adaptive rather than pathological; they are the person’s best effort to cope with the experience.

 

While many human health and social service organizations have implemented trauma-informed practices, they are hardly ever acknowledged in organizations serving individuals with intellectual and developmental disabilities (IDD). The effects and prevalence of trauma among people with IDD are difficult to ignore, and implementing a trauma-informed care system at your organization can benefit the people you serve.

 

Trauma is common for people with IDD

People with disabilities are more likely to experience trauma than the general population. The most commonly experienced traumas among people with IDD can include:

 

• Childhood abuse or neglect

• Abandonment/isolation

• Domestic violence

• Bullying/harassment

• Restraint/Seclusion

• Institutionalization such as foster care placements and educational placements

• Sexual assault/sexual abuse

• The unexpected loss of a parent or caregiver

• Global disasters

• Trauma-related medical issues

 

How to recognize trauma in an individual with IDD

Individuals with IDD experience a variety of trauma-based responses. For people who have limited cognitive or communication abilities, it can be difficult for them to express their traumas to caregivers. Some signs that a person with IDD has experienced trauma can include:

 

• Cognitive effects: Difficulty acquiring new skills, difficulty processing new information, poor verbal communication or loss of communication ability, and memory loss.

• Physiological effects: Stomachaches, headaches, nightmares, difficulties sleeping, loss of developmental skills, bed-wetting.

• Behavioural effects: Aggressive behaviour, screaming or crying excessively, irritable mood, verbally abusive behaviour, social anxiety.

Often, some symptoms of trauma are interpreted as challenging behaviours or “outbursts” by healthcare staff. Pacing, yelling, or self-injurious behaviour can be a response to a triggering event that is reminiscent of a traumatic experience. It is important that staff are trained in ways to prevent triggers and de-escalate crisis behaviour, rather than quickly responding with restraints or therapeutic holds, as these interventions can cause more trauma for a person with a disability.

 

Key principles of trauma-informed care

There are six key principles of trauma-informed care that all healthcare clinicians and staff need to follow:

 

1. Safety: Ensure the physical and emotional safety of all patients and staff.

2. Trustworthiness and transparency: Care providers need to be transparent with patients to build a sense of trustworthiness.

3. Peer support: Care providers must thoroughly understand various traumatic conditions and how they affect patient care.

4. Collaboration and mutuality: Care providers should view patients as partners in the effort to develop treatment plans.

5. Empowerment, voice, and choice: Care providers work to empower patients who have experienced trauma to take back control of their health.

6. Cultural issues: Care providers must recognize and eliminate any potential cultural, racial, gender, or other biases.

 

Community Living North Perth is a non-profit organization in Ontario, Canada, advocating for the well-being of adults with disabilities. For more information on how to implement trauma-informed care practices in your organization, contact info@clnorthperth.ca or call 519-291-1350.

 

External resources:

• Trauma-Informed Toolkit for Providers in the Field of Intellectual and Developmental Disabilities

• The Importance of Trauma-Informed Care For IDD Organizations