During the first years of life, children's formation of their sense of self is bound up with their relationship with their parents and caregivers. One of the important factors in this relationship is children's expectation that parents will protect them from harm. For children who suffer traumatic events or who live in a violent or abusive environment, this expectation breaks down. The resulting lack of trust, coupled with the child's traumatic responses, can have a strong negative impact on children's development. Left untreated, these traumatized infants and toddlers may fail to meet normal developmental milestones.
Lieberman and Van Horn recommend that mental health professionals use a number of strategies to assess these children. One interview or checklist is not enough to get a full understanding of the child's experiences and needs. Interviews with the child's caregivers are important, but assessors need to observe the child at play and in interactions with his or her caregivers. The child can provide his or her own narrative of the traumatic events, either through telling a story, creating a picture, or playing with dolls. It may also be appropriate to interview child care providers and to observe the child interacting with other children in daycare or preschool. These methods can help the clinician make a more accurate diagnosis.
There are many forms of treatment that can be used with young traumatized children. They share one basic principle: to provide a safe, stable environment as an aid to healing. Because relationships with caregivers are so important, many treatment methods include both caregivers and children, either in every session or as a supplement to individual therapy. Treatment also must focus on the child's everyday functioning and on helping the child deal with reminders of the trauma he or she has suffered.