Communicating Trauma: Clinical Presentations and Interventions with Traumatized Children

260 Pages·2016·0.929 MB·English

by  Na'ama Yehuda

Communicating Trauma
Communicating Trauma explores the various aspects of language and communica-
tion and how their development can be affected by childhood trauma and over-
whelm. Multiple case-study vignettes describe how different kinds of childhood
trauma can manifest in children’s ability to relate, attend, learn, and communi-
cate. These examples offer ways to understand, respond, and support children who
are communicating overwhelm. In this book, psychotherapists, speech-language
pathologists, social workers, educators, occupational and physical therapists, medical
personnel, foster parents, adoption agencies, and other child professionals and care-
givers will find information and practical direction for improving connection and
behavior, reducing miscommunication, and giving a voice to those who are often our
most challenging children.
Na’ama Yehuda, MSC, SLP, is a speech-language pathologist and audiologist
with over 25 years’ experience. A clinician in private practice, she consulted for
the New York City Department of Education; provides international profes-
sional development and consultations on communication, language, trauma,
and development; and is the author of several publications on the topic. She
was elected to serve on the boards of directors of the Israeli Speech Hearing
Language Association (ISHLA) and the International Society for the Study of
Trauma and Dissociation (ISSTD), chairs and volunteers on task forces and
committees, and co-chairs the Child and Adolescent Committee of ISSTD. She
also writes and publishes fiction.
This page intentionally left blank
Communicating Trauma
Clinical Presentations and Interventions
with Traumatized Children
Na’ama Yehuda
First published 2016
by Routledge
711 Third Avenue, New York, NY 10017
and by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2016 Na’ama Yehuda
The right of Na’ama Yehuda to be identified as author of this work has been asserted
by her in accordance with sections 77 and 78 of the Copyright, Designs and Patents
Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or utilised in
any form or by any electronic, mechanical, or other means, now known or hereafter
invented, including photocopying and recording, or in any information storage or
retrieval system, without permission in writing from the publishers.
Trademark notice : Product or corporate names may be trademarks or registered
trademarks, and are used only for identification and explanation without intent to
infringe.
Library of Congress Cataloging-in-Publication Data
Yehuda, Na’ama.
Communicating trauma : clinical presentations and interventions with traumatized
children / Na’ama Yehuda. — 1 Edition.
pages cm
Includes bibliographical references and index.
1. Psychic trauma in children—Treatment. 2. Child
development. 3. Communication. I. Title.
RJ506.P66Y44 2016
618.92′8521—dc23
2015013577
ISBN: 978-0-415-74309-9 (hbk)
ISBN: 978-0-415-74310-5 (pbk)
ISBN: 978-1-315-81386-8 (ebk)
Typeset in Minion
by Apex CoVantage, LLC
For a little girl
With yellow hair
And for children
Everywhere
This page intentionally left blank
Contents
Acknowledgments ix
Preface x
PART 1
A Brief Overview of Communication, Language, and Development 1
1 Infant Communication and Attachment: Reciprocity,
Verbalization, and Regulation 3
2 Early Language Development: How Language Shapes Reality
and Reality Shapes Communication 13
3 Socialization, Semantics, Humor, Symbolic Language, and
Empathy 24
PART 2
Trauma, Maltreatment, and Developmental Impact 31
4 Indirect Trauma: Medical, Intrauterine, Environmental, and
Societal Trauma 33
5 Maltreatment: Neglect and Abuse 54
6 The Neuroscience of Trauma, Emotional Regulation, and
the Developing Self 74
PART 3
The Language of Trauma 87
7 How Trauma Affects Language and Why It Matters So Much
More in Children 89
viii Contents
8 Trauma’s Impact on Attention and Learning 98
9 Trauma’s Impact on Children’s Vocabulary and Semantics 107
10 Trauma’s Impact on Pragmatics: Language Use, Social Cues,
and Discourse Rules 118
11 Trauma’s Impact on Memory, Organization, and Retrieval 132
PART 4
When Communication Goes Awry: Clinical Presentation and
Assessment Challenges 141
12 Communication Symptoms in Traumatized and Dissociative
Children 143
13 History, Screening, and Assessment Indicators 155
PART 5
Mending Meaning: Intervention Strategies, Collaboration,
and the Importance of Taking Care 169
14 Psychoeducation and Everyday Tools for Reducing Overwhelm 171
15 Communication Intervention for Traumatized Children 185
16 The Promises and Challenges of Teamwork 206
17 Supporting the Supporters: Recognizing and Managing
Secondary Traumatization 219
Afterword: A Prognosis of Hope 225
References 226
Index 239
Acknowledgments

T his book would never have been written if it were not for my clients. My first
thanks go to the children and their families in all their configurations and presen-
tations. They are steadfast teachers and continue to educate me, each in his or her
unique way of communicating and relating. This book is really theirs: a product
of the questions they raised in me and which sent me searching for what else
might be going on and the skills I needed to help them better; of the feelings they
communicated and evoked in me; of the actions that spoke volumes even when
there were no words. To all my clients, past and present, you have my gratitude.
Thanks go to my friends and colleagues at my professional homes at ISHLA
(Israeli Speech Hearing Language Association), and ISSTD (the International
Society for the Study of Trauma and Dissociation), my colleagues on the Child
and Adolescent Committee, and my friends at ISSTDNYC—too numerous to
list, yet the source of many friendships. Special thanks to Dr. Joy Silberg for open-
ing the door at ISSTD and to Fran Waters and Sandra Baita for warm friendships
and expertise. To my sister Dr. Ruth Rosen-Zvi, clinical child psychologist: for
consults, venting, and more. To my friend and colleague of thirty years Ronit
Koren and to Dr. Tova Most and Dr. Etti Dromi of Tel-Aviv University, profes-
sors extraordinaire and supporters of all my professional adventures. To my TT
friends: for the profound healing of centering and compassion.
T hank you to Anna Moore, senior editor at Routledge, for the seed of this
book and for being there for every query, and to the rest of the staff at Routledge,
turning draft manuscripts into books: I love this magic.
V ery special thanks go to Dr. Adele Ryan McDowell, an always-there cheer-
leader, good juju sender, and mentor; to Jenny Heinz, a better attuned clinician
no one can find: Your love amazes me. To my incredible friends and loved ones,
so understanding of my ‘hibernation’ when I was busy writing: my brilliant fam-
ily; my mom Riva Yehuda and my sisters Tamar, Michal, Hadasa, Yael, Shulamit,
and Ruth; my nieces and nephews, grand-nieces and grand-nephews—you
are tremendous blessings. Last but not least, soul-kisses to Carol Hornig and
Kathryn Cameron—I know the two of you watch over me and over the children
who did not make it. I love you more.