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The Impact of Early Trauma on DevelopmentT he idea that our earliest experiences have lasting consequences for who we become has long been central to the field of psychology. It is perhaps surprising that many still believe that young children are not affected by early trauma, or if they are, they will naturally grow out of their negative reactions. Although many children demonstrate remarkable resilience in the face of adversity, a growing body of research indicates that although events that occur during the first years of life may feel distant or vague, their effects on biological, cognitive, and socioemotional development are significant.In this chapter, we review research and theory describing how trauma in early life influences the development of young children. We provide information about how children's development can be altered, both adversely when children are exposed to trauma, and positively when children experience sensitive and responsive caregiving. This illustrative review provides

R esearch evidence, in addition to anecdotal information, indicates that children are exposed to a wide range of traumatic experiences during infancy and early childhood, a sensitive period for development (Osofsky, 2011). Indeed, in a representative sample of approximately 1,000 young children, Briggs-Gowan and colleagues (2010) found that by 2 to 3 years of age, approximately 26% of children had been exposed to trauma and 14% exposed to violence. Highlighting the vulnerability of particular groups, exposure was even more pronounced in children with additional risk factors. For example, 49% of children living in poverty had been exposed to trauma and were 2 to 5 times more likely to be exposed to violence. Researchers have documented a dose-response effect of childhood exposure to trauma, such that cumulative trauma places children at higher risk for long-term problems. Specifically, findings from the landmark Adverse Childhood Experiences Study (Felitti & Anda, 2010), which we describe Introduction: Recognizing the Impact of TraumaExposure on Young Children

Considerations in Choosing aTreatment That Works I n the previous chapters, we described three evidence-based treatments designed to help young children and their families affected by trauma, including child-parent psychotherapy (CPP), attachment and biobehavioral catch-up (ABC), and parent-child interaction therapy (PCIT). All of these treatments work through the parent-child relationship to help the child recover and resume a positive developmental trajectory, while also supporting the parent and healing the parent-child relationship.The goal of this chapter is to assist the clinician in deciding which treatment approach is most helpful when addressing a specific behavioral problem, relational issue, or both. To assist the reader in comparing and contrasting approaches, Table 5.1 provides side-by-side descriptions of each treatment. We also outline criteria relevant to choosing a treatment that works. This method for helping the clinician decide which treatment "might work for whom" has been used in previous guides for clinical work